长期照护制度中的“绩效同构”与“风险共担”:一个“协同治理”的解释框架

发布时间：2018-04-15 13:30

本文选题：协同治理 + 长期照护服务　；参考：《浙江学刊》2017年02期

【摘要】：长期照护应是一种基于"情境主义"范式的制度性安排,我国对于长期照护概念的引入,比西方及东亚发达国家(地区)晚了近二十年,至今尚未开启"长期照护"的制度化建设。中国是世界上失能老年人口最多、亦是唯一失能老年人口超千万的国家。因应"健康和积极老龄化"、尽快构建一体化的老年照护服务制度,采用"多阶段照护与分级制护理"的策略已成尽早实施的方向。本文在"协同治理"的解释框架下遵循两条逻辑主线——明线为"绩效"和"风险"、暗线为"公平"和"义务"。制度绩效方面,提出了多元照护主体在"照护制度框架同构"过程中的"照护制度效率增效链条";服务绩效方面,选取"全景式"和"精准化"双维度来细观"一站式"全生命周期的"长期照护连续统";制度避险方面,论证政府、市场、社会组织等多元照护持份者达成"高结构拟合度、低度可控型结构风险"的制度设计可能。本文甄选广州市L区作为典型个案、对其长期照护的"地方性事实"进行循证研究,试图为我国长期照护在结构层面的制度化建设提供具有区域前瞻性的启示。
[Abstract]:Long-term care should be a kind of institutional arrangement based on the "situational" paradigm. China's introduction of the concept of long-term care is nearly 20 years later than that of the western and East Asian developed countries (regions).Up to now, the institutionalization of long-term care has not been started.China is the world's largest disabled elderly population, but also the only disabled elderly population of more than 10 million countries.In response to "healthy and active aging", it has become the direction to implement the strategy of "multi-stage care and graded nursing" as soon as possible to establish an integrated care service system for the elderly.This paper follows two logical main lines under the framework of "cooperative governance"-"performance" and "risk", and "equity" and "obligation".In terms of institutional performance, this paper puts forward the "efficiency and efficiency chain" of multiple care subjects in the process of "isomorphism of care system framework", as well as the service performance.Selecting the "panoramic" and "precision" two dimensions to observe the "long-term care continuum" of "one-stop" and "whole life cycle", and proving that the government, market, social organization and other multiple stakeholders have reached a "high structural fit degree" in the aspect of institutional risk avoidance.The system design of low degree controllable structural risk is possible.This paper selects L District of Guangzhou as a typical case to conduct evidence-based research on the "local facts" of long-term care in order to provide a regional perspective for the institutionalization of long-term care at the structural level in China.
【作者单位】：南京航空航天大学人文与社会科学学院公共管理学系;香港中文大学社会工作学系;
【基金】：国家社会科学基金项目(青年项目)“我国城市社区治理的‘绩效’-“风险”双轴效应研究”[15CSH071]
【分类号】：D669.6

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