医养结合对老年人代际支持的影响——基于医养结合试点的准自然实验  

The Impact of Integrated Medical and Elderly Care Models on Intergenerational Support for the Elderly:A Quasi-Natural Experiment Based on the Integrated Medical and Elderly Care Pilot Program

作　　者：欧阳宇明 申曙光[1] Ouyang Yuming;Shen Shuguang(Lingnan College,Sun Yat-sen University,Guangzhou)

机构地区：[1]中山大学岭南学院

出　　处：《经济社会体制比较》2025年第2期135-147,共13页Comparative Economic & Social Systems

基　　金：国家社会科学基金重大项目“预防为主的大健康格局与健康中国建设研究”(项目编号:17ZDA080)。

摘　　要：推广与应用医养结合养老模式是积极应对人口老龄化、合理配置医疗和养老资源、完善中国养老服务体系的重要途径。本文将2016年开展的医养结合试点作为准自然实验,基于2011~2020年中国健康与养老追踪调查数据(CHARLS),运用双重差分法,从生活照料、经济支持和情感慰藉三个方面,实证检验医养结合试点政策对老年人代际支持的影响。研究发现,医养结合试点政策显著提升了老年人社会化照料服务利用率,降低了老年人收到的子代情感慰藉,但对子代生活照料和子代经济支持没有显著影响。异质性分析发现,上述政策作用在低龄、高受教育水平、低健康水平、参保养老保险的老年群体中表现得更为显著。进一步研究发现,抑郁程度强化了试点政策对老年人社会化照料服务的正向影响,而子女数量弱化了试点政策对老年人收到的子代情感慰藉的负向影响。本文的研究为评估医养结合试点政策的实施效果提供了新的视角,也为优化医养结合养老模式提供了经验证据。The promotion and implementation of integrated medical and elderly care represent a vital strategy in actively addressing the demographic challenge of population aging.It plays a pivotal role in the rational distribution of healthcare and eldercare resources,and in the refinement of China's broader elderly service system.This study regards the 2016 pilot initiative of integrated care as a quasi-natural experiment.Drawing on panel data from the China Health and Retirement Longitudinal Study(CHARLS)between 2011 and 2020,and employing a Difference-in-Differences(DID)methodology,the research explores the policy's impact on intergenerational support for the elderly across three dimensions:daily caregiving,financial assistance,and emotional solace.The findings reveal that the pilot policy significantly enhanced the elderly's access to socialized care services,while concurrently diminishing the emotional comfort received from their adult children.However,the policy exerted no statistically significant influence on the provision of daily care or financial support from offspring.Further heterogeneity analyses indicate that these effects are most pronounced among elderly individuals who are younger,more educated,in poorer health,and enrolled in pension insurance programs.Moreover,the study uncovers that symptoms of depression among the elderly amplify the positive impact of the pilot policy on their utilization of socialized care services.In contrast,the number of children attenuates the negative effect on emotional support from adult offspring.This research offers a nuanced perspective on the policy's implementation,providing empirical insights to inform the ongoing optimization of integrated elderly care models.

关 键 词：医养结合 社会养老模式 代际支持 社会支持 

分 类 号：C913.6[经济管理]