养老服务与农村家庭养老——来自中国居家和社区养老服务改革试点的证据

Elderly Services and Rural-family Elderly Care:Evidence from the Pilot Reform of Home and Community-based Elderly Care Services in China

在人口老龄化与城镇化并行背景下,农村养老服务需求增加与家庭养老资源供给紧缩的矛盾比较明显,农村家庭养老功能也趋于弱化。文章基于能力和环境压力理论分析了居家和社区养老服务对农村家庭养老的影响,并使用CHARLS数据和双重差分模型进行实证检验。研究发现,居家和社区养老服务提高了农村中老年人的总体活动能力和生活满意度,降低了其失能发生率。但这一影响在不同居住安排的群体中存在显著差异:居家和社区养老服务显著提升了与子女同住的农村中老年人的身心健康水平,对养老问题更加突出的农村空巢老人作用有限。进一步分析表明,居家和社区养老服务可以通过提高照护依赖者的照护服务可及性来改善其身心状态。居家和社区养老服务具有溢出效应,这有效减轻了老年人配偶的照护负担及其子女的经济负担。文章研究结论不仅为重新审视社会养老与家庭养老的关系提供了新视角,也为居家和社区养老服务的未来改革提供了经验支撑。

China has entered a moderately aging society,and the mass exodus of rural labor has reconfigured the structure of rural families,leading to widespread intergenerational spatial separation and weakened elderly care functions in rural families.In order to resolve the dual dilemmas,the Ministry of Civil Affairs and the Ministry of Finance have launched a pilot reform of home and community-based elderly care services.Existing research mainly focuses on the matching of supply and demand and the sustainable development of elderly care services,with little attention paid to the impact of rural-family elderly care.Based on the competence-environment stress theory model,this paper uses the China Health and Retirement Longitudinal Study(CHARLS)data to build a DID model for empirical testing,and analyzes the impact of home and communitybased elderly care services on rural-family elderly care.The results show that:(1)Home and community-based elderly care improves the overall mobility and life satisfaction of the rural elderly,and reduces the incidence of disability.(2)This effect varies significantly among groups with different living arrangements:Elderly services have a positive impact only on the health of the rural elderly living with their children,and a limited impact on rural empty nesters,whose elderly care problems are more prominent.(3)Elderly services can improve the physical and mental conditions of care-dependent persons by increasing their access to care services.(4)Elderly services have a spillover effect,effectively reducing the burden of care for elderly spouses and the financial burden on their children.The marginal contributions of this paper are as follows:(1)It fills the research gap on the impact of home and community-based elderly care services on the physical and mental health of the rural elderly,as well as on support behaviors within the family.(2)Using the competence-environment stress theory as an analytical framework,it extends the research object to family elderly caregivers who bear the main care function,expanding the chain of evaluating the effectiveness of elderly service policies.(3)The findings show that elderly care services play a primarily complementary role to family care,providing a new perspective for understanding the relationship between social elderly care and family elderly care.