RTI International, Waltham, Massachusetts, USA.
Health Aff (Millwood). 2012 Dec;31(12):2764-73. doi: 10.1377/hlthaff.2012.0535.
In China, formal long-term care services for the large aging population have increased to meet escalating demands as demographic shifts and socioeconomic changes have eroded traditional elder care. We analyze China's evolving long-term care landscape and trace major government policies and private-sector initiatives shaping it. Although home and community-based services remain spotty, institutional care is booming with little regulatory oversight. Chinese policy makers face mounting challenges overseeing the rapidly growing residential care sector, given the tension arising from policy inducements to further institutional growth, a weak regulatory framework, and the lack of enforcement capacity. We recommend addressing the following pressing policy issues: building a balanced system of services and avoiding an "institutional bias" that promotes rapid growth of elder care institutions over home or community-based care; strengthening regulatory oversight and quality assurance with information systems; and prioritizing education and training initiatives to grow a professionalized long-term care workforce.
在中国，随着人口结构变化和社会经济变革削弱了传统的老年人护理模式，为满足不断增长的需求，针对庞大老年人口的正规长期护理服务有所增加。我们分析了中国不断变化的长期护理格局，并追溯了塑造这一格局的主要政府政策和私营部门举措。尽管居家和社区为基础的服务仍然零星存在，但机构护理却在蓬勃发展，而几乎没有监管监督。鉴于政策鼓励进一步扩大机构规模、监管框架薄弱以及执法能力不足，给监督快速增长的居民护理部门带来了紧张局面，中国政策制定者面临着越来越多的挑战。我们建议解决以下紧迫的政策问题：构建一个平衡的服务体系，避免“机构偏见”，即促进养老机构的快速增长，而不是家庭或社区为基础的护理；利用信息系统加强监管监督和质量保证；并优先开展教育和培训计划，以培养一支专业化的长期护理人员队伍。
