我国“体卫融合”养老服务体系的多元主体协同治理困境与优化对策

The Challenges and Optimization Strategies for Multi-Stakeholder Collaborative Governance in China’s “Sports-Health Integration” Elderly Care System

摘要: 面对“银发浪潮”加速演进带来的系统性挑战，我国“体卫融合”养老模式虽已进入政策顶层设计，却在基层实践中深陷“体、医、养脱嵌”困境。本文援引协同治理理论，构建“政府–市场–社会–老年人”四维分析框架进行深度诊断。研究发现，政府部门职能分割、医保支付缺位、复合型人才匮乏及老年人数字鸿沟是制约协同效能的关键症结。为此，本文提出建立权责清单制度、探索运动处方入医保、构建产学研用人才体系及适老化赋权等对策，旨在重塑多元主体协同生态，实现体育育人价值与养老服务的深度耦合。

Abstract: Facing systemic challenges posed by the accelerating “silver wave”, China’s “integrated physical fitness and healthcare” elderly care model has entered policy-level design yet remains mired in a “disembedded” dilemma at the grassroots level, where physical fitness, medical care, and elderly care remain disconnected. Drawing on collaborative governance theory, this paper constructs a four-dimensional analytical framework encompassing “government-market-society-elderly” for in-depth diagnosis. Research reveals that fragmented government functions, inadequate medical insurance coverage, shortages of multidisciplinary talent, and the digital divide among the elderly are key bottlenecks constraining collaborative effectiveness. To address these issues, this paper proposes establishing a list system for rights and responsibilities, exploring the inclusion of exercise prescriptions in medical insurance, building a talent system integrating industry, academia, research, and application, and implementing age-friendly empowerment strategies. These measures aim to reshape a collaborative ecosystem among multiple stakeholders and achieve deep integration between the educational value of sports and elderly care services.