本文選題：長(zhǎng)期護(hù)理保險(xiǎn)　切入點(diǎn)：嵌入醫(yī)保　出處：《吉林大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：隨著我國(guó)人口老齡化的加劇,老年人口不斷增多,尤其是高齡老人占老年群體的比重逐漸加大,一方面是身體機(jī)能的自然衰退,另一方面是老年疾病、慢性病高發(fā),還有少數(shù)其他因素,導(dǎo)致失能、半失能老人的數(shù)量也不斷上升。這一現(xiàn)象同時(shí)激發(fā)了關(guān)于老人的日常生活照料、康復(fù)保健式護(hù)理、精神慰藉等方面需求的增長(zhǎng)。與此同時(shí),家庭結(jié)構(gòu)小型化、婦女職業(yè)化、人口社會(huì)流動(dòng)的加劇,導(dǎo)致家庭在供養(yǎng)老人(尤其是服務(wù)供給)方面日趨乏力。老人大量的護(hù)理需求或者被抑制或者需求家庭以外的方式來(lái)滿足。在現(xiàn)有的護(hù)理模式中,無(wú)論是醫(yī)院護(hù)理還是護(hù)理院護(hù)理,不僅價(jià)格昂貴且數(shù)量不足,雖然商業(yè)護(hù)理保險(xiǎn)發(fā)揮了一定的保障功能,但是因其覆蓋范圍狹小,費(fèi)率較高、易發(fā)生道德風(fēng)險(xiǎn),所以無(wú)法滿足老人普遍性的護(hù)理需求。面對(duì)嚴(yán)峻的現(xiàn)實(shí),學(xué)界正在不斷探索將護(hù)理服務(wù)納入到保險(xiǎn)保障范圍,發(fā)展社會(huì)性的長(zhǎng)期護(hù)理保險(xiǎn)以便更好地解決失能、半失能老人的護(hù)理問題。簡(jiǎn)而言之,老人護(hù)理的主要責(zé)任已經(jīng)由家庭轉(zhuǎn)向社會(huì),如何保障老年人的生活質(zhì)量、心理健康和生命尊嚴(yán),滿足老年護(hù)理需求,對(duì)長(zhǎng)期護(hù)理保險(xiǎn)的建立和發(fā)展提出了挑戰(zhàn)。在當(dāng)前的社會(huì)經(jīng)濟(jì)環(huán)境下,對(duì)于長(zhǎng)期護(hù)理保險(xiǎn)的發(fā)展模式,學(xué)術(shù)界普遍認(rèn)為需要制度創(chuàng)新,但對(duì)于如何創(chuàng)新存在分歧,主要圍繞著長(zhǎng)期護(hù)理保險(xiǎn)獨(dú)立成體系、嵌入養(yǎng)老保險(xiǎn)、嵌入醫(yī)療保險(xiǎn)和三險(xiǎn)合一四種模式產(chǎn)生爭(zhēng)論。本文以我國(guó)失能半失能老人比重不斷上升而產(chǎn)生的長(zhǎng)期護(hù)理服務(wù)供給不足、價(jià)格昂貴為主要問題,以長(zhǎng)期護(hù)理保險(xiǎn)的最優(yōu)模式選擇為研究目標(biāo),查閱了國(guó)內(nèi)外相關(guān)文獻(xiàn)資料,運(yùn)用制度創(chuàng)新理論、社會(huì)分工論和生命周期假說(shuō)三種理論分析了我國(guó)推行長(zhǎng)期護(hù)理保險(xiǎn)制度模式的必要性和緊迫性,主要包括居民老有所養(yǎng)的需要、保險(xiǎn)制度自身創(chuàng)新的需要和資源優(yōu)化配置的需要。在詳細(xì)闡述目前關(guān)于長(zhǎng)期護(hù)理保險(xiǎn)的四種構(gòu)建模式的起源和特點(diǎn)的基礎(chǔ)上,對(duì)比分析了四種創(chuàng)新模式的優(yōu)勢(shì)和不足,得出結(jié)論:將長(zhǎng)期護(hù)理保險(xiǎn)制度嵌入醫(yī)療保險(xiǎn)是符合當(dāng)前社會(huì)經(jīng)濟(jì)發(fā)展階段的最優(yōu)模式選擇。進(jìn)而,通過(guò)借鑒國(guó)外成熟的發(fā)展經(jīng)驗(yàn)和國(guó)內(nèi)試點(diǎn)經(jīng)驗(yàn),總結(jié)長(zhǎng)期護(hù)理保險(xiǎn)制度發(fā)展的一般規(guī)律,探尋長(zhǎng)期護(hù)理保險(xiǎn)與醫(yī)療保險(xiǎn)的結(jié)合點(diǎn),從立法規(guī)范、多元主體參與、保障范圍、籌資模式、待遇給付和質(zhì)量控制等方面設(shè)計(jì)長(zhǎng)期護(hù)理保險(xiǎn)嵌入醫(yī)保的具體模式,并對(duì)模式構(gòu)建進(jìn)程中可能出現(xiàn)的問題做出預(yù)測(cè)并提出應(yīng)對(duì)之策。
[Abstract]:With the aggravation of the aging population in our country, the elderly population is increasing, especially the proportion of the elderly people in the elderly population is gradually increasing. On the one hand, the natural decline of the body function, on the other hand, is the disease of the elderly, the high incidence of chronic diseases. There are a few other factors that lead to disability and the increasing number of semi-disabled elderly people. This phenomenon has also stimulated an increase in the demand for daily care, rehabilitation care, psychological comfort, etc. The miniaturization of the family structure, the professionalization of women, the intensification of social mobility, As a result, families are becoming increasingly weak in providing for the elderly (especially in the provision of services). A large number of nursing needs of the elderly are either suppressed or met in ways other than the family. In the current care model, Both hospital nursing and nursing care are not only expensive and insufficient in quantity. Although commercial nursing insurance plays a certain protective role, it is prone to moral hazard because of its narrow coverage and high rates. Therefore, the universal nursing needs of the elderly cannot be met. In the face of the severe reality, the academic community is constantly exploring the integration of nursing services into the scope of insurance protection, and developing social long-term care insurance in order to better solve the problem of disability. In short, the primary responsibility for the care of the elderly has shifted from family to society. How to ensure the quality of life, mental health and dignity of life of the elderly and meet the needs of elderly care, It is a challenge to the establishment and development of long-term nursing insurance. In the current social and economic environment, the academic community generally thinks that the development mode of long-term care insurance needs institutional innovation, but there are differences on how to innovate. This paper focuses on the independent system of long-term nursing insurance, including old-age insurance, medical insurance and the integration of three insurance. This paper focuses on the shortage of long-term nursing services due to the increasing proportion of disabled and semi-disabled elderly people in China. Taking the choice of the optimal mode of long-term care insurance as the research goal, the paper reviews the relevant literature at home and abroad, and applies the theory of institutional innovation. Three theories of social division of labor and life cycle hypothesis have analyzed the necessity and urgency of carrying out the long-term nursing insurance system in China, including the needs of the elderly and the security of the residents. On the basis of expounding in detail the origin and characteristics of the four construction modes of long-term nursing insurance, the advantages and disadvantages of the four innovative modes are compared and analyzed. The conclusion is that it is the best choice to embed the long-term nursing insurance system into medical insurance in line with the current stage of social and economic development. This paper summarizes the general law of the development of long-term nursing insurance system, explores the combination of long-term nursing insurance and medical insurance, and discusses the legislative norms, the participation of multiple subjects, the scope of security, and the mode of financing. The specific model of long-term nursing insurance embedded in medical insurance is designed in the aspects of benefits and quality control, and the possible problems in the process of model construction are forecasted and countermeasures are put forward.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：F842.684;R47

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