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长期护理保险对公平与效率影响的初步分析——以中国青岛市为例。

An Initial Analysis of the Effects of a Long-Term Care Insurance on Equity and Efficiency: A Case Study of Qingdao City in China.

机构信息

Department of Global Health & Social Medicine, 4616King's College London, United Kingdom.

Department of Computer Science, 13290Tokyo Institute of Technology, Japan.

出版信息

Res Aging. 2021 Mar-Apr;43(3-4):156-165. doi: 10.1177/0164027520907346. Epub 2020 Feb 25.

Abstract

Finding a suitable mechanism to finance long-term care (LTC) is a pressing policy concern for many countries. Using Qingdao city in China as a case study, this article presents an initial assessment of a newly piloted LTC insurance by evaluating its effects on equity and efficiency in financing. Drawing data from 47 in-depth interviews conducted in 2016, this study found that there remain sizable disparities in financial burden among insurance participants, despite an emphasis on ensuring equitable access to care. Although the insurance brought cost savings to the health care sector, the LTC providers are incentivized to provide care at the least cost, even when such care is deemed inadequate due to the fixed payment for their services. This article offers critical insights into the potentials and challenges of applying the LTC insurance model in a developing country, where critical lessons can be drawn for public LTC insurance in other countries.

摘要

为长期护理(LTC)找到合适的融资机制是许多国家面临的紧迫政策问题。本文以中国青岛市为例,通过评估其对融资公平性和效率的影响,初步评估了新试点的长期护理保险。本研究从 2016 年进行的 47 次深入访谈中提取数据,发现尽管强调确保公平获得护理,但保险参与者之间的经济负担仍存在较大差距。尽管该保险为医疗保健部门节省了成本,但长期护理提供者受到激励以最低成本提供护理,即使由于其服务的固定支付而认为这种护理不足。本文为在发展中国家应用长期护理保险模式的潜力和挑战提供了重要见解,其他国家可以从中吸取有关公共长期护理保险的重要经验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f9f/7961619/220dc6ff6337/10.1177_0164027520907346-fig1.jpg

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