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政策变迁,护理模式转变:丹麦与瑞典居家护理处于十字路口

Changing policies, changing patterns of care: Danish and Swedish home care at the crossroads.

作者信息

Rostgaard Tine, Szebehely Marta

机构信息

Aalborg University, Fibigerstræde 1, 9220 Aalborg Ø, Denmark.

Department of Social Work, Stockholm University, 106 91 Stockholm, Sweden.

出版信息

Eur J Ageing. 2012 Jan 26;9(2):101-109. doi: 10.1007/s10433-011-0209-1. eCollection 2012 Jun.

Abstract

Despite pursuing the policy of ageing in place, the two Nordic countries of Denmark and Sweden have taken diverse roads in regard to the provision of formal, public tax-financed home care for older people. Whilst Sweden has cut down home care and targeted services for the most needy, Denmark has continued the generous provision of home care. This article focuses on the implication of such diverse policies for the provision and combination of formal and informal care resources for older people. Using data from Level of Living surveys (based on interviews with a total of 1,158 individuals aged 67-87 in need of practical help), the article investigates the consequences of the two policy approaches for older people of different needs and socio-economic backgrounds and evaluates how the development corresponds with ideals of universalism in the Nordic welfare model. Our findings show that in both countries tax-funded home care is used across social groups but targeting of resources at the most needy in Sweden creates other inequalities: Older people with shorter education are left with no one to resort to but the family, whilst those with higher education purchase help from market providers. Not only does this leave some older people more at risk, it also questions the degree of de-familialisation which is otherwise often proclaimed to be a main characteristic of the Nordic welfare model.

摘要

尽管丹麦和瑞典这两个北欧国家奉行就地养老政策,但在为老年人提供由公共税收资助的正规居家护理方面却走上了不同的道路。瑞典削减了居家护理并将服务目标对准最有需求的人群,而丹麦则继续慷慨地提供居家护理。本文重点探讨这种不同政策对老年人正规和非正规护理资源的提供与组合所产生的影响。利用生活水平调查数据(基于对总共1158名年龄在67 - 87岁且需要实际帮助的个人进行的访谈),本文研究了这两种政策方法对不同需求和社会经济背景的老年人所产生的后果,并评估了这种发展与北欧福利模式中的普遍主义理想的契合程度。我们的研究结果表明,在这两个国家,由税收资助的居家护理在社会群体中都有使用,但瑞典将资源对准最有需求人群的做法造成了其他不平等现象:受教育程度较低的老年人只能求助于家庭,而受教育程度较高的老年人则从市场供应商那里购买帮助。这不仅使一些老年人面临更大风险,也对去家庭化程度提出了质疑,否则去家庭化通常被宣称是北欧福利模式的一个主要特征。

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