中国失能老人机构照护服务体系的构建

发布时间：2018-11-24 21:03

【摘要】：老龄化背景下,银色浪潮席卷全球,老年照护服务问题严峻而突出,尤其是失能老人的照护服务问题。中国作为世界上老年人口最多的国家,面临的形势则更为严峻,再加上经济发展的不均衡,社会保障制度的不健全等因素,失能老人照护服务问题正渐渐成为一个亟需要解决的公共问题。依照国外经验,建立长期照护服务体系是解决失能老人照护服务问题的有效手段。但国内尚未建立起与失能老人照护需求相适应的长期照护服务体系,失能老人的照护服务被零散的分落在家庭、社区与养老机构中。失能老人因其自身的特殊性,对外依赖程度很高,而随着家庭结构的小型化,子女就业异地化,父辈与子辈居住方式的分离,家庭养护功能日渐弱化,筹备建设中的社区,养老服务功能并不无完善,失能老人很难得到高质量的照护服务。养老机构因其专业化综合性的老年服务而成为失能老人照护服务最佳的选择。在失能者众多的中国,围绕养老机构建立失能老人机构照护服务将是解决失能老人长期照护服务问题的重要途径。机构照护服务体系的构建是满足失能老人的照护需求为出发点的,为了更好的了解失能老人照护需求,解决其老年服务问题,本文以“中国失能老人多元需求分析与长期照护服务体系的构建”课题组为依托。首先,通过问卷调查与实地访谈相结合的方式对失能老人机构照护需求、养老机构服务供给及其他相关方面进行了调查研究,并在结合相关理论的基础上,通过对失能老人选择机构照护的意愿、机构照护的内容、可支付能力、人员需求、服务规范化等方面分析获得失能老人机构照护服务需求。其次,在明确失能老人机构照护需求的基础上对进而对比养老机构服务供给。研究显示,我国失能老人机构照护的服务供给与照护需求仍旧不对称,机构服务供给存在着机构服务数量不足,服务项目简单、服务费用高昂、护理人员缺乏、服务规范化不足的问题。就其原因来看,主要是我国养老资源未整合,整体布局缺乏、机构发展不充分,服务定位不明确、机构筹资机制不完善、护理人员薪酬待遇不高,职位缺乏吸引力、相关法律法规建设滞后。最后提出失能老人照护服务体系的构建建议:建立需求评估机制,优化资源配置、丰富机构服务项目,提高机构老人满意度、完善资金筹集机制、建立人员培训机制,提高人员“数质”、完善法律法规,提高服务规范化等。
[Abstract]:Under the background of aging, the silver wave is sweeping the whole world, and the problem of elderly care service is serious and prominent, especially for the disabled elderly. As the country with the largest number of elderly people in the world, China faces a more severe situation, coupled with the imbalance in economic development and the unsound social security system. The problem of disabled care for the elderly is becoming a public problem that needs to be solved. According to the experience of foreign countries, the establishment of long-term care service system is an effective means to solve the problem of care service for the disabled elderly. However, China has not yet established a long-term care service system adapted to the care needs of the disabled elderly, and the care services for the disabled elderly have been scattered in the family, community and pension institutions. Because of their own particularity, the disabled elderly have a high degree of external dependence. With the miniaturization of the family structure, the employment of their children and the separation of their parents from their children, the maintenance function of the family is weakening day by day. Pension service function is not perfect, disabled elderly people are very difficult to obtain high quality care services. Pension institutions have become the best choice for disabled elderly care services because of their specialized and comprehensive elderly services. In China, where there are many disabled people, it is an important way to solve the problem of long-term care service for the disabled elderly by setting up care service for disabled elderly institutions. The construction of institutional care service system is to meet the needs of disabled elderly care as the starting point, in order to better understand the needs of the disabled elderly care needs, solve their elderly service problems, This paper is based on the research group of "multiple needs Analysis and long-term Care Service system Construction for disabled elderly in China". First of all, through the combination of questionnaires and field interviews, this paper investigates the demand for care, service supply and other related aspects of institutions for the disabled elderly, and on the basis of relevant theories. Through the analysis of the willingness of the disabled elderly to choose institutional care, the content of institutional care, the ability to pay, the needs of personnel, and the standardization of service, the needs of care services in institutions for the disabled are analyzed. Secondly, on the basis of defining the needs of care for disabled elderly institutions, it contrasts the service supply of pension institutions. The research shows that the service supply and care demand of disabled elderly institutions in our country are still asymmetric, the institutional service supply is insufficient in quantity, the service item is simple, the service cost is high, and the nursing staff is short. Insufficient standardization of services. The main reasons are the unconformity of endowment resources, the lack of overall layout, the inadequate development of institutions, the unclear orientation of service, the imperfect mechanism of institutional financing, the low salary and treatment of nursing personnel, and the lack of attraction of posts. The construction of relevant laws and regulations lags behind. Finally, the paper puts forward some suggestions for constructing the service system of disabled elderly care: establishing a needs assessment mechanism, optimizing the allocation of resources, enriching the institutional service projects, improving the satisfaction of the elderly in institutions, perfecting the mechanism of raising funds, and establishing a personnel training mechanism. Improve the number and quality of personnel, improve laws and regulations, and improve the standardization of services.
【学位授予单位】：重庆大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：D669.6

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