摘要
在历经“补充”“支撑”到“充分发展”的定位转变过程中,养老机构在老年健康照护体系中的作用不断突显,形成了以民办养老机构为主体的社会力量参与养老服务供给的社会化格局。在积极应对人口老龄化上升为国家战略背景下,民办养老机构如何化解当下发展困境、实现可持续发展成为十四五时期乃至2035远景规划目标下需要解决的新问题。本文运用吉林省养老机构微观调查数据,构建Lo⁃gistic回归模型并运用极大似然估计法中的似然比检验和沃尔德检验分别进行参数估计。研究发现:财政补贴、持证比率、长期照护报销、功能分类、比较优势、医养结合、智能服务指标从理论上显著影响养老机构可持续发展。但现实中各影响因素无法充分发挥正向效应,面临机构定位不清、服务内容缺乏精细化;医养结合程度低、结合推进难度大;智慧养老发展有限、创新动力不足;机构资金来源有限,政府激励不足“四重”困境。因此,明确以“护理型机构”为核心定位,充分运用智慧养老为老年人提供精准服务,坚持以“健康养老+分层分类”为原则推进医养有机结合,落实以“财政专项+保险互助+老年人付费”为筹资机制稳定资金来源,才能使民办养老机构实现可持续发展。
Through the transition from“supplement”and“support”to“full development”,the role of private old-care institutions in the elderly health care system has been increasingly prominent,forming a socialized pattern of social forces as the main body to participate in the supply of old-care service.Under the back⁃ground that actively respond to the aging of population has become a national strategy,how to solve the cur⁃rent development dilemma of private old-care institutions to achieve high-quality sustainable development has become a new problem that needs to be solved in the 14th Five-Year Plan period and even in the 2035 Vision Plan.This study takes the micro survey of old-care institutions in Jilin Province as the data source,uses the logistic regression model,and uses the likelihood ratio test and Wald test in the maximum likeli⁃hood estimation method to estimate the parameters.The results show that:financial subsidies,certificate holding ratio,long-term reimbursement,functional classification,comparative advantage,combination of medical care and nursing,intelligent service indicators have significant impact on the sustainable develop⁃ment of old-care institutions in theory.However,the influencing factors can not give full play to the positive effect,facing the“four fold”dilemma of unclear institutional positioning and lack of refinement of service content;low degree of integration of medical care and pension;limited development of smart pension and in⁃sufficient innovation power;limited sources of institutional funds and insufficient government incentives.Therefore,we should make clear the core positioning of“nursing institutions”,make full use of smart pen⁃sion to provide accurate services for the elderly,adhere to the principle of“healthy pension+hierarchical classification”,promote the organic combination of medical care and pension,implement the financing mech⁃anism of“financial special+mutual insurance+elderly payment”,and stabilize the source of funds,so as to make t
作者
韩烨
冀然
付佳平
HAN Ye;JI Ran;FU Jiaping(School of Social Philosophy,Jilin University,Changchun Jilin,130012,China)
出处
《人口学刊》
CSSCI
北大核心
2021年第4期89-97,共9页
Population Journal
基金
中国博士后科学基金项目:社会力量参与养老服务供给的模式研究(2018M631860)
吉林省教育厅社会科学项目:“机构-社区-居家”融合式养老服务供给的吉林模式创新(JJKH20211244SK)
吉林大学研究生创新基金资助项目:“机构-社区-居家”融合式养老服务供给模式研究(101832020CX004)。
