上海市长期护理保险服务提供现状及监管对策分析  

Analysis on the Current Situation and Regulatory Countermeasures of Long-term Care Insurance Service in Shanghai

作　　者：李梦颖 李星辉[1] 黄志诚 鲍建武 郑嘉毅 陈思睿 李成志 王颖[1] LI Meng-ying;LI Xing-hui;HUANG Zhi-cheng;BAO Jian-wu;ZHENG Jia-yi;CHEN Si-rui;LI Cheng-zhi;WANG Ying(School of Public Health,Fudan University/NHC Key Laboratory of Health Technology Assessment(Fudan University),Shanghai,200032,China;不详)

机构地区：[1]复旦大学公共卫生学院/国家卫生健康委员会卫生技术评估重点实验室/公共卫生安全教育部重点实验室,上海20032 [2]上海市医疗保障局,上海20032 [3]上海市医疗保险监督检查所,上海20032 [4]湖南师范大学,湖南长沙410081

出　　处：《中国初级卫生保健》2022年第1期34-36,共3页Chinese Primary Health Care

基　　金：国家自然科学基金面上项目“我国长期护理保险制度优化研究”(71974034);国家自然科学基金面上项目“健康老龄化视角下我国医养整合性体系优化研究”(71673055)。

摘　　要：目的:梳理当前上海市长期护理保险服务提供现状,并从服务环节涉及的各个主体及其相互之间的关系入手,为切实提高服务质量提供可行的监管对策。方法:运用政策梳理、二次数据采集以及与关键知情人访谈的方法,为评价长期护理保险服务环节的成效、经验及潜在监管问题提供证据支撑。结果:截至2020年底,上海市长期护理保险共服务失能老人55.58万人,每千名户籍老人可拥有10.25个养老护理员(医疗照护)。制度设计中各类服务标准规范、细则和惩罚措施还不够完善,监管APP的功能有待进一步强化。结论:对服务提供方增加规制并为护理机构赋权,同时,积极引入视频监控、RFID电子标签等新技术,充分发挥信息化监管的力量。OBJECTIVE To analyze the current situation of long-term care insurance service provision in Shanghai and to provide feasible regulatory countermeasures for improving the service quality on the basis of the subjects involved in the service and their relationship.METHODS Combed the policies,analyzed secondary data and interviewed key insiders to get evidence supporting for evaluating the current situation of long-term care insurance services.RESULTS By the end of 2020,long-term care insurance in Shanghai covered 555800 disabled elderly people,and each thousand registered residence elderly had 10.25 nursing care providers(medical care).The standards,rules and punishment measures in the service system design still needed to be modified,and the function of regulatory app needs to be further strengthened.CONCLUSION It should increase regulation on service providers and empower nursing institutions.At the same time,it introduced new technologies such as video surveillance and RFID electronic tags to fully utilize the power of information-based supervision.

关 键 词：长期护理保险 服务 监管 

分 类 号：R197[医药卫生—卫生事业管理]