家庭的“失灵”与干预:多元照护协同对失能老人健康的影响  

Family"Failure"and Intervention:The Impact of Multi-Carer Collaboration on the Health of the Disabled Elderly

作　　者：张驰 费舒澜 Zhang Chi;Fei Shulan

机构地区：[1]浙江财经大学公共管理学院

出　　处：《中国人口科学》2025年第1期94-111,共18页Chinese Journal of Population Science

基　　金：浙江省社科规划“党的二十大和省委十五届二次全会精神研究阐释”专项课题“需求视角下农村长期护理服务高质量发展的实现路径与保障策略研究”的阶段性成果。

摘　　要：构建非正式照护和正式照护相辅相成的长期照护服务体系是“未富先老”背景下积极应对人口老龄化的关键之举。文章利用2018和2020年中国老年社会追踪调查数据,考察由家人提供的非正式照护和由专业人员提供的居家社区养老服务对失能老人健康的影响。研究结果表明:(1)家人照护和居家社区养老服务在改善失能老人健康方面均发挥着积极作用,但两者的照护效果存在一定差异,家人往往因不具备专业的护理知识和技能,在维持和恢复失能老人身体机能方面存在“失灵”现象;(2)家人照护能通过情感维系改善失能老人的精神健康,居家社区养老服务主要通过优化失能老人的健康行为遏制其身体健康水平的恶化;(3)两者的照护效果与作用机制的差异表明,家人照护和居家社区养老服务之间具有一定的互补性,两者协作存在正向协同效应;(4)随着失能程度加深,养老服务的作用及其与家人照护的协同效应不断减弱,这可能与当前养老服务供需错配和保障不足有关。文章的结论对合理配置家庭和社会照护资源,完善多层次长期照护服务体系具有政策意义。Using the 2018 and 2020 CLASS survey data,this paper investigates the impact of informal care and formal care on the well-being of disabled elderly and further explores its underlying mechanisms.This paper finds that:(1)Both informal care and formal care play a positive role in caring for the disabled elderly,but with different impacts.There is a phenomenon of"failure"in maintaining and restoring the body functions of the disabled elderly because family members often do not have medical or rehabilitation knowledge and skills.(2)Informal care improves the life satisfaction of the disabled elderly by strengthening family and emotional connections,while formal care curbs the deterioration of the health of the disabled elderly by optimizing their health behaviors.(3)Such differences suggest that informal care and formal care are complementary in disabled elderly care.The disabled elderly who receive both forms of care have better health conditions,suggesting that the two forms of care have a synergistic effects.(4)This paper further finds that the two care methods have heterogeneous impact.When family care resources are scarce and the elderly are severely disabled,the care effect of elderly care services is greater,while family care is no longer effective.Our findings imply that,in the future,family and social elderly care resources should be optimally allocated based on full consideration of family needs and characteristics,and the complementary integration of multi-level elderly care service systems should be actively promoted.

关 键 词：失能老人 家庭支持 长期照护服务 协同效应 家庭“失灵” 

分 类 号：D669.6[政治法律—政治学] C913.11[政治法律—中外政治制度] R197.1[经济管理]