目的: 探讨我国长期护理保险服务供给与多元化服务诉求下的系统问题和应对策略。方法: 基于共生理论,解析当前长期护理服务方案、护理人员、政府经济支持与长期护理保险基金等统筹难题,探讨发展长期护理保险制度共生模式、拓展社会参与功能的可行性及相应挑战。结果: 研究围绕护理系统、社康系统、社区照护三个共生单元互动的协同前景和现实障碍,进一步从权责分配、利益循环、资源供给等角度对长期护理保险服务体系共生机制的构建提出适宜的路径构想。结论: 研究发现,从共生体系看,长期护理保险制度尚存在共生组织模式待转变、体系内行业准入门槛高、服务内容灵活性欠缺、护理资源吸纳—下沉功能未实现的问题。政府应积极构建、完善对称性互惠共生模式;降低准入门槛,深化支付政策改革,打造适宜服务扩围的共生环境;藉由信息共享和资源协同手段,赋能共生单元交互和吸纳—下沉功能。

Objective: The paper explores the system problems and countermeasures of long-term care insurance service supply with diversified service demands in China. Methods: Based on the symbiosis theory, this research analyzed the current long-term care service plan, nursing staff, government's financial support, long-term care insurance fund planning and other related issues, and discussed the feasibility and corresponding challenges of developing the symbiosis model of long-term care insurance system and expanding the social participation function. Results: The study focused on collaborative prospects and practical obstacles of the three symbiotic units of nursing system, social health system and community care, and further proposed a suitable path for the construction of the symbiotic mechanism of long-term care insurance service system from the perspectives of the power and responsibility distribution, the interest circulation and the resource supply. Conclusion: The study revealed that, from the perspective of a symbiotic system, the long-term care insurance system still faces several challenges, including the need to modify the symbiotic organizational model, lower industry access threshold within the system, enhance flexibility in service, and address the unrealized function of nursing resource absorption and sinking. It is imperative for the government to actively construct and refine the symmetrical-mutualistic symbiotic model, lower access threshold and deepen reforms in service payment policies to foster a symbiotic environment suitable for service expansion. By promoting information sharing and resource coordination, interactions among symbiotic units can be facilitated along with effective absorption-sinking functions.