日本介护保险制度运行模式及其对中国的经验借鉴

发布时间：2018-03-02 07:26

本文关键词： 介护保险人口老龄化日常照护　出处：《辽宁大学》2017年硕士论文　论文类型：学位论文

【摘要】：进入21世纪以来,全世界都在密切关注着同一个问题:人口老龄化。无论是发达国家还是发展中国家,老龄人口的快速增长已经成为世界各国亟需解决的难题,我国当然也不例外。据统计资料显示2015年年底,我国65岁以上的老年人群体有14386万人,占总人口的10.5%。而根据专家预测到2050年,我国将成为全世界第一大的老年人口国家,老年人口将达到惊人的4.8亿。而且随着科学技术水平、卫生医疗技术、饮食条件等因素的提高和改善,我国人口的平均寿命还在不断提高,老龄化甚至高龄化的问题日益严峻。此外,我们还面临着老龄化向高龄化转换的风险。高龄群体的患病率大大增加,其对护理的需求也逐渐提高,如何构建合理的长期护理保险模式,解决庞大的市场需求是我国政府接下来工作的重点之一。日本作为世界上老龄化程度最高的国家,其在治理老年人问题方面有着非常丰富且有效的经验,介护保险便是其中一项切实可行的应对策略。日本的长期护理保险,也称作介护保险,早在1960年便开始着手策划制定介护保险制度,当时日本的老龄化率为5.7%。1962年访问护理(居家帮助服务)事业创建,1963年《老年人福利法》制定,明确了访问护理的法制化,随后历经长达40年的不断探索与发展,在2000年4月日本正式出台介护保险法,将介护保险纳入到社会保险体系之中。本文通过对日本介护保险模式的分析,整理出日本模式的成功经验以及存在的问题,由于日本是我国的近邻,且在生活方式、文化观念以及家庭结构上与我国有着诸多的相似之处,所以本文以日本为参考,为我国的长期护理保险制度的构建提出建议。本文首先对日本介护保险制度等相关概念理论做出总结性的概述,紧接着从人口老龄化角度分析了日本介护保险建立的原因,并且对现行的介护保险制度的模式、水平和效用进行了系统的论述。其次主要研究了日本介护保险制度建立的背景,并总结了发展的经验教训,涉及到了制度建立的原因、合理的制度模式以及适度水平。主要对护理保险的缴费、给付水平进行研究论证,得出合理适度的保险水平,同时引出了日本介护保险存在的问题。即财政支出水平过高、服务运行过程中的不公平以及地区间给付水平的差异。以日本介护保险为借鉴,结合我国国情,从模式、水平及可行性角度分析构建出合理的护理保险制度。最后是将理论分析中得到的启示建议与中国实际结合起来,并提出四点优化设计构想。1.建立长期护理保险的合理模式。2.设计政府、企业与个人三方筹资适度水平。3.加强长期护理保险的专业人才队伍建设。4.强化地方长期护理保险与服务的资源配置。
[Abstract]:Since 21th century, the world has been paying close attention to the same problem: the aging of the population. The rapid growth of the aging population, both in developed and developing countries, has become a difficult problem for all countries of the world to solve. Of course, China is no exception. According to statistics, at the end of 2015, there were 143.86 million elderly people over 65 years old in our country, accounting for 10.5 percent of the total population. According to experts' forecast, by 2050, China will become the largest elderly population country in the world. The elderly population will reach an astonishing 480 million. And with the improvement and improvement of science and technology, health and medical technology, diet and other factors, the average life expectancy of the Chinese population is still increasing. The problem of aging and even aging is becoming more and more serious. In addition, we are also facing the risk of the transition from aging to aging. The prevalence rate of the elderly population has increased greatly, and the demand for nursing care has gradually increased. How to build a reasonable long-term care insurance model and solve the huge market demand is one of the key tasks of our government. Japan is the most aging country in the world. It has a very rich and effective experience in dealing with older people, and referral insurance is one of the practical coping strategies. Japan's long-term care insurance, also known as referral insurance, As early as 1960, it began to plan and formulate a system of insurance for the elderly. At that time, the aging rate in Japan was 5.7.1962 when the cause of visiting nursing (home help services) was founded. The "Welfare of the elderly" Act of 1963 was enacted, which clarified the legalization of visiting nursing. Then after 40 years of continuous exploration and development, in April 2000, Japan formally introduced the law of insurance, which brought it into the social insurance system. Collate the successful experience and existing problems of the Japanese model. Because Japan is a close neighbor of our country, and has many similarities with our country in life style, cultural concept and family structure, so this paper takes Japan as a reference. In this paper, the author makes a summary of Japan's insurance system and other related concepts, and then analyzes the reasons for the establishment of Japan's insurance system from the point of view of aging population. Secondly, it mainly studies the background of the establishment of the insurance system in Japan, and summarizes the experience and lessons of the development, involving the reasons for the establishment of the system. The reasonable system model and appropriate level. This paper mainly studies and proves the payment and payment level of nursing insurance, and obtains the reasonable and moderate insurance level, and at the same time leads to the problems existing in Japan's insurance system, that is, the level of financial expenditure is too high. The unfairness in the process of service operation and the differences in the level of payment between regions. Taking Japanese insurance as a reference, combining with the national conditions of our country, from the mode, A reasonable nursing insurance system is constructed from the angle of level and feasibility. Finally, the enlightening suggestions obtained from the theoretical analysis are combined with the actual situation in China. And put forward a four-point optimal design concept. 1. Establish a reasonable mode of long-term care insurance. 2.Design the government, The appropriate level of financing between enterprises and individuals. 3. Strengthen the construction of long-term nursing insurance professionals. 4. Strengthen the local long-term care insurance and service resources allocation.
【学位授予单位】：辽宁大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：F843.13;F842.6

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