我国“体卫融合”养老服务体系的演进逻辑、现实困境与路径优化

The Evolutionary Logic, Practical Dilemmas, and Path Optimization of China’s “Sports-Medical Integration” Elderly Care Service System

摘要: 人口老龄化程度持续加深，使我国养老服务体系面临由生活照料型向健康促进型转变的现实要求。在健康中国、积极应对人口老龄化和全民健身战略协同推进的背景下，“体卫融合”逐渐成为完善健康养老服务供给的重要路径。本文基于相关政策文件与既有研究，分析我国“体卫融合”养老服务体系的演进逻辑、现实困境与优化路径。研究认为，我国“体卫融合”养老服务体系呈现出政策上由养老保障向健康促进转变、需求上由生活照料向主动健康转变、服务上由一般活动供给向科学干预转变、空间上由机构养老向社区嵌入转变、治理上由部门分割向多主体协同转变的基本逻辑。然而，当前实践仍存在制度接口不清、服务链条断裂、社区承载能力不足、复合型人才短缺、标准评价体系不健全以及数字化和支付支撑不足等问题。未来应从强化制度统筹、完善社区服务链条、加强复合型人才培养、健全标准评价与数字化管理体系等方面推进优化，推动体育真正嵌入养老服务全过程，为健康老龄化提供持续支撑。

Abstract: With the deepening of population aging, China’s elderly care service system is facing an urgent need to shift from life-care-oriented provision to health-promotion-oriented services. Against the background of the Healthy China strategy, the national strategy for actively responding to population aging, and the development of public fitness services, sports-health integration has gradually become an important approach to improving health-oriented elderly care services. Based on relevant policy documents and existing studies, this paper analyzes the evolutionary logic, practical dilemmas, and optimization paths of China’s sports-health integrated elderly care service system. The study finds that the system has evolved from elderly care security to health promotion in policy orientation, from life care to active health in demand structure, from general activity provision to scientific intervention in service content, from institution-based care to community-based embedding in spatial organization, and from departmental separation to multi-actor collaboration in governance. However, several problems remain in practice, including unclear institutional interfaces, fragmented service chains, insufficient community capacity, a shortage of interdisciplinary professionals, incomplete standards and evaluation systems, and inadequate digital and payment support. Therefore, future development should focus on strengthening institutional coordination, improving community-based service chains, cultivating interdisciplinary professionals, and establishing standardized evaluation and digital management systems, so as to embed sports more effectively into the whole process of elderly care services and provide sustained support for healthy aging.