我国长期护理保险制度筹资与待遇给付政策的优化——基于全国15个试点城市的对比分析  

Optimization of Financing and Benefits Payment Policies for China's Long-term Care Insurance System——Comparative Analysis based on 15 Pilot Cities Nationwide

作　　者：李长远 钱雁星 Li Changyuan;Qian Yanxing

机构地区：[1]甘肃政法大学公共管理学院,甘肃兰州730070

出　　处：《西南金融》2023年第8期97-108,共12页Southwest Finance

基　　金：国家社会科学基金项目“少数民族地区医养结合养老服务体系构建研究”(项目编号:17CMZ030);甘肃省高等学校青年博士基金项目“甘肃普惠型养老服务发展策略研究”(项目编号:2022QB-125);甘肃省科技计划软科学专项“甘肃养老服务支持政策需求、评估与优化研究”(项目编号:23JRZA458)。

摘　　要：长期护理保险制度是我国积极应对人口老龄化的重要制度安排和实施“健康中国”战略的现实路径。文章从筹资方式、筹资渠道、筹资标准、参保对象、给付水平、给付内容等方面进行了深入研究,梳理了全国15个试点城市长期护理保险制度的实施方案,通过对比分析发现试点过程中还存在着筹资责任分担不明确、对医保基金依赖较大、各筹资标准不一、参保对象尚不统一、给付水平参差不齐、待遇给付内容单一化等诸多亟待解决的问题。据此,本文提出了落实筹资主体责任、健全多元化筹资机制、提高长护险统筹层次、逐步拓宽覆盖范围、建立统一的失能评估标准、因地制宜丰富服务形式等一系列具有针对性的建议,以期推动长期护理保险制度高质量发展、可持续发展。The long-term care insurance system is an important system arrangement for China to actively re⁃spond to the aging population and a practical path for implementing the"Healthy China Strategy".The article con⁃ducts an in-depth study on financing methods,financing channels,financing standards,insured objects,payment levels,payment contents of long-term care insurance,and sorts out the implementation plans of the long-term care insurance system in 15 pilot cities nationwide.Through comparative analysis,it finds that there are still many prob⁃lems to be solved in the pilot process,such as unclear sharing of financing responsibilities,greater reliance on the medical insurance fund,uneven levels of financing standards,not yet unified insured objects,uneven levels of pay⁃ment,and single payment contents.Based on this,this paper further proposes a series of targeted optimization paths,such as implementing the responsibility of financing entities,improving diversified financing mechanisms,improving the overall level of long-term care insurance,gradually expanding coverage,establishing unified disabil⁃ity assessment standards,and enriching service forms according to local conditions,so as to promote the high-qual⁃ity and sustainable development of the long-term care insurance system.

关 键 词：人口老龄化 长期护理保险 保险筹资 保险给付 医疗保险 养老服务 医养结合 健康中国 

分 类 号：R197.1[医药卫生—卫生事业管理] F842.6[医药卫生—公共卫生与预防医学]