人口老龄化对长期照护体系的影响探析
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摘要
在我国人口老龄化已是一个不争的事实。据2009年度民政事业发展统计报告显示,当年我国65岁及以上老年人口达到1.13亿,占总人口的8.5%。在我国人口老龄化高速增长的同时,高龄化的趋势也非常明显。《2009年度中国老龄事业发展统计公报》显示80岁以上高龄老年人口达到1899万,且今后每年以100万速度增加。笔者根据2000年人口五普数据、2005年人口抽样调查数据及历年人口抽样调查数据保守估计到本世纪中叶,我国65岁及以上老年人口将达到3.1亿,从而步入世界人口老龄化的最高行列。
我国人口老龄化、高龄化的同时,我国老年人群体的健康状态不容乐观。在这种情况下,我国老年长期照料需求呈现加速增长趋势。那么到本世纪中叶,我国需要长期照护的老人规模是多少?其特点又是什么?在经济学中,精确分析与预测未来市场供需及分布,是有效发展与规划相关体系的重要基石。运用于此处,笔者认为精确预测未来需要长期照料老年人口规模非常重要,因为这是长期照料体系规划工作的基础。
Population aging in China is an indisputable fact.According to 2009 statistical report conducted by Development of Civil Affairs shows that, our elderly population aged 65 and over to reach 113 million of the total population of 8.5%.With the rapid population aging in China's growth, the elderly aging trend is also very obvious."2009 Statistical Bulletin of China Aging Development" shows that the elderly population over the age of 80 have reached 18.99 million, and the future rate of increase of 100 million per year. According to the author predicted that by mid-century of 21st the elderly population aged 65 and over will reach 3.1 billions. Then China will get into the highest ranks of the aging population in the world.
Since the start of family planning, the last century, population control in China has made remarkable achievements. Since the 90 years the birth rate has fallen below the population replacement level. With the first generation of one-child parents into old age, elderly empty-nest families will further increase created a significant challenge to the traditional home care.
The health of the elderly population, aging at the same time, is not very good. In this case, needs of elderly long-term care have showed accelerated growth trend. By the middle of this century, how many elderly people need long-term care in our country and what's their characterization?
我国人口老龄化、高龄化的同时,我国老年人群体的健康状态不容乐观。在这种情况下,我国老年长期照料需求呈现加速增长趋势。那么到本世纪中叶,我国需要长期照护的老人规模是多少?其特点又是什么?在经济学中,精确分析与预测未来市场供需及分布,是有效发展与规划相关体系的重要基石。运用于此处,笔者认为精确预测未来需要长期照料老年人口规模非常重要,因为这是长期照料体系规划工作的基础。
Population aging in China is an indisputable fact.According to 2009 statistical report conducted by Development of Civil Affairs shows that, our elderly population aged 65 and over to reach 113 million of the total population of 8.5%.With the rapid population aging in China's growth, the elderly aging trend is also very obvious."2009 Statistical Bulletin of China Aging Development" shows that the elderly population over the age of 80 have reached 18.99 million, and the future rate of increase of 100 million per year. According to the author predicted that by mid-century of 21st the elderly population aged 65 and over will reach 3.1 billions. Then China will get into the highest ranks of the aging population in the world.
Since the start of family planning, the last century, population control in China has made remarkable achievements. Since the 90 years the birth rate has fallen below the population replacement level. With the first generation of one-child parents into old age, elderly empty-nest families will further increase created a significant challenge to the traditional home care.
The health of the elderly population, aging at the same time, is not very good. In this case, needs of elderly long-term care have showed accelerated growth trend. By the middle of this century, how many elderly people need long-term care in our country and what's their characterization?
引文
[1]. 乌沧萍.社会老年学.中国人民大学出版社.2003(2)：386-491.
[2]. 乌沧萍,姜向群.老年学概论.中国人民大学出版社.2006(5)：236-254.
[3]. 乔晓春,李建民,陈卫,段成荣,穆光宗,朱国宏.人口学教程.人民教育出版社.2001(2)：34-106.
[4].温勇,尹勤,帅友良.人口统计学.东南大学出版社.2006(1)：60-295.
[5]. 李竞能.现代西方人口理论.2004(1)：101-134.
[6]. 曾毅.人口分析方法与应用.北京大学出版社.1989(1)：47-72.
[7]. 乔晓春.人口普查资料分析技术.中国人口出版社.1991(1)：434-476.
[8]. 黄荣清.人口分析技术.北京经济学院出版社.1989(1)：111-143.
[9]. 顾大男,曾毅.1992～2002年中国老年人生活自理能力变化研究.人口与经济.2006(4)：9-13.
[10].李强,杜鹏.1994～2004年中国老年人的生活自理预期寿命及其变化析[J].人口研究.2006(5)：9-16.
[11].汤哲,项曼君,方向华.北京市不同社会经济状况老年人的预期寿命和健康预期寿命.中国临床康复.2004(30)：6569-6571.
[12].贾云竹.北京市城市老年人对社区助老服务的需求研究.人口研究.2002(2)：44-48.
[13].倪荣,刘新功,朱晨曦.城市失能老人长期照料现状及对策.卫生经济研究.2010(7)：39-41.
[14].曾毅,顾大男,凯·兰德.健康期望寿命估算方法的拓展及其在中国高龄老人研究中的应用.中国人口科学.2007(6)：1-12.
[15].顾大男,曾毅,柳玉芝.健康预期寿命计算方法述评.市场与人口分析.2001(4)：9-17.
[16].顾大男.中国高龄老人生活自理能力多变量多状态生命表分析.人口与经济.2004(4)：15-21.
[17].蒋承,顾大男,柳玉芝,曾毅.中国老年人照料成本研究——多状态生命表方法.中国人口资源与环境.2009(3)：81-88.
[18].姜小鹰.北欧老年护理的发展及启示.心血管康复医学杂志,2000(5)：82-83.
[19].宋洁,刘金凤,崔宁.空巢老人家庭护理需求状况及影响因素分析.护理学杂志,2008(11)：16-17.
[20].刘乃睿,于新循.论我国孝道传统下老年人长期照护制度的构建.西南大学学报,2008(5)：106-110.
[21].谷琳,杜鹏.我国老年人健康自评的差异性分析—基于2002年和2005年全国老年跟踪调查数据.南方人口,2007(2)：58-64.
[22].尹德挺.中国高龄老人生活自理能力纵向动态研究.人口学刊,2007(6)：27-32.
[23].廖少宏.老年人照料需求与照料费用研究综述.山东工商学院学报,2010(6)：96-99.
[24].黄成礼.北京市老年人口长期护理需求分析.卫生经济研究,2005(4)：28-30.
[25].吴蓓,徐勤.城市社区长期照料体系的现状与问题——以上海为例.地理研究,人口研究,2007(3)：61-68.
[26].人口研究编辑部.发展老龄产业：应对人口老龄化的一项重要战略.人口研究,2001(2)：28-40.
[27].杜本峰,沈航.老年人口的长期护理服务需求及产业发展模式略探.经济问题探索,2008(3)：34-38.
[28].顾大男.老年人健康变动趋势和预测方法国际研究动态.中国人口科学,2005(3)：81-86.
[29].刘鹏飞.老年照料需求与成本——文献回顾与评述.中国医药指南,2009(7)：33-35.
[30].姜晶梅,孙国强,张承训.我国农村老年人生活自理能力受损情况分析.现代预防医学,2001(1)：119-122.
[31].李波,姜全保.基于五普数据对四普数据质量的估计.西北人口,2010(3)：37-40.
[32].李树茁,姜全保,孙福滨.“五普”人口总量和结构的分析与调整.人口学刊,2006(5)：3-8.
[33]. Heffler S, Smith S, Keehan S, et al.U. S. Health spending projections for 2004-2014[J]. Health Affairs,2005,5:74-85.
[34]. Manton KG, Gu XL, Lamb VL. Change in chronic disability from 1982 to 2004/2005 as measured by long term changes in function and health in the U.S. elderly population[J]. PNAS,2006,103:18374-18379.
[35]. Crimmins E. M, Trend in the Health of the Elderly.Annual Review of Public health,2004,25:79-98.
[36]. Joshua M. Wiener, Jane Tilly, Anna Howe, etal. Quality assurance for Long-Term Care:The Experiences of England, Australia, Gerrnany and Japan[DB/OL], http://assets.aarp.org/rgcenter/il/2007_05_1tc.pdf
[37]. Staicovici S. Respite Care for All Family Caregiver s:The Lifespan Respite Care Act[J]. Journal of Contemporary Healt h Law and Policy,2003,20:243-272.
[38]. Alemayehu B, Warner KE. The life-time distribution of healthcare costs [J]. Health Services Research,2004,39:627-642.
[39]. Giustra FC, Crowley A, Gorin SH. Crisis in Care-giving:a Call to Action[J]. Health and Social Work,2002,27:307-311.
[40]. Gibson MJS, Gregory SR, Pandya SM. Long-term Care in Developed Nations:A Brief Overview[J]. American Association of Retirement Association,2003.
[41]. Gu, D., Dupre, M. E., and Liu, G. Characteristics of the institutionalized and community-residing oldest-old in China. Social Science & Medicine. 2007,64:871-883.
[42]. Wachterman, M. W., and Sommers, B. D. The impact of gender and marital status on end-of-life care:Evidence f rom the National Mortality Follow-back Survey. Journal of Palliative Medicine,2006,9(2),343-52
[43]. Shugarman, L. R. et al. Differences in Medicare expenditures during the last 3 years of life. Journal of General Internal Medicine,2004,19 (2),127-135.
[44]. Chiu. L., Tang. K. Y., and Liu Y. H. Cost analyses of homecare and nursing home services in the southern Taiwan Area. Public Health Nursing,2000,17(5):325-335.
[45]. Gu, D. and Vlosky, D. A. Long-term care and it s related issues in China. In J anet B. Garner and Thelma C. Christiansen (eds.). Social Sciences in Health Care and Medicine.2008:51-84.
[46]. Shugarman, L. R. et al. Differences in Medicare expenditures during the last 3 years of life. Journal of General Internal Medicine,2004,19 (2),127-135.
[47]. Zeng, Y., Gu, D., Land, K. C. Correcting underestimation of disabled life expectancy:Methodology and application, In Y. Zeng, E. Crimmins, Y. Carrie re, and J-M. Robine (eds.). Longer Life and Healthy Aging. Netherlands Springer.2005,49-70.
[48]. Mui AC, Bumette D. Long-term care services used by frail elders:Is ethnicity a factor? [J]. The Gerontologist,1994,34:190-198.
[49]. Norgard TM, Rodgers WL. Patterns of in-home care among elderly Black and White Americans[J]. J Gerontol,1997,52:93-101.
[2]. 乌沧萍,姜向群.老年学概论.中国人民大学出版社.2006(5)：236-254.
[3]. 乔晓春,李建民,陈卫,段成荣,穆光宗,朱国宏.人口学教程.人民教育出版社.2001(2)：34-106.
[4].温勇,尹勤,帅友良.人口统计学.东南大学出版社.2006(1)：60-295.
[5]. 李竞能.现代西方人口理论.2004(1)：101-134.
[6]. 曾毅.人口分析方法与应用.北京大学出版社.1989(1)：47-72.
[7]. 乔晓春.人口普查资料分析技术.中国人口出版社.1991(1)：434-476.
[8]. 黄荣清.人口分析技术.北京经济学院出版社.1989(1)：111-143.
[9]. 顾大男,曾毅.1992～2002年中国老年人生活自理能力变化研究.人口与经济.2006(4)：9-13.
[10].李强,杜鹏.1994～2004年中国老年人的生活自理预期寿命及其变化析[J].人口研究.2006(5)：9-16.
[11].汤哲,项曼君,方向华.北京市不同社会经济状况老年人的预期寿命和健康预期寿命.中国临床康复.2004(30)：6569-6571.
[12].贾云竹.北京市城市老年人对社区助老服务的需求研究.人口研究.2002(2)：44-48.
[13].倪荣,刘新功,朱晨曦.城市失能老人长期照料现状及对策.卫生经济研究.2010(7)：39-41.
[14].曾毅,顾大男,凯·兰德.健康期望寿命估算方法的拓展及其在中国高龄老人研究中的应用.中国人口科学.2007(6)：1-12.
[15].顾大男,曾毅,柳玉芝.健康预期寿命计算方法述评.市场与人口分析.2001(4)：9-17.
[16].顾大男.中国高龄老人生活自理能力多变量多状态生命表分析.人口与经济.2004(4)：15-21.
[17].蒋承,顾大男,柳玉芝,曾毅.中国老年人照料成本研究——多状态生命表方法.中国人口资源与环境.2009(3)：81-88.
[18].姜小鹰.北欧老年护理的发展及启示.心血管康复医学杂志,2000(5)：82-83.
[19].宋洁,刘金凤,崔宁.空巢老人家庭护理需求状况及影响因素分析.护理学杂志,2008(11)：16-17.
[20].刘乃睿,于新循.论我国孝道传统下老年人长期照护制度的构建.西南大学学报,2008(5)：106-110.
[21].谷琳,杜鹏.我国老年人健康自评的差异性分析—基于2002年和2005年全国老年跟踪调查数据.南方人口,2007(2)：58-64.
[22].尹德挺.中国高龄老人生活自理能力纵向动态研究.人口学刊,2007(6)：27-32.
[23].廖少宏.老年人照料需求与照料费用研究综述.山东工商学院学报,2010(6)：96-99.
[24].黄成礼.北京市老年人口长期护理需求分析.卫生经济研究,2005(4)：28-30.
[25].吴蓓,徐勤.城市社区长期照料体系的现状与问题——以上海为例.地理研究,人口研究,2007(3)：61-68.
[26].人口研究编辑部.发展老龄产业：应对人口老龄化的一项重要战略.人口研究,2001(2)：28-40.
[27].杜本峰,沈航.老年人口的长期护理服务需求及产业发展模式略探.经济问题探索,2008(3)：34-38.
[28].顾大男.老年人健康变动趋势和预测方法国际研究动态.中国人口科学,2005(3)：81-86.
[29].刘鹏飞.老年照料需求与成本——文献回顾与评述.中国医药指南,2009(7)：33-35.
[30].姜晶梅,孙国强,张承训.我国农村老年人生活自理能力受损情况分析.现代预防医学,2001(1)：119-122.
[31].李波,姜全保.基于五普数据对四普数据质量的估计.西北人口,2010(3)：37-40.
[32].李树茁,姜全保,孙福滨.“五普”人口总量和结构的分析与调整.人口学刊,2006(5)：3-8.
[33]. Heffler S, Smith S, Keehan S, et al.U. S. Health spending projections for 2004-2014[J]. Health Affairs,2005,5:74-85.
[34]. Manton KG, Gu XL, Lamb VL. Change in chronic disability from 1982 to 2004/2005 as measured by long term changes in function and health in the U.S. elderly population[J]. PNAS,2006,103:18374-18379.
[35]. Crimmins E. M, Trend in the Health of the Elderly.Annual Review of Public health,2004,25:79-98.
[36]. Joshua M. Wiener, Jane Tilly, Anna Howe, etal. Quality assurance for Long-Term Care:The Experiences of England, Australia, Gerrnany and Japan[DB/OL], http://assets.aarp.org/rgcenter/il/2007_05_1tc.pdf
[37]. Staicovici S. Respite Care for All Family Caregiver s:The Lifespan Respite Care Act[J]. Journal of Contemporary Healt h Law and Policy,2003,20:243-272.
[38]. Alemayehu B, Warner KE. The life-time distribution of healthcare costs [J]. Health Services Research,2004,39:627-642.
[39]. Giustra FC, Crowley A, Gorin SH. Crisis in Care-giving:a Call to Action[J]. Health and Social Work,2002,27:307-311.
[40]. Gibson MJS, Gregory SR, Pandya SM. Long-term Care in Developed Nations:A Brief Overview[J]. American Association of Retirement Association,2003.
[41]. Gu, D., Dupre, M. E., and Liu, G. Characteristics of the institutionalized and community-residing oldest-old in China. Social Science & Medicine. 2007,64:871-883.
[42]. Wachterman, M. W., and Sommers, B. D. The impact of gender and marital status on end-of-life care:Evidence f rom the National Mortality Follow-back Survey. Journal of Palliative Medicine,2006,9(2),343-52
[43]. Shugarman, L. R. et al. Differences in Medicare expenditures during the last 3 years of life. Journal of General Internal Medicine,2004,19 (2),127-135.
[44]. Chiu. L., Tang. K. Y., and Liu Y. H. Cost analyses of homecare and nursing home services in the southern Taiwan Area. Public Health Nursing,2000,17(5):325-335.
[45]. Gu, D. and Vlosky, D. A. Long-term care and it s related issues in China. In J anet B. Garner and Thelma C. Christiansen (eds.). Social Sciences in Health Care and Medicine.2008:51-84.
[46]. Shugarman, L. R. et al. Differences in Medicare expenditures during the last 3 years of life. Journal of General Internal Medicine,2004,19 (2),127-135.
[47]. Zeng, Y., Gu, D., Land, K. C. Correcting underestimation of disabled life expectancy:Methodology and application, In Y. Zeng, E. Crimmins, Y. Carrie re, and J-M. Robine (eds.). Longer Life and Healthy Aging. Netherlands Springer.2005,49-70.
[48]. Mui AC, Bumette D. Long-term care services used by frail elders:Is ethnicity a factor? [J]. The Gerontologist,1994,34:190-198.
[49]. Norgard TM, Rodgers WL. Patterns of in-home care among elderly Black and White Americans[J]. J Gerontol,1997,52:93-101.