积极老龄化视角下社区养老服务供给的结构性困境与治理路径

Structural Dilemmas and Governance Paths of Community Elderly Care Service Provision from the Perspective of Active Aging

摘要: 在积极应对人口老龄化上升为国家战略的时代背景下，社区养老服务供给的数量扩张并未自动转化为服务质量的同步提升，供需错位、结构失衡、主体缺位等深层矛盾日趋凸显。本文以积极老龄化的“健康–参与–保障”三维分析框架为理论工具，系统审视当前社区养老服务供给的结构性困境，揭示其背后隐含的“衰退范式”支配、部门壁垒与协同失灵，以及老年人从供给客体到服务主体的角色悬置，提出确立需求导向的分类分层供给机制、构筑社区嵌入式医养融合服务体系、推进智慧养老的技术赋能与制度配套、激活老年人主体性的互助参与网络等治理路径，以期为构建适应积极老龄化要求的社区养老服务供给体系提供学理支撑与政策启示。

Abstract: Against the backdrop where actively responding to population aging has been elevated to a national strategy, the quantitative expansion of community elderly care service provision has not automatically translated into a synchronous improvement in service quality. Deep-seated contradictions such as the mismatch between supply and demand, structural imbalance, and the absence of key stakeholders have become increasingly prominent. This paper adopts the three-dimensional analytical framework of “Health-Participation-Security” from active aging theory as its theoretical tool to systematically examine the structural dilemmas in current community elderly care service provision. It reveals the underlying issues: the dominance of the “decline paradigm”, departmental barriers and coordination failures, and the role suspension of older adults from passive service recipients to active service participants. The paper further proposes governance paths including establishing a demand-oriented classified and hierarchical provision mechanism, constructing a community-embedded integrated medical and elderly care service system, advancing technological empowerment and institutional support for smart elderly care, and activating mutual aid participation networks that enhance the subjectivity of older adults. This research aims to provide theoretical support and policy implications for building a community elderly care service provision system that meets the requirements of active aging.