家庭养老床位政策的府际差异与模式研究——基于26个市级政策文本的比较分析

Study on the Intergovernmental Differences and Models of Home-Based Care Bed Policies Based on the Comparative Analysis of 26 Municipal Policy Texts

目的:家庭养老床位作为链接基层医疗服务资源与养老服务的中介,可有效解决社区、机构养老照护资源失配、错配与家庭照护负担过重的问题,对该政策进行量化分析,对完善家庭养老床位政策内容,优化资源配置,推动家庭养老床位建设具有重要意义。方法:收集我国省会及试点成效较好城市出台的共26份家庭养老床位政策文本,运用文本挖掘和PMC指数模型,构建量化指标评价已有政策,并以上海、杭州、长春、苏州作为典型案例,梳理政策特征差异。结果:政策总体评价为合格等级,质量提升潜力较大;主要呈现学习-试验型、回应一赋能型、模仿一指令型三类政策模式;政策PMC指数在空间维度上存在差异,政策一致性呈现出东高西低的阶梯状,东、中、西、东北地区政策在不同层面各具优势。结论:我国家庭养老床位政策应根据各地区政策模式进行针对性改良,强化基层医养结合制度建设,通过科技赋能优化照护资源整合与配置,并大力发展养老产业,培育照护人才。

Objective To quantitatively analyze the policy of home-based care beds,improve the policy content,optimize the resource allocation,and advance its development.Methods A total of 26 policy texts on home-based care beds issued by provincial capitals and cities with successful pilot results were collected.Text mining and the PMC index model were utilized to establish quantitative indicators for evaluating the existing policies.Shanghai,Hangzhou,Changchun,and Suzhou were selected as typical cases to identify the differences in policy characteristics.Results The overall policy evaluation received a qualified grade,with significant potential for quality improvement.Three main policy models were identified as learning-experimental model,response-enabling model and imitation-instruction model.The policy PMC index varied in spatial dimensions,showing high policy consistency in the east while lower consistency in the west.Policies in the east,middle,west,and northeast regions demonstrated different levels of advantages.Conclusion It is suggested to improve China's home-based care bed policy according to local policy modes,strengthen the basic medical care system,optimize the integration and allocation of care resources through technology,actively promote the development of the elderly care industry,and cultivate health care professionals.