供需匹配视角下老龄化社区居家养老服务的困境与优化路径

The Dilemma and Optimization Path of Home-Based Elderly Care Services in Aging Communities from the Perspective of Supply and Demand Matching

摘要: 在人口老龄化快速加深的背景下，社区居家养老服务作为我国养老服务体系的主体，其供需匹配程度直接关系到老年人的生活质量与社会福利制度的可持续性。本研究从供需匹配视角出发，构建“总量–结构–时空–质量”四维分析框架，系统考察老龄化对社区居家养老服务带来的供需失衡困境。研究发现：需求侧面临总量激增、高龄化与失能化加速、需求内容升级等压力；供给侧则存在资金依赖单一、人力短缺低质、设施布局失衡、部门协调碎片化等短板。两者在总量、结构、时空、质量四个维度上出现系统性匹配失灵。究其根源，在于社区居家服务的“准公共物品”属性导致市场失灵与政府干预不足并存，以及劳动力再生产成本的社会化转嫁机制。研究提出，应从筹资多元化、人力职业化、设施适老化、服务整合化、制度匹配优化五个维度构建优化路径，为完善社区居家养老服务体系提供理论参考。

Abstract: Against the background of rapid deepening of population aging, community-based home care services serve as the mainstay of China’s elderly care service system, and the degree of matching between their supply and demand is directly related to the quality of life of the elderly and the sustainability of the social welfare system. From the perspective of supply-demand matching, this study constructs a four-dimensional analytical framework encompassing “total volume-structure-spatiotemporal-quality” to systematically investigate the supply-demand imbalance dilemma brought about by aging to community-based home care services. Research has found that the demand side faces pressures such as a surge in overall demand, an accelerating trend towards an ageing population and increased disability, and evolving needs; whilst the supply side suffers from shortcomings including over-reliance on a single source of funding, a shortage of low-quality labour, an unbalanced distribution of facilities, and fragmented inter-departmental coordination. A systemic mismatch has emerged between the two sides across four dimensions: volume, structure, spatial and temporal distribution, and quality. The root cause lies in the “quasi-public goods” nature of community-based home services, which leads to a coexistence of market failures and insufficient government intervention, as well as a socialized transfer mechanism for labor reproduction costs. The study proposes that an optimization path should be constructed from five dimensions: diversified financing, professionalization of human resources, aging-friendly facilities, integrated services, and optimized institutional matching, providing theoretical references for improving the community-based home care service system.