随着人口老龄化趋势日益严重,国内外实施长期护理保险制度过程中面临着失能老人护理需求日益增长与基金收入有限的突出矛盾。美国通过HHVBP价值支付机制实现了长期护理费用控制与质量提升,为制度的稳定持续实施提供了坚实基础。本文重点分析其制度演进、多层次制度结构体系、HHVBP价值支付机制,在总结其实践经验和不足的基础上提出对我国长期护理保险发展的启示。建议我国构建多层次长期护理保障体系,强化政府社保与商业保险的协同联动,引入服务价值导向的支付方式,加快专业护理人才培养,以提升服务供给能力,推动制度可持续发展。
Abstract
As population aging intensifies globally, countries implementing long-term care insurance (LTCI) systems face the prominent contradiction between the growing care needs of the disabled elderly and limited fund revenues. The US has achieved cost control and quality improvement in long-term care through the Home Health Value-Based Purchasing (HHVBP) payment mechanism, providing a solid foundation for the sustainable implementation of the system. This paper focuses on analyzing the institutional evolution, multi-tiered institutional structure, and HHVBP value-based payment mechanism of the US LTCI system. Based on a summary of its practical experiences and shortcomings, it proposes implications for the development of LTCI in China. It is recommended that China build a multi-tiered long-term care security system, strengthen the synergy between government social insurance and commercial insurance, introduce value-oriented payment mechanisms, and accelerate the training of professional care workers to enhance service supply capacity and promote sustainable development of the system.
关键词
长期护理保险 /
医疗保障 /
价值支付 /
公私合作
Key words
long-term care insurance /
healthcare security /
value-based payment /
public-private partnership
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基金
国家社会科学基金年度项目“资源配置视域下长期护理保险制度可持续发展演化研究”（25BGL223）
