养老机构服务质量危机及对策研究

Research on the Service Quality Crisis and Countermeasures in Elderly Care Institutions

摘要: 本研究针对中国养老机构面临的服务质量危机展开系统性分析。在人口老龄化加剧与家庭养老功能弱化的背景下，养老机构呈现“高端过剩、普惠短缺”的结构性失衡，同时暴露养老机构存在基础服务质量低下、设施安全隐患、护工情感劳动异化、监管体系滞后等核心问题。基于公共产品理论、情感劳动理论与资源依赖理论，研究揭示危机的深层成因：政府与市场责任边界模糊导致补贴不足与监管失效；护工群体因情绪耗竭与职业歧视陷入服务异化；机构对外部资源的过度依赖引发服务标准波动。为破解危机，论文提出三维对策：政策层面构建“需求–成本–绩效”精准补贴模型，推行长护险试点，建立智慧监管平台；管理层面设计“一人一案”个性化照护方案，量化情感劳动价值，实施透明化运营；行业层面深化医养结合资源整合，搭建“金字塔式”人才晋升体系。研究旨在通过多元协同治理推动养老行业从“生存型”向“质量型”转型，保障老年人权益并缓解社会养老压力。

Abstract: This study conducts a systematic analysis of the service quality crisis faced by elderly care institutions in China. Against the backdrop of an intensifying aging population and the weakening of family support functions, elderly care institutions exhibit a structural imbalance of “excess at the high end and shortage at the inclusive level”, while also revealing core issues such as low basic service quality, potential safety hazards in facilities, alienation of emotional labor among caregivers, and lagging regulatory systems. Based on public goods theory, emotional labor theory, and resource dependence theory, the study uncovers the underlying causes of the crisis: the blurring of responsibility boundaries between the government and the market leads to insufficient subsidies and ineffective regulation; the caregiver group falls into service alienation due to emotional exhaustion and occupational discrimination; and institutions’ excessive dependence on external resources triggers fluctuations in service standards. To address the crisis, the paper proposes a three-dimensional approach: at the policy level, constructing a “demand-cost-performance” precision subsidy model, piloting long-term care insurance, and establishing a smart regulatory platform; at the management level, designing personalized care plans for each individual, quantifying the value of emotional labor, and implementing transparent operations; and at the industry level, deepening the integration of medical and elderly care resources and building a “pyramid-style” talent promotion system. The study aims to promote the transformation of the elderly care industry from a “survival-oriented” to a “quality-oriented” model through multi-dimensional collaborative governance, safeguarding the rights and interests of the elderly and alleviating social pressure on elderly care.