Rostgaard Tine, Jacobsen Frode, Kröger Teppo, Peterson Elin
Roskilde University, Roskilde, Denmark.
Stockholm University, Stockholm, Sweden.
Eur J Ageing. 2022 May 3;19(2):201-210. doi: 10.1007/s10433-022-00703-4. eCollection 2022 Jun.
With the extensive long-term care services for older people, the Nordic countries have been labelled 'caring states' as reported (Leira, Welfare state and working mothers: the Scandinavian experience, Cambridge University Press, Cambridge, 1992). The emphasis on services and not cash benefits ensures the Nordics a central place in the public service model (Anttonen and Sipilä, J Eur Soc Policy 6:87-100, 1996). The main feature of this ideal model is public social care services, such as home care and residential care services, which can cover the need for personal and medical care, as well as assistance with household chores. These services are provided within a formally and professionally based long-term care system, where the main responsibility for the organization, provision and financing of care traditionally lays with the public sector. According to the principle of universalism (in: Antonnen et al. (eds), Welfare state, universalism and diversity, Elgar, Cheltenham, 2013), access to benefits such as home care and residential care is based on citizenship and need, not contributions nor merit. Also, care services should be made available for all and generally be used by all, with no stigma associated. Vabø and Szebehely (in: Anttonen (ed), Welfare State, universalism and diversity, Edward Elgar Publishing, London, 2012)) further argue that the Nordic service universalism is more than merely issues of eligibility and accessibility, in that it also encompasses whether services are attractive, affordable and flexible in order to meet a diversity of needs and preferences. However, recent decades have seen a continuous tendency towards prioritization of care for the most frail, contributing to unmet need, informalization of care and privatization in the use of topping up with market-based services. These changes have raised questions about increasing inequalities within Nordic long-term care systems. We investigate in the article what effect changes have for equality across social class and gender, for users and informal carers. The article is based on analysis of comparable national and international statistics and a review of national research literature and policy documents.
正如报道的那样，随着为老年人提供广泛的长期护理服务，北欧国家被称为“关爱型国家”（莱拉，《福利国家与职业母亲：斯堪的纳维亚的经验》，剑桥大学出版社，剑桥，1992年）。对服务而非现金福利的重视确保了北欧国家在公共服务模式中占据核心地位（安托宁和西皮拉，《欧洲社会政策杂志》6：87 - 100，1996年）。这种理想模式的主要特征是公共社会护理服务，如家庭护理和寄宿护理服务，它们可以满足个人护理、医疗护理以及家务协助的需求。这些服务是在一个基于正式和专业的长期护理系统内提供的，传统上，护理的组织、提供和融资的主要责任在于公共部门。根据普遍主义原则（见：安托宁等人（编），《福利国家、普遍主义与多样性》，埃尔加出版社，切尔滕纳姆，2013年），获得家庭护理和寄宿护理等福利的依据是公民身份和需求，而非缴费或功绩。此外，护理服务应向所有人提供，并且通常应由所有人使用，不存在相关污名。瓦博和泽贝希利（见：安托宁（编），《福利国家、普遍主义与多样性》，爱德华·埃尔加出版社，伦敦，2012年）进一步指出，北欧的服务普遍主义不仅仅是资格和可及性问题，还包括服务是否具有吸引力、可承受性和灵活性，以满足多样化的需求和偏好。然而，近几十年来，一直存在一种持续的趋势，即优先照顾最脆弱的人群，这导致了需求未得到满足、护理非正规化以及在使用基于市场的服务进行补充时出现私有化。这些变化引发了关于北欧长期护理系统内不平等加剧的问题。我们在本文中研究这些变化对社会阶层和性别平等、对用户和非正式护理人员产生了什么影响。本文基于对可比的国家和国际统计数据的分析以及对国家研究文献和政策文件的综述。
