摘要
非正式照护服务是发达国家解决失能老人长期照料问题的主要方式。美国政府为满足失能老人的照护需求并控制照护成本,在全国推广依赖于非正式照护服务体系的"居家扶助服务"模式。该模式强调失能老人的个性化照护需求,赋予其自主权,即失能老人以政府给予的现金津贴为限自由选择护理服务项目以及护工。同时,该模式仅针对具有符合医疗补助计划资格的经济困难人士,因此是一种低层次的保障。中国可借鉴美国"居家扶助服务"模式的部分经验,并结合中国的实际设计中国特色的"居家扶助型"养老模式,可实行两步走、以点覆面模式,在模式运行初期,政府筹资仅对部分经济困难的老年人提供居家照护服务津贴,长期来看,应建立以长期护理保险制度为主的筹资机制,并将范围覆盖延伸至所有农村居民。
Informal care services are an important and major way for developed countries to address the longterm care of disabled elderly. In order to meet the care needs of disabled elderly and to control the cost of care, the US government promotes an "In-home Supportive Services" model that relies on the informal care service system throughout the country. This model emphasizes the individualized care needs and autonomy of disabled elderly. To be specific, the disabled elderly have freedom to choose in-home care services and workers with the government’s cash allowance. At the same time, this model is only for low-income people who are eligible for Medicaid, so it is a safe-net guarantee. China can learn from the experience of the US "In-home Supportive Services" model and design localized "In-home Supportive Services" model based on local needs. It can be implemented as a two-step and pointto-face model. In the early stage of the model operation, the government raises funds to provide home care service allowance only for elderly people under poverty line. However, in the long run, a fund-raising mechanism based on the long-term care insurance system should be established and the coverage should be extended to all rural residents.
作者
荆涛
杨舒
仲维树
Jing Tao;Yang Shu;Zhong Wei-shu
出处
《社会建设》
CSSCI
2019年第6期25-33,共9页
Social Construction
基金
教育部人文社会科学研究规划基金项目“人口移出老龄化背景下我国农村失能老年人‘居家扶助型’养老模式研究”（16YJA840004）
中国人民大学科学研究基金重大规划项目“健康老龄化视域下的中国老年照护体系研究”（17XNLG08）
中华女子学院校级课题“我国西北欠发达地区农村创新型养老模式研究”（KY2019-0303）
