Wolf D A
Center for Policy Research, Syracuse University, USA.
J Aging Health. 1999 Aug;11(3):360-82. doi: 10.1177/089826439901100306.
The passage of the baby-boom generation into old age raises the prospect of intense pressures on public programs benefiting the elderly, limiting any contemplated expansion of programs serving those needing sustained personal care. This necessitates consideration of comparative efficiency of alternative resources for elder care. I focus on two distinct aspects of such efficiency: productive--the relationship between inputs and outputs--and target--the coincidence of served and those viewed as needing services. I argue that for theoretical reasons family members, specifically children, may be more productive and efficient carers than paid helpers. Furthermore, even if no more efficient than formal providers, care provided by children reduces public expenditures on long-term care. In view of the value to society of children's caregiving activities, if a collective program of long-term care insurance were to be adopted, it should be configured to target its financing and benefits according to family composition.
婴儿潮一代步入老年，这使得惠及老年人的公共项目面临巨大压力，限制了任何为需要长期个人护理者提供服务的项目的预期扩张。这就需要考虑老年护理替代资源的相对效率。我关注这种效率的两个不同方面：生产性——投入与产出之间的关系——以及针对性——所服务对象与被视为需要服务对象的契合度。我认为，出于理论原因，家庭成员，特别是子女，可能比付费帮助者更具生产性和效率。此外，即使不比正规护理提供者更有效率，子女提供的护理也能减少公共长期护理支出。鉴于子女护理活动对社会的价值，如果要采用长期护理保险集体项目，就应根据家庭构成来配置其融资和福利。
