城郊小型村庄何以承接城市养老外溢？——城乡互益性康养村的建设逻辑与机制设计

Why Can Small Villages in the Rural Areas Take on the Elderly Care Services Excessed by the Cities?—The Construction Logic and Mechanism Design of Urban-Rural Mutual-Benefit Health Care Villages

摘要: 人口老龄化加速与城乡融合的推进，使城乡互益性养老成为疏解城市养老压力、盘活乡村资源的潜在路径。既有研究多停留于模式可行性论证，缺乏面向村庄实际、回应城市老人真实需求的可操作方案。本文基于推拉理论、退休迁移阶段理论与社会交换理论，以天津市蓟州区小穿芳峪村为案例，运用实地调研与半结构访谈等质性方法开展研究。结果表明：该村在生态、文化、基础设施与组织动员方面具备建设优势，但存在医疗服务薄弱、专业人才匮乏、城乡养老供需信息不对称等制约；城郊小型村庄规模适中，熟人社会特征明显，适宜承接健康自理型城市老人养老外溢需求；城乡双向互益须落实经济、服务、文化、治理四个层面，其中非物质资源交换(尊重、归属、自我实现)是维系互益的深层纽带。据此，本文提出康养村建设应坚持“服务优先”，把医疗连续性、应急保障与社会工作介入置于硬件投入之前。

Abstract: The acceleration of population aging and the implementation of the urban-rural integration have made inter-beneficial elderly care in urban and rural areas a potential path to alleviate the pressure of elderly care in cities and revitalize rural resources. Existing studies mostly focus on the feasibility of the model, lacking practical and actionable solutions that are tailored to the actual conditions of villages and respond to the real needs of urban elderly people. This paper uses the push-pull theory, the retirement migration stage theory, and the social exchange theory, and takes Xiaochuanfangyu Village in Jizhou District, Tianjin as a case, conducting research through qualitative methods such as field investigations and semi-structured interviews. The results show that this village has advantages in terms of ecology, culture, infrastructure, and organizational mobilization, but there are constraints such as weak medical services, lack of professional talents, and asymmetric information on urban-rural elderly care supply and demand; small suburban villages have an appropriate scale and obvious characteristics of a familiar social network, making them suitable to undertake the external demand for elderly care of healthy self; the two-way mutual-benefit between urban and rural areas must be implemented at the economic, service, cultural, and governance levels, among which the non-material resource exchange (respect, belonging, self-actualization) is the deep bond that maintains mutual benefit. Based on this, this paper proposes that the construction of health care villages should adhere to “prioritizing services”, placing medical continuity, emergency support, and social work intervention before hardware investment.