摘要
长期护理保险异地待遇机制是保障失能人员照护权益连续与待遇公平的关键制度安排。结合全国试点地区的政策文件,系统梳理我国长期护理保险异地待遇机制的实施现状。研究发现,试点地区已在异地失能评估互认、待遇支付和即时费用结算等方面取得初步进展,但仍存在异地政策覆盖有限、失能评估不完善、待遇享受差距大、异地结算待打通、监督管理不充分等问题。基于上述分析,提出优化长期护理保险异地待遇机制的路径选择,包括完善异地待遇与关系转移接续机制,推动失能评估标准化与结果互认,推动异地待遇衔接与公平给付,推进信息共享与跨统筹区直接结算,健全协同共管与反馈回访机制。
Abstract
The cross-regional benefit mechanism of long-term care insurance (LTCI) is a critical institutional arrangement for safeguarding the continuity of care rights and the equity of care benefits for disabled individuals. Drawing on policy documents from pilot regions across China, this study systematically reviews the implementation of cross-regional LTCI benefits. The paper found that although initial progress has been made in mutual recognition of cross-regional disability assessments, delivery of benefits and real-time expense settlement, challenges remain, including limited policy coverage, inadequate disability assessment, disparities in benefit access, unrealized cross-regional settlement, and insufficient oversight. Based on the analysis, this study proposes optimization pathways for the cross-regional benefit mechanism of LTCI: improving benefit portability and insurance transfer arrangements, standardizing assessments and promoting mutual recognition, coordinating cross-regional benefits and ensuring equitable payment, facilitating information sharing and direct settlement across pooling areas, and strengthening collaborative oversight and follow-up mechanisms.
关键词
长期护理保险 /
异地待遇机制 /
实施现状 /
优化路径
Key words
long-term care insurance /
cross-regional benefit mechanism /
current practices /
optimization pathways
胡宏伟, 张泽, 张伯千.
长期护理保险异地待遇机制实施现状与优化路径[J]. 中国医疗保险. 2026, 0(7): 46-54 https://doi.org/10.19546/j.issn.1674-3830.2026.7.006
Current Practices and Optimization Pathways of the Cross-Regional Benefit Mechanism for Long-Term Care Insurance[J]. China Health Insurance. 2026, 0(7): 46-54 https://doi.org/10.19546/j.issn.1674-3830.2026.7.006
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基金
北京市社会科学基金项目重点项目“失能失智老人家庭照护社会支持体系优化研究”（24SRA006）
