发达国家养老服务发展状况及借鉴
|
摘要
中国已经步入老龄化加速期,面临日益严峻的养老服务问题和挑战,充分吸收借鉴发达国家在应对老龄化、促进养老服务方面的经验教训,有助于建好制度、少走弯路,是我们作为后发国家的特殊优势,也是有效破解养老服务难题的科学路径。为此,本研究着眼于中国养老服务体系建设的现实关切,在系统梳理总结发达国家和地区养老服务发展的现状与趋势、典型模式、主要问题及对策的基础上,发现各国大多在政策理念上倡导积极老龄化,在管理体制上强调立法与放权,在供给主体上借力市场与社会,在递送模式上倾向社区居家服务,在服务内容上推动专业化、标准化、精细化,在质量控制上注重受众评价,在保障水平上坚持适度可持续,并在此基础上形成了市场导向型、普惠共济型、风险共担型、家庭基础型、多元混合型等养老服务典型模式。基于上述发现,结合中国实际,本文从法治建设、政府职责、供给主体、医养结合、体系建设、服务质量等方面提出应对策略,探索具有中国特色的科学化养老服务道路。
With the accelerated aging, China is facing increasingly grave questions and challenges. The experiences and lessons on aging and pension services in developed countries will benefit us to establish a sound legal and policy system to solve the difficult questions we face in aging services with the late-mover advantage. After we summarize and analye the current situation, development trend, typical models and main questions in developed countries and regions, we find most countries make policies to encourage active aging, emphasize legislation and delegate powers to lower levels, give full play to the role of market and society, focus on community care and in home services for the elder people, promote professionalism, standardization and refinement, attach importance to the evaluation of audience on quality control and insist the sustainable development. There are many models in aging service in the world, such as market oriented, universalism, risk-sharing and home-based care services. Based on the above, combined with Chinese situation, we put forward recommendation of appropriate solutions on legal construction, governmental responsibility, supplying subject, system building, service quality in order to create the path of socialism with Chinese characteristics on aging services.
With the accelerated aging, China is facing increasingly grave questions and challenges. The experiences and lessons on aging and pension services in developed countries will benefit us to establish a sound legal and policy system to solve the difficult questions we face in aging services with the late-mover advantage. After we summarize and analye the current situation, development trend, typical models and main questions in developed countries and regions, we find most countries make policies to encourage active aging, emphasize legislation and delegate powers to lower levels, give full play to the role of market and society, focus on community care and in home services for the elder people, promote professionalism, standardization and refinement, attach importance to the evaluation of audience on quality control and insist the sustainable development. There are many models in aging service in the world, such as market oriented, universalism, risk-sharing and home-based care services. Based on the above, combined with Chinese situation, we put forward recommendation of appropriate solutions on legal construction, governmental responsibility, supplying subject, system building, service quality in order to create the path of socialism with Chinese characteristics on aging services.
引文
[1]博·罗斯坦,《正义的制度:全民福利国家的道德和政治逻辑》,靳继东、丁浩译,中国人民大学出版社,2017年4月。
[2]丁英顺,《韩国老年福利制度的发展及特征》,《东北亚学刊》,2017年,第3期,第52-57页。
[3]丁英顺,《日本老年贫困现状及应对措施》,《日本问题研究》,2017年,第4期,第69-80页。
[4]贡森、葛延风,《福利体制和社会政策的国际比较》,中国发展出版社,2012年9月。
[5]郭爱妹、石盈,《积极老龄化:一种社会建构论观点》,《江海学刊》,2006年,第5期,第124-128页。
[6]冀勇,《日本修改介护保险相关法律》,法制日报,2017年9月18日。
[7]龙朝阳,《新加坡中央公积金模式的实施利弊浅析》,《湖湘公共管理研究(第二卷)》,2010年8月。
[8]林闽钢,《西方“福利社会”的理论和实践——兼论构建中国式的“福利社会”》,《江苏社会科学》,2010年第4期,第46-51页。
[9]林卡、吕浩然,《四种老龄化理念及其政策蕴意》,《浙江大学学报(人文社会科学版)》,2016年,第4期,第74页。
[10]刘涛,《福利多元主义视角下的德国长期照护保险制度研究》,《公共行政评论》,2016年第4期,第68-87、207页。
[11]刘维涛,《民政部:中国养老模式居家为主鼓励多样》,《人民日报》,2005年4月4日。
[12]吕学静,《日本长期护理保险制度最新改革的启示》,《中国人力资源社会保障》,2016年,第4期,第23-25页。
[13]全国老龄工作委员会办公室,《国外涉老政策概览》,华龄出版社,2010年。
[14]世界卫生组织,《2016-2020年老龄化与健康全球战略与行动计划:建设每个人都能健康长寿的世界》,2016年5月,http://apps.who.int/iris/bitstream/handle/10665/254136/A69_ACONF8-ch.pdf;jsessionid=832BAA8DDE1579F5797915F6B7E23B6E?sequence=1.
[15]王莉莉、吴子攀,《英国社会养老服务建设与管理的经验与借鉴》,《老龄科学研究》,2014年,第7期,第61-70页。
[16]王名,李勇,黄浩明,《德国非营利组织》,清华大学出版社,2006年,第53页。
[17]杨楠、胡守忠、贾萍,《国外长期照护保险计划比较分析——以德国、日本为例》,《劳动保障世界》,2013年第2期,第75-77页。
[18]翟绍果等,《长期护理保险核心问题之辨析:日本介护保险的启示》,《西北大学学报(哲学社会科学版)》,2016年,第5期,第116-123页。
[19]中华人民共和国民政部,《养老服务业标准体系框架研究报告》,2013年23月,files2.mca.gov.cn/fss/201312/20131212101001413.doc.
[20]中华人民共和国商务部驻德国经商参处,《德国家政服务业简介》,2016年3月,http://de.mofcom.gov.cn/article/ztdy/201603/20160301268084.shtml.
[21]钟慧澜,《从国家福利到混合福利:瑞典、英国、澳大利亚养老服务市场化改革道路选择及启示》,《经济体制改革》,2016年,第5期,第160-165页。
[22]张志雄、陈琰、孙建娥,《老年人长期照护服务模式研究现状和反思》,《老龄科学研究》2015年,第8期,第28页。
[23]Adam Davey,Bo Malmberg,Gerdt Sundstr?m,Aging in Sweden:Local Variation,Local Control,The Gerontologist.,2014,https://a c a d e m i c.o u p.c o m/g e r o n t o l o g i s t/a r t i c le/54/4/525/650763#94694640.
[24]Amalavoyal V.Chari,John Engberg,Kristin N.Ray,and Ateev Mehrotra.(2015).The Opportunity Costs of Informal Elder-Care in the United States:New Estimates from the American Time Use Survey.Health Services Research,50(3),871-882.
[25]Anderson A.(2012).Europe’s Care Regimes and the Role of Migrant Care Workers Within Them.Journal of Population Ageing,5(2):135-146.
[26]Anneli Anttonen and Olli Karsio.(2017).Marketization from within:changing governance of care services.To be published in Martinelli,Flavia&Anttonen,Anneli&M?tzke,Margitta.
[27]Anttonen,A.and H?iki?,L.(2011).Care"going market":Finnish elderly-care policies in transition.Nordic Journal of Social Research.
[28]Applebaum,Bardo,Robbins.(2013).International Approaches to long-term Services and Supports.http://www.asaging.org/blog/international-approaches-long-term-servicesand-supports.
[29]Bergmark?.Parker M.G.Thorslund M.(2000).Priorities in care and services for elderly people:A path without guidelines?Journal of Medical Ethics,26,312–318.
[30]Bram Sybrandus de Boer.et al.(2015).Living at the farm,innovative nursing home care for people with dementia–study protocol of an observational longitudinal study,BMC Geriatrics,(15),144.
[31]Care Quality Commission,The State of Adult Social Care Services 2014 to 2017:Findings from CQC’s initial Programme of comprehensive inspections in adult social care,2017.http://www.cqc.org.uk/sites/default/files/20170703_ASC_end_of_programme_FINAL2.pdf.
[32]Chari,A.V.,Engberg,J.,Ray,K.N.,&Mehrotra,A.(2015).The Opportunity Costs of Informal Elder-Care in the United States:New Estimates from the American Time Use Survey.Health Services Research,50(3),871–882.
[33]Christine de la Maisonneuve and Joaquim Oliveira Martins.(2014).The Future of Health and Long-term Care Spending,OECD Journal:Economic Studies,https://www.oecd.org/eco/growth/Thefuture-of-health-and-long-term-care-spendingOECD-Journal-Economic-Studies-2014.pdf.
[34]Colombo,F.et al.(2011).Help Wanted?Providing and Paying for Long-Term Care,OECD Health Policy Studies,OECD,Publishing,http://dx.doi.org/10.1787/9789264097759-en.
[35]Dexter Whitfield.(2012).UK Social Services:The mutation of privatisation.Studies in Social Service.https://www.european-services-strategy.org.uk/wp-content/uploads/2012/09/uk-socialservices-mutation-of-privatisation.pdf.
[36]Edebalk.(2010).Ways of Funding and Organising Elderly,in T.Bengtsson,ed.,Population Ageing-A Threat to the Welfare State?,Demographic Research Monographs,DOI10.1007/978-3-642-12612-3_5,#SpringerVerlag Berlin Heidelberg.
[37]Elizabeth Parkin and Carl Baker.(2016).Dementia:policy,services and statistics.researchbriefings.files.parliament.uk/documents/SN07007/SN07007.pdf.
[38]Erica L.Reaves&Mary Beth Musumec.(2015).Medicaid and Long-Term Services and Supports:A Primer,KFF:https://www.kff.org/medicaid/report/medicaid-and-long-termservices-and-supports-a-primer/.
[39]Evashwick,Connie J.(2001).The continuum of long-term care:An integrated systems approach.2nd edition.New York:Delmar Publishers.
[40]Gibson,Mary J.Gregory,Steven R.(2003).Pandya,Sheel M.,Long-Term Care in Developed Nations:A Brief Overview.New York:AARP.
[41]Heinicke,K.,and Thomsen,S.(2010).The Social Long-term Care Insurance in Germany:Origin,Situation,Threats and Perspectives,Center for European Economic Research,Discussion Paper No.10-012.,ftp://ftp.zew.de/pub/zewdocs/dp/dp10012.pdf.
[42]Howard Glennerster.(2009).Understanding the Finace of Welfare:What welfare costs and how to pay for it,Bristol:The Policy Press.
[43]Huber,M.,Rodrigues,R.,Hoffmann,F.,Gasior,K.,&Marin,B.(2009).Facts and figures on long-term care.Europe and North America.Vienna:European Centre for Social Welfare Policy and Research.
[44]Mary Daly.(2012).Making policy for care:experience in Europe and its implications in Asia.International Journal of Sociology and Social Policy,(32),623-635.
[45]Moise,P.,M.Schwarzinger and M.Um.(2004).Dementia Care in 9 OECD Countries:A Comparative Analysis,OECD Health Working Papers,No.13,OECD Publishing,Paris.http://dx.doi.org/10.1787/485700737071.
[46]OECD.(2011).Help Wanted?Providing and Paying for Long-Term Care,Paris,www.oecd.org/health/longtermcare/helpwanted.
[47]OECD.(2015).Addressing Dementia:The OECD Response,OECD Health Policy Studies,OECD Publishing,Paris,http://sci-hub.tw/10.1787/9789264231726-en
[48]OECD.(2017)."Dementia prevalence",in Health at a Glance 2017:OECD Indicators,OECD Publishing,Paris,http://dx.doi.org/10.1787/health_glance-2017-76-en.
[49]OECD/European Commission.(2013).A Good Life in Old Age?Monitoring and Improving Quality in Long-term Care,OECD Health Policy Studies,OECD Publishing,http://dx.doi.org/10.1787/9789264194564-en.
[50]Pavolini&Ranci.(2008).Restructuring the welfare state-reforms in long-term care in Western European countries”,Journal of European Social Policy,18(3):246–259.
[51]Parliament of Australia.(2017).Caring for the Elderly'-an Overview of Aged Care Support and Services in Australia,https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/Publications_Archive/archive/agedcare?print=1.
[52]Paul&Schaeffer.(2017).Long-term care policy-What the United States can learn from Denmark,Sweden,and the Netherlands,Business and Health Administration Association Annual Conference.
[53]Simone R.de Bruin et al.(2015).Green Care Farms:An Innovative Type of Adult Day Service to Stimulate Social Participation of People With Dementia,Gerontal Geriatr Med,
[54]Singh,D.ed.(2016).Long Term Care Policy:Past,Present and Future.In:Effective Management of Long-Term Care Facilities,3rd ed.[online]Jones&Bartlett Learning,LLC,Available at:http://samples.jbpub.com/9780763774035/74035_CH02_5368.pdf.
[55]Stone,R.,Long-Term Care for the Elderly,Washington DC:Urban Institute Press,2011.
[56]Teppo Kr?ger.(2011).Defamilisation,dedomestication and care policy.International Journal of Sociology and Social Policy,31(7/8),424-440.
[57]U.S.Department of Health and Human Services.(2003).State-Based Initiatives to Improve The Recruitment and Retention of the Paraprofessional Long-Term Care Workforce,https://aspe.hhs.gov/system/files/pdf/72731/pltcwf.pdf.
[58]UK Department of Health&Social Care.(2015).2010 to 2015 Government Policy:Dementia,https://www.gov.uk/government/publications/2010-to-2015-government-policydementia/2010-to-2015-government-policydementia.
[59]Wikgren Orstam,A.(2006).Care of the Elderly in Sweden Today,Health and Social Care Division-Swedish Association of Local Authorities and Regions.
[60]World Health Organization.(2012).Active Ageing:A Policy Framework.http://apps.who.int/iris/bitstream/handle/10665/67215/WHO_NMH_NPH_02.8.pdf?sequence=1.
(1)OECD数据库:http://www.oecd.org/els/health-systems/long-term-care.htm。
(1)OECD数据库:http://www.oecd.org/els/health-systems/long-term-care.htm。
(1)CDC:https://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf,appendix table1。
(2)OECD数据库:http://www.oecd.org/els/health-systems/long-term-care.htm。
(3)Swedish Long-Term Eldercare:A Retreat from the Welfare State,MJIL online:http://www.mjilonline.org/swedish-long-term-eldercare-a-retreat-from-the-welfare-state/.
(1)Ministry of Health and Social Affairs,National follow-up to the Regional Implementation Strategy of the Madrid International Plan of Action on Ageing(MIPAA)in Sweden,2016.
(2)OECD数据库:http://www.oecd.org/els/health-systems/long-term-care.htm.
(3)OECD 2009-2010 Questionnaire on long-term care workforce and financing.
(1)OECD数据库:http://www.oecd.org/els/health-systems/long-term-care.htm。
(1)多元混合型养老服务模式在一定程度上是“福利社会”思潮的制度产物。米什拉将“福利社会”笼统地视为“福利多元主义”或“混合福利经济”的同义语。
(1)钱随人走(Money Follows the Person,简称MFP)”计划是2004年小布什总统执政期间“新自由倡议(New Freedom Initiative)”的一部分,计划在之后的5年里由联邦政府划拨专门款项给各州政府,用于支付将老年人从护理院等机构中转出,回到家庭或社区中接受照护服务的一年的全部费用,这个计划的目的就是直接激励长期照护服务由机构提供转向家庭和社区提供。
(2)“Olmstead v.L.C.判例”,指的是1999年7月美国最高法院对Olmstead V.L.C.&E.W.判决一案。L.C.和E.W.是佐治亚州两位患有精神疾病的女性,她们常在精神病治疗机构接受治理。经二人的主治医生确定,二人的精神疾病状况最好在社区而非机构中生活,但是由于缺乏必要的照护,二人即便回到自家所在的社区也无法正常生活。因此,L.C.和E.W.依据残疾人保障法提起对州政府相关部门的诉讼,认为后者未能为残疾人提供可融入社区的生活设施,涉嫌歧视残疾人。美国最高法院基于此案判定,按照《美国残障人士法案》的“融合条款(integration mandate)”要求,各州公共机构必须为有能力的残障人士保持社会融入的机构提供服务,除非该州有能力证明这些举措动摇社会项目的根基。否则就是对残障人士的歧视。
(1)“社会性住院”是指这样一种现象:由于医疗费用的负担低于老人看护设施的负担,许多人选择长期性住院而不愿意到老人看护机构。
(1)“今井事件”发生于2014年的日本神奈川县的一家养老院,名为今井隼人的24岁养老院护理员在两个月内先后将院内居住的三名老人从阳台扔下致死,老人分别为87岁、86岁和96岁,在老人死亡之初都未能发现其真正死因,直到发现这三人均在今井值夜班期间非正常死亡警察才慢慢发现事件真相。来源:新华侨报,《是什么让日本护工将老人残忍扔下楼》,2016年2月18日,http://www.chinanews.com/hb/2016/02-18/7762885.shtml。
(1)Inter RAI是一套由33个国家的研究人员参与开发而成的老年卫生需求评估体系,已有三十余年历史。在欧美,这套体系由一系列用于不同场所的评估工具和一个信息网络平台组成,其目标是通过评估实现对老年人和残疾人卫生服务的有效管理。Inter RAI在欧美各国等应用效果良好。
(1)全国人大相关负责人就“人大监督工作”答问,新华网,http://www.xinhuanet.com/politics/2018lh/zb/20180312b/wzsl.htm,2018年4月12日。
[2]丁英顺,《韩国老年福利制度的发展及特征》,《东北亚学刊》,2017年,第3期,第52-57页。
[3]丁英顺,《日本老年贫困现状及应对措施》,《日本问题研究》,2017年,第4期,第69-80页。
[4]贡森、葛延风,《福利体制和社会政策的国际比较》,中国发展出版社,2012年9月。
[5]郭爱妹、石盈,《积极老龄化:一种社会建构论观点》,《江海学刊》,2006年,第5期,第124-128页。
[6]冀勇,《日本修改介护保险相关法律》,法制日报,2017年9月18日。
[7]龙朝阳,《新加坡中央公积金模式的实施利弊浅析》,《湖湘公共管理研究(第二卷)》,2010年8月。
[8]林闽钢,《西方“福利社会”的理论和实践——兼论构建中国式的“福利社会”》,《江苏社会科学》,2010年第4期,第46-51页。
[9]林卡、吕浩然,《四种老龄化理念及其政策蕴意》,《浙江大学学报(人文社会科学版)》,2016年,第4期,第74页。
[10]刘涛,《福利多元主义视角下的德国长期照护保险制度研究》,《公共行政评论》,2016年第4期,第68-87、207页。
[11]刘维涛,《民政部:中国养老模式居家为主鼓励多样》,《人民日报》,2005年4月4日。
[12]吕学静,《日本长期护理保险制度最新改革的启示》,《中国人力资源社会保障》,2016年,第4期,第23-25页。
[13]全国老龄工作委员会办公室,《国外涉老政策概览》,华龄出版社,2010年。
[14]世界卫生组织,《2016-2020年老龄化与健康全球战略与行动计划:建设每个人都能健康长寿的世界》,2016年5月,http://apps.who.int/iris/bitstream/handle/10665/254136/A69_ACONF8-ch.pdf;jsessionid=832BAA8DDE1579F5797915F6B7E23B6E?sequence=1.
[15]王莉莉、吴子攀,《英国社会养老服务建设与管理的经验与借鉴》,《老龄科学研究》,2014年,第7期,第61-70页。
[16]王名,李勇,黄浩明,《德国非营利组织》,清华大学出版社,2006年,第53页。
[17]杨楠、胡守忠、贾萍,《国外长期照护保险计划比较分析——以德国、日本为例》,《劳动保障世界》,2013年第2期,第75-77页。
[18]翟绍果等,《长期护理保险核心问题之辨析:日本介护保险的启示》,《西北大学学报(哲学社会科学版)》,2016年,第5期,第116-123页。
[19]中华人民共和国民政部,《养老服务业标准体系框架研究报告》,2013年23月,files2.mca.gov.cn/fss/201312/20131212101001413.doc.
[20]中华人民共和国商务部驻德国经商参处,《德国家政服务业简介》,2016年3月,http://de.mofcom.gov.cn/article/ztdy/201603/20160301268084.shtml.
[21]钟慧澜,《从国家福利到混合福利:瑞典、英国、澳大利亚养老服务市场化改革道路选择及启示》,《经济体制改革》,2016年,第5期,第160-165页。
[22]张志雄、陈琰、孙建娥,《老年人长期照护服务模式研究现状和反思》,《老龄科学研究》2015年,第8期,第28页。
[23]Adam Davey,Bo Malmberg,Gerdt Sundstr?m,Aging in Sweden:Local Variation,Local Control,The Gerontologist.,2014,https://a c a d e m i c.o u p.c o m/g e r o n t o l o g i s t/a r t i c le/54/4/525/650763#94694640.
[24]Amalavoyal V.Chari,John Engberg,Kristin N.Ray,and Ateev Mehrotra.(2015).The Opportunity Costs of Informal Elder-Care in the United States:New Estimates from the American Time Use Survey.Health Services Research,50(3),871-882.
[25]Anderson A.(2012).Europe’s Care Regimes and the Role of Migrant Care Workers Within Them.Journal of Population Ageing,5(2):135-146.
[26]Anneli Anttonen and Olli Karsio.(2017).Marketization from within:changing governance of care services.To be published in Martinelli,Flavia&Anttonen,Anneli&M?tzke,Margitta.
[27]Anttonen,A.and H?iki?,L.(2011).Care"going market":Finnish elderly-care policies in transition.Nordic Journal of Social Research.
[28]Applebaum,Bardo,Robbins.(2013).International Approaches to long-term Services and Supports.http://www.asaging.org/blog/international-approaches-long-term-servicesand-supports.
[29]Bergmark?.Parker M.G.Thorslund M.(2000).Priorities in care and services for elderly people:A path without guidelines?Journal of Medical Ethics,26,312–318.
[30]Bram Sybrandus de Boer.et al.(2015).Living at the farm,innovative nursing home care for people with dementia–study protocol of an observational longitudinal study,BMC Geriatrics,(15),144.
[31]Care Quality Commission,The State of Adult Social Care Services 2014 to 2017:Findings from CQC’s initial Programme of comprehensive inspections in adult social care,2017.http://www.cqc.org.uk/sites/default/files/20170703_ASC_end_of_programme_FINAL2.pdf.
[32]Chari,A.V.,Engberg,J.,Ray,K.N.,&Mehrotra,A.(2015).The Opportunity Costs of Informal Elder-Care in the United States:New Estimates from the American Time Use Survey.Health Services Research,50(3),871–882.
[33]Christine de la Maisonneuve and Joaquim Oliveira Martins.(2014).The Future of Health and Long-term Care Spending,OECD Journal:Economic Studies,https://www.oecd.org/eco/growth/Thefuture-of-health-and-long-term-care-spendingOECD-Journal-Economic-Studies-2014.pdf.
[34]Colombo,F.et al.(2011).Help Wanted?Providing and Paying for Long-Term Care,OECD Health Policy Studies,OECD,Publishing,http://dx.doi.org/10.1787/9789264097759-en.
[35]Dexter Whitfield.(2012).UK Social Services:The mutation of privatisation.Studies in Social Service.https://www.european-services-strategy.org.uk/wp-content/uploads/2012/09/uk-socialservices-mutation-of-privatisation.pdf.
[36]Edebalk.(2010).Ways of Funding and Organising Elderly,in T.Bengtsson,ed.,Population Ageing-A Threat to the Welfare State?,Demographic Research Monographs,DOI10.1007/978-3-642-12612-3_5,#SpringerVerlag Berlin Heidelberg.
[37]Elizabeth Parkin and Carl Baker.(2016).Dementia:policy,services and statistics.researchbriefings.files.parliament.uk/documents/SN07007/SN07007.pdf.
[38]Erica L.Reaves&Mary Beth Musumec.(2015).Medicaid and Long-Term Services and Supports:A Primer,KFF:https://www.kff.org/medicaid/report/medicaid-and-long-termservices-and-supports-a-primer/.
[39]Evashwick,Connie J.(2001).The continuum of long-term care:An integrated systems approach.2nd edition.New York:Delmar Publishers.
[40]Gibson,Mary J.Gregory,Steven R.(2003).Pandya,Sheel M.,Long-Term Care in Developed Nations:A Brief Overview.New York:AARP.
[41]Heinicke,K.,and Thomsen,S.(2010).The Social Long-term Care Insurance in Germany:Origin,Situation,Threats and Perspectives,Center for European Economic Research,Discussion Paper No.10-012.,ftp://ftp.zew.de/pub/zewdocs/dp/dp10012.pdf.
[42]Howard Glennerster.(2009).Understanding the Finace of Welfare:What welfare costs and how to pay for it,Bristol:The Policy Press.
[43]Huber,M.,Rodrigues,R.,Hoffmann,F.,Gasior,K.,&Marin,B.(2009).Facts and figures on long-term care.Europe and North America.Vienna:European Centre for Social Welfare Policy and Research.
[44]Mary Daly.(2012).Making policy for care:experience in Europe and its implications in Asia.International Journal of Sociology and Social Policy,(32),623-635.
[45]Moise,P.,M.Schwarzinger and M.Um.(2004).Dementia Care in 9 OECD Countries:A Comparative Analysis,OECD Health Working Papers,No.13,OECD Publishing,Paris.http://dx.doi.org/10.1787/485700737071.
[46]OECD.(2011).Help Wanted?Providing and Paying for Long-Term Care,Paris,www.oecd.org/health/longtermcare/helpwanted.
[47]OECD.(2015).Addressing Dementia:The OECD Response,OECD Health Policy Studies,OECD Publishing,Paris,http://sci-hub.tw/10.1787/9789264231726-en
[48]OECD.(2017)."Dementia prevalence",in Health at a Glance 2017:OECD Indicators,OECD Publishing,Paris,http://dx.doi.org/10.1787/health_glance-2017-76-en.
[49]OECD/European Commission.(2013).A Good Life in Old Age?Monitoring and Improving Quality in Long-term Care,OECD Health Policy Studies,OECD Publishing,http://dx.doi.org/10.1787/9789264194564-en.
[50]Pavolini&Ranci.(2008).Restructuring the welfare state-reforms in long-term care in Western European countries”,Journal of European Social Policy,18(3):246–259.
[51]Parliament of Australia.(2017).Caring for the Elderly'-an Overview of Aged Care Support and Services in Australia,https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/Publications_Archive/archive/agedcare?print=1.
[52]Paul&Schaeffer.(2017).Long-term care policy-What the United States can learn from Denmark,Sweden,and the Netherlands,Business and Health Administration Association Annual Conference.
[53]Simone R.de Bruin et al.(2015).Green Care Farms:An Innovative Type of Adult Day Service to Stimulate Social Participation of People With Dementia,Gerontal Geriatr Med,
[54]Singh,D.ed.(2016).Long Term Care Policy:Past,Present and Future.In:Effective Management of Long-Term Care Facilities,3rd ed.[online]Jones&Bartlett Learning,LLC,Available at:http://samples.jbpub.com/9780763774035/74035_CH02_5368.pdf.
[55]Stone,R.,Long-Term Care for the Elderly,Washington DC:Urban Institute Press,2011.
[56]Teppo Kr?ger.(2011).Defamilisation,dedomestication and care policy.International Journal of Sociology and Social Policy,31(7/8),424-440.
[57]U.S.Department of Health and Human Services.(2003).State-Based Initiatives to Improve The Recruitment and Retention of the Paraprofessional Long-Term Care Workforce,https://aspe.hhs.gov/system/files/pdf/72731/pltcwf.pdf.
[58]UK Department of Health&Social Care.(2015).2010 to 2015 Government Policy:Dementia,https://www.gov.uk/government/publications/2010-to-2015-government-policydementia/2010-to-2015-government-policydementia.
[59]Wikgren Orstam,A.(2006).Care of the Elderly in Sweden Today,Health and Social Care Division-Swedish Association of Local Authorities and Regions.
[60]World Health Organization.(2012).Active Ageing:A Policy Framework.http://apps.who.int/iris/bitstream/handle/10665/67215/WHO_NMH_NPH_02.8.pdf?sequence=1.
(1)OECD数据库:http://www.oecd.org/els/health-systems/long-term-care.htm。
(1)OECD数据库:http://www.oecd.org/els/health-systems/long-term-care.htm。
(1)CDC:https://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf,appendix table1。
(2)OECD数据库:http://www.oecd.org/els/health-systems/long-term-care.htm。
(3)Swedish Long-Term Eldercare:A Retreat from the Welfare State,MJIL online:http://www.mjilonline.org/swedish-long-term-eldercare-a-retreat-from-the-welfare-state/.
(1)Ministry of Health and Social Affairs,National follow-up to the Regional Implementation Strategy of the Madrid International Plan of Action on Ageing(MIPAA)in Sweden,2016.
(2)OECD数据库:http://www.oecd.org/els/health-systems/long-term-care.htm.
(3)OECD 2009-2010 Questionnaire on long-term care workforce and financing.
(1)OECD数据库:http://www.oecd.org/els/health-systems/long-term-care.htm。
(1)多元混合型养老服务模式在一定程度上是“福利社会”思潮的制度产物。米什拉将“福利社会”笼统地视为“福利多元主义”或“混合福利经济”的同义语。
(1)钱随人走(Money Follows the Person,简称MFP)”计划是2004年小布什总统执政期间“新自由倡议(New Freedom Initiative)”的一部分,计划在之后的5年里由联邦政府划拨专门款项给各州政府,用于支付将老年人从护理院等机构中转出,回到家庭或社区中接受照护服务的一年的全部费用,这个计划的目的就是直接激励长期照护服务由机构提供转向家庭和社区提供。
(2)“Olmstead v.L.C.判例”,指的是1999年7月美国最高法院对Olmstead V.L.C.&E.W.判决一案。L.C.和E.W.是佐治亚州两位患有精神疾病的女性,她们常在精神病治疗机构接受治理。经二人的主治医生确定,二人的精神疾病状况最好在社区而非机构中生活,但是由于缺乏必要的照护,二人即便回到自家所在的社区也无法正常生活。因此,L.C.和E.W.依据残疾人保障法提起对州政府相关部门的诉讼,认为后者未能为残疾人提供可融入社区的生活设施,涉嫌歧视残疾人。美国最高法院基于此案判定,按照《美国残障人士法案》的“融合条款(integration mandate)”要求,各州公共机构必须为有能力的残障人士保持社会融入的机构提供服务,除非该州有能力证明这些举措动摇社会项目的根基。否则就是对残障人士的歧视。
(1)“社会性住院”是指这样一种现象:由于医疗费用的负担低于老人看护设施的负担,许多人选择长期性住院而不愿意到老人看护机构。
(1)“今井事件”发生于2014年的日本神奈川县的一家养老院,名为今井隼人的24岁养老院护理员在两个月内先后将院内居住的三名老人从阳台扔下致死,老人分别为87岁、86岁和96岁,在老人死亡之初都未能发现其真正死因,直到发现这三人均在今井值夜班期间非正常死亡警察才慢慢发现事件真相。来源:新华侨报,《是什么让日本护工将老人残忍扔下楼》,2016年2月18日,http://www.chinanews.com/hb/2016/02-18/7762885.shtml。
(1)Inter RAI是一套由33个国家的研究人员参与开发而成的老年卫生需求评估体系,已有三十余年历史。在欧美,这套体系由一系列用于不同场所的评估工具和一个信息网络平台组成,其目标是通过评估实现对老年人和残疾人卫生服务的有效管理。Inter RAI在欧美各国等应用效果良好。
(1)全国人大相关负责人就“人大监督工作”答问,新华网,http://www.xinhuanet.com/politics/2018lh/zb/20180312b/wzsl.htm,2018年4月12日。