中国社区居家养老服务均等化研究——基于有照料需求老年人的分析
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摘要
老龄化带来的重要挑战之一就是失能老人的照料问题。促进基本公共服务均等化既是落实以人民为中心理念、保障公民基本权益的应有之义,也是政府提供公共服务的出发点和目标。本文使用"第四次中国城乡老年人生活状况抽样调查"原始数据,以有照料需求老人为对象,探讨他们在社区居家养老服务中的总体状况和在城乡、地区、群体间的差异。分析发现对有照顾需要的老人来讲,各项养老服务总体上呈现出服务需求大于服务供给和服务供给大于服务利用的特征。各项养老服务的供给、需求、利用结构存在明显差异,有照料需求老人对上门看病需求最大,其次是康复护理、上门做家务和日间照料,对老年辅具用品租赁和助浴服务需求比较低。群体方面,除性别外,年龄、婚姻和经济状况都影响着养老服务的均等化实施。地区层面的养老服务供给、利用等方面也存在显著差异。基于此,本文提出了一些针对性的措施,如未来要大力发展上门看病、康复护理、日间照料、上门做家务、助餐服务和助浴服务等居家养老服务;政府、社会、组织要逐步改变老年人观念,引导老年人积极利用各项养老服务;政府和社会要加大对丧偶、经济困难老人的服务力度;同时也要加大农村和中西部地区的养老服务设施建设。
One of the most important challenges brought about by aging is the care of the disabled elderly.Promoting the equalization of basic public services is not only the proper meaning of implementing the people-centered concept and protecting the basic rights and interests of citizens,but also the starting point and destination of the government’s provision of public services.We used the raw data of the fourth sample survey of the living conditions of urban and rural elderly in China to analyze the overall situation of community-based aged care services and the differences between urban and rural areas,regions and groups.We found that,for the elderly who have the need for care,the various pension services generally show that the service demand is greater than the service supply and service supply is greater than the service utilization.There are obvious differences in the supply,demand,and utilization structure of various aged care services.The elderly with care needs have the greatest demand for on-the-spot treatment,followed by rehabilitation care,homework and day care,while they have lower demand for elderly accessory supplies and bathing services.In terms of groups,in addition to gender,age,marriage,education level and economic status all affect the implementation of equalization of old-age services.There are also significant differences in the supply and utilization of aged care services at the region level.Based on the above analysis,the paper puts forward some targeted measures,such as the development of home-based care services,rehabilitation care,day care,housework,food service and bathing services;the government,society and organizations should gradually change the attitude of the elderly and guide the elderly to actively use the various old-age services;the government and the society should increase the service for widowed,low-educated and economically disadvantaged elderly;and it is necessary to increase the construction of old-age service facilities in rural areas,central and western regions.
One of the most important challenges brought about by aging is the care of the disabled elderly.Promoting the equalization of basic public services is not only the proper meaning of implementing the people-centered concept and protecting the basic rights and interests of citizens,but also the starting point and destination of the government’s provision of public services.We used the raw data of the fourth sample survey of the living conditions of urban and rural elderly in China to analyze the overall situation of community-based aged care services and the differences between urban and rural areas,regions and groups.We found that,for the elderly who have the need for care,the various pension services generally show that the service demand is greater than the service supply and service supply is greater than the service utilization.There are obvious differences in the supply,demand,and utilization structure of various aged care services.The elderly with care needs have the greatest demand for on-the-spot treatment,followed by rehabilitation care,homework and day care,while they have lower demand for elderly accessory supplies and bathing services.In terms of groups,in addition to gender,age,marriage,education level and economic status all affect the implementation of equalization of old-age services.There are also significant differences in the supply and utilization of aged care services at the region level.Based on the above analysis,the paper puts forward some targeted measures,such as the development of home-based care services,rehabilitation care,day care,housework,food service and bathing services;the government,society and organizations should gradually change the attitude of the elderly and guide the elderly to actively use the various old-age services;the government and the society should increase the service for widowed,low-educated and economically disadvantaged elderly;and it is necessary to increase the construction of old-age service facilities in rural areas,central and western regions.
引文
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[2]曲嘉瑶,杜鹏.中国城镇老年人的居住意愿对空巢居住的影响[J].人口与发展,2014,(2):87-94.
[3]许琪.扶上马再送一程:父母的帮助及其对子女赡养行为的影响[J].社会,2017,(2):216-240.
[4]常修泽.中国现阶段基本公共服务均等化研究[J].中共天津市委党校学报,2007,(2):66-71.
[5]郭小聪,代凯.国内近五年基本公共服务均等化研究:综述与评估[J].中国人民大学学报,2013,(1):145-154.
[6]丁志宏,王莉莉.我国居家养老中社区为老服务的均等化研究[J].社会保障研究,2011,(3):10-15.
[7]屈群苹,许佃兵.养老服务均等化:基于阿玛蒂亚·森可行能力的理性审视[J].南京社会科学,2018,(2):69-74.