基于关键流程的长期护理保险运行指数模型与应用研究  

Operation Index Model and Application Research of Long-Term Care Insurance Based on Key Process

作　　者：康蕊 KANG Rui(National Institute of Social Development,Chinese Academy of Social Science,Beijing 100005)

机构地区：[1]中国社会科学院社会发展战略研究院,北京100005

出　　处：《北京劳动保障职业学院学报》2023年第2期44-53,共10页Journal of Beijing Vocational College Of Labour And Social Security

基　　金：国家社会科学基金青年项目“医养结合养老服务模式的治理体系研究”(项目编号:20CRK012);北京市社会科学基金重点项目“PPP模式下首都养老服务资源配置研究”(项目编号:19YJA005)。

摘　　要：长期护理保险试运行以来,学界展开了诸多评估,但仍未形成统一的评估指标体系与评估方法。根据对关键流程的划分,长期护理保险制度本身运行的评估主要包括参保缴费、资金筹集、待遇给付等,其社会经济影响的评估主要包括对医保基金和老年人支出、长期照护服务的利用以及对产业、就业及经济带动的影响等,据此设计出四级指标体系。在该评估体系下,试点城市N市的运行监测数据显示,当前存在基金运营管理、待遇支付、对象准入等方面的突出问题,建议合理调整医保基金筹资和财政补贴,合理调整支出结构,建立预警机制,提升中度失能评定通过率。Since the trial operation of long-term care insurance,the academic community has conducted many evaluations but has not yet formed a unified evaluation index system and evaluation methods.According to the division of key processes,the evaluation of the operation of the long-term care insurance system itself mainly includes insurance contributions,fund raising,and benefits payment.The evaluation of its socio-economic impact mainly includes the expenditure on medical insurance funds and elderly people,the utilization of long-term care services,and the impact on industry,employment,and economic growth.Based on this,a four-level indicator system can be designed.Under this evaluation system,the operation monitoring data of pilot city N city shows that there are currently prominent problems in fund operation management,treatment payment,and object access.Tt is recommended to reasonably adjust the financing of medical insurance funds and financial subsidies,reasonably adjust the expenditure structure,establish an early warning mechanism,and improve the passing rate of the moderate disability assessment.

关 键 词：长期护理保险 社会经济影响 评估指标 

分 类 号：F842.6[经济管理—保险]