积极老龄化视角下县域农村老年人居家养老服务供需匹配研究

Research on the Supply-Demand Matching of Home-Based Elderly Care Services in County Rural Areas from the Perspective of Active Aging

摘要: 在人口老龄化与城乡人口流动叠加背景下，县域农村呈现老龄化程度加深、家庭照护能力弱化与养老需求多元化等特征，成为居家养老供需矛盾的集中区域。本文以积极老龄化“健康–参与–保障”为理论框架，在刻画农村老年人需求强度与需求结构的基础上，依托第七次全国人口普查、2024年度国家老龄事业发展公报及《第五次中国城乡老年人生活状况抽样调查基本数据公报》等数据，构建“结构–空间–能力–支付”四维供需匹配分析框架，用以识别县域农村居家养老服务的供需特征及其错位机制。分析表明：农村老年人居家照护偏好显著，核心需求集中于上门医疗、助餐等到户型服务；供给侧总体规模扩张，但“床位型–设施型”供给与“到户型–综合型”需求存在结构性错位，专业照护与医养协同能力相对不足；叠加村落分散带来的可及性约束与农村老年人支付能力较弱等因素，形成“有资源但不匹配”的现实困境。基于此，本文提出以县域统筹为抓手，通过需求评估清单化、健康服务上门化、助餐照料网络化、互助养老组织化与数字治理闭环化等路径提升供需匹配度，推动积极老龄化目标在县域农村落地。

Abstract: Against the backdrop of overlapping population aging and rural-urban migration, rural county areas are characterized by a deepening aging trend, weakened family care capacity and diversified demands for elderly care services. Based on the analytical framework of active aging featuring “health-participation-security” and authoritative data including the 7th National Population Census and the 2024 National Report on the Development of the Cause of Aging, this paper constructs a four-dimensional supply-demand matching framework of “demand intensity-supply structure-accessibility-payment constraint” to explore the supply-demand imbalances of home-based elderly care services in rural county areas. The study finds that rural elderly in counties show a prominent preference for home-based care, with core demands focusing on home medical visits, meal assistance and other services. While the supply side has expanded significantly in scale, there exists a structural mismatch between bed-and-facility-oriented supply and home-and-comprehensive demand, accompanied by insufficient professional care and sustainable operation capacity. The core cause of the imbalance lies in the lack of precise service delivery, medical-care integration and affordable continuous services. Accordingly, this paper proposes to take county-level coordination as the key measure, and improve the supply-demand matching degree through such paths as list-based demand assessment and home-based health services, so as to advance the realization of active aging goals in rural county areas.