南京市长期护理保险财务供需平衡分析

发布时间：2018-02-28 14:51

本文关键词： 长期护理保险财务供需平衡护理需求总费用每月缴费额　出处：《南京财经大学》2015年硕士论文　论文类型：学位论文

【摘要】：人口老龄化程度的加深、预期寿命的延长,造成老年人口数量的不断增加：慢性病的多样化以及老年群体的生理特性,使得老年人的失能风险日益增大,与之而来的是潜在的巨大长期护理需求；而家庭结构的核心化、女性劳动参与率的提高给传统的家庭护理模式带来巨大的冲击,再加上长期护理具有费用上的长期性、资源上的稀缺性,完全由个人或者家庭来承担显然是缺乏效率的。南京市作为人口老龄化最为严重的地区之一,开办长期护理保险是势在必行,同时南京市作为经济较为发达的地区之一,拥有护理资源以及配套设施上的优势,这为长期护理保险的开办提供了有利的条件。本文首先以德国和日本为例,介绍了国外己经建立起来的长期护理保险制度,并对南京市护理保险的筹资机制以及给付机制进行了制度设计。其次,选择适当的变量建立起长期护理需求宏观仿真模型对南京市2015-2030年长期护理需求的总费用进行了测算,而后依据供需平衡的原则对南京市2015-2030年长期护理保险法定缴费人群的每月缴费额以及费率进行了测算。具体得到以下几点结果：①南京市长期护理保险应属于社会保险性质,充分体现政府、企业、个人的责任,实行现收现付制的筹资模式,为南京市所有65岁及以上不同等级的失能老人提供护理服务。②通过核算,家庭／社区护理模式的护理成本按护理等级高低依次为632元/月、1264元/月、2528元/月,机构护理成本依次为1400元/月、2472元/月、3880元/月,预计南京市2015年护理需求总费用为18.58亿元,到2030年将达到52.75亿元。③依据现收现付制“以支定收”的原则,本文测算出南京市2015年法定缴费人群每月缴费额为32.70元/月,2030年上升为104.41元/月,护理保险费率也由2015年的0.85%上升到2030年的1.30%。最后,本文依据实证所得到的结果,对南京市开办长期护理保险提出以下三点政策建议：①在制度上,完善相关法律法规,强化政府的责任。②在护理保险的基金平衡上,拓宽筹资渠道、科学合理的厘定保险费率。③在护理服务供给上,大力培养护理人员,提高服务质量。
[Abstract]:With the deepening of population aging and the prolongation of life expectancy, the number of the elderly population is increasing. The diversification of chronic diseases and the physiological characteristics of the elderly population increase the risk of disability of the elderly. On the other hand, there is the potential for enormous long-term care needs; the centralization of the family structure, the increased female labour force participation rate, and the impact on traditional home-based care models, coupled with the long-term cost of long-term care, The scarcity of resources is clearly inefficient for individuals or families. Nanjing, as one of the regions with the most ageing population, is imperative to introduce long-term care insurance. At the same time, Nanjing, as one of the economically developed regions, has the advantages of nursing resources and supporting facilities, which provides favorable conditions for the establishment of long-term care insurance. This paper introduces the long-term nursing insurance system that has been established in foreign countries, and designs the financing mechanism and payment mechanism of Nanjing nursing insurance. Secondly, The macroscopical simulation model of long-term nursing demand was established by selecting appropriate variables to calculate the total cost of long-term nursing demand in Nanjing from 2015 to 2030. Then, according to the principle of balance between supply and demand, this paper calculates the monthly contribution amount and the rate of the legal contributory population of long-term nursing insurance in Nanjing from 2015 to 2030. The specific results are as follows: 1. The long-term nursing insurance in Nanjing should belong to the nature of social insurance. Fully embodying the responsibility of the government, enterprises and individuals, implementing the pay-as-you-go financing model, providing nursing services for all disabled people aged 65 and above in Nanjing through accounting, The nursing cost of family / community nursing model was 632 yuan / month / month 1264 yuan / month / month 2528 yuan / month, and institutional nursing cost was 1400 yuan / month / month 2472 yuan / month / month 3880 yuan / month. It is estimated that the total cost of nursing demand in Nanjing is one billion eight hundred and fifty-eight million yuan in 2015, and will reach five billion two hundred and seventy-five million yuan in 2030 according to the principle of pay-as-you-go system. This paper calculates that the monthly contribution of the legal contributory population in Nanjing is 32.70 yuan / month in 2015 and 104.41 yuan / month in 2030. The rate of nursing insurance has also risen from 0.85% in 2015 to 1.30 in 2015. Finally, this paper bases on the empirical results. The following three policy suggestions on the establishment of long-term care insurance in Nanjing: 1. In terms of the system, perfect the relevant laws and regulations, strengthen the government's responsibility .2 in the fund balance of nursing insurance, and broaden the channels for raising funds. Scientifically and reasonably determine the insurance rate .3 in the nursing service supply, vigorously train nursing staff, improve service quality.
【学位授予单位】：南京财经大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：F842.6;F840.4

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