人口老龄化视角下长护险制度均衡发展路径——基于ISM模型

The Balanced Development Path of Long-Term Care Insurance System under the Perspective of Population Aging—Based on ISM Model

摘要: 人口老龄化是指人口中老年人比重日益上升的现象，尤其是指在已经达到老年状态的人口中，老年人口比重继续提高的过程。随着人口老龄化和慢性病的不断增加，使得急需一种为老人提供长期护理服务以及为此服务提供经济保障的长期护理保险。因此本文从国家政府层面、机构市场层面、个体家庭层面等3个维度出发，得出影响长护险长期均衡发展的15个相关因素，运用ISM模型分析因素之间的相互关系以及影响路径，绘制出多层递阶结构图，分析因素影响机理。结果表明，保障范围、照料减负、经办机构数量、服务质量、居住方式、家庭内部道德风险、以及需要长期照料的自我意识等因素是影响长护险长期均衡发展的表层因素；筹资机制、监督机制、个人健康状况、婚姻状况、其他保障机制替代效应和个体年龄是中间层影响因素；经济状况和受教育程度是深层影响因素。

Abstract: Population ageing refers to the phenomenon of an increasing proportion of older persons in the population, and in particular to the process of continuing to increase the proportion of older persons in a population that has already reached old age. With the aging of the population and the increasing number of chronic diseases, there is an urgent need for a long-term care insurance that provides long-term care services for the elderly as well as financial protection for such services. Therefore, this paper starts from three dimensions: national government level, institutional market level, and individual family level, and derives 15 relevant factors affecting the long-term balanced development of long-term care insurance, analyzes the interrelationships between the factors and their influence paths by using the ISM model, and draws a multilayered hierarchical structure diagram to analyze the influence mechanism of the factors. The results show that factors such as coverage, care reduction, number of providers, service quality, mode of residence, moral risk within the family, and self-awareness of the need for long-term care are the superficial factors affecting the long-term balanced development of long-term care insurance; the financing mechanism, supervision mechanism, individual health status, marital status, substitution effect of other protection mechanisms, and age of the individual are the intermediate influences; and the economic status and education level are the deep influences.