广州市长期护理保险试点现状、问题及对策分析

Analysis of the current situation,problems and countermeasures of long-term care insurance pilots in Guangzhou

广州市自2017年试点运行长期护理保险以来,在参保人群范畴、筹资与待遇、失能认定与护理服务等级划分、护理服务项目、服务定点机构以及监督管理体系等方面进行了积极探索,取得了长护险制度逐步优化、服务主体产业化、社区居家模式逐步成熟、服务及管理水平提升等成效。广州市长期护理保险目前尚存在人口老龄化趋势与长护险定点机构区域发展失衡、部分定点机构服务监管质量欠佳、服务实践覆盖面有待提升等问题。结合国家保险制度政策及信息化发展,提出了优化提升长护险服务主体空间布局、扩大长护险服务保障项目范围、灵活长护险给付制度、监管制度闭环体系和智慧化运行体系等建议。

Since the operation of long-term care insurance pilots in 2017,Guangzhou has actively explored the scope of insured population,financing and treatment,disability identification and classification of nursing service grade,nursing services,designated service institutions and supervision and management system.The following results have been achieved:the gradually optimized long-term care insurance system,industrialized service providers,gradually matured model of community-based home elderly care,and improved services and management level.At present,there are still some problems in Guangzhou long-term care insurance,such as the trend of aging population and the imbalance of regional development of designated institutions,the poor quality of service supervision of some designated institutions,and inadequate coverage of service practice.Combined with the national policies of insurance system and information development,suggestions are put forward to optimize the spatial layout of service providers of long-term care insurance,expand the scope of security of long-term care insurance,make flexible payment system of long-term care insurance,improve closed loop of supervision system and intelligent operation system.