金融学院知识库

随着我国人口老龄化趋势加剧和预期寿命的延长，失能人口数量持续增长，从而对长期护理的需求呈上升态势。当前，传统的家庭照护功能弱化、社会保障程度不足等问题凸显，农村失能老人的长期护理需求无法得到有效保障，亟需构建系统的长期护理保险来确保护理资源的有效供给。

文章首先从筹资机制、给付标准和服务形式三个方面，对我国26个试点地区长期护理保险的现状进行总结与分析，为后文测算农村长期护理保险需求规模及筹资路径奠定基础。其次，通过2015和2018年CHARLS 关于农村老人的追踪调查数据，采用Markov模型测算农村老人健康转移概率矩阵，预测农村老年失能人口规模，并在26个试点地区现行政策的基础上预测出在低、中、高方案下农村长期护理保险需求规模。再次，通过ILO模型预测了2023—2035年低、中、高方案下政府对农村长期护理保险的财政支持力度和农村居民个人的缴费率。研究结果表明：（1）未来农村失能老年人口规模将逐步扩大，从年龄分布看，65—69岁组的失能人口数量最多；（2）在年龄相同的情况下，健康转移概率性别差异显著，女性失能转移概率相对男性更高；（3）农村长期护理保险需求规模持续攀升；（4）现有试点城市长期护理保险的筹资率短期内合理，但长远看来筹资比例偏低将不能有效满足农村失能老人对长期护理保险的需求。

针对我国农村老年人失能程度加深和长期护理保险发展需求，文章提出以下政策建议：首先，应重点关注农村老人中的失能群体，努力改善其身体状况，防止其病情恶化至重度失能。通过有效措施延缓轻度失能老人向重度失能的转变，从而减轻长期护理保险基金的负担。其次，在推动长期护理保险发展方面，应加快试点政策的实施进程，确保其在各地区得到有效推广。在此基础上，进一步加强对农村居民的长期护理保障，确保广大农村老年人能够享受到应有的护理服务。最后，为保障长期护理保险的可持续发展，需要探索多元化且可持续的筹资路径。可通过拓宽筹资渠道、优化筹资结构，来确保长期护理保险有足够的资金支持，以满足不断增长的护理需求。

With the increasing trend of population aging and the extension of life expectancy in China, the number of disabled people continues to grow, so the demand for long-term care is on the rise. At present, the traditional family care function is weakened, and the degree of social security is insufficient. The long-term care needs of the rural disabled elderly cannot be effectively guaranteed. It is urgent to build a systematic long-term care insurance to ensure the effective supply of nursing resources.

Firstly, this paper summarizes and analyzes the current situation of long-term care insurance in 26 pilot areas in China from three aspects : financing mechanism, payment standard and service form, which lays a foundation for calculating the demand scale and financing path of rural long-term care insurance. Secondly, through the tracking survey data of CHARLS on rural elderly in 2015 and 2018, the Markov model is used to calculate the health transfer probability matrix of rural elderly, and the scale of rural elderly disabled population is predicted. Based on the current policies of 26 pilot areas, the scale of rural long-term care insurance demand under low, medium and high schemes is predicted. Thirdly, through the ILO model, the government 's financial support for rural long-term care insurance and the individual contribution rate of rural residents under the low, medium and high programs from 2023 to 2035 are predicted. The results show that : (1) In the future, the size of the rural disabled elderly population will gradually expand. From the perspective of age distribution, the number of disabled people in the 65-69 age group is the largest. (2) In the case of the same age, the gender difference of health transition probability is significant, and the probability of female disability transition is higher than that of male. (3) The demand scale of rural long-term care insurance continues to rise ; (4) The financing rate of long-term care insurance in the existing pilot cities is reasonable in the short term, but in the long run, the financing is reasonable.

 In view of the deepening of the disability of the rural elderly in China and the development needs of long-term care insurance, the article puts forward the following policy recommendations: First of all, we should focus on the disabled groups in the rural elderly, strive to improve their physical condition, and prevent their condition from deteriorating to severe disability. Through effective measures to delay the transition from mild disability to severe disability, so as to reduce the burden of long-term care insurance fund. Secondly, in promoting the development of long-term care insurance, the implementation process of the pilot policy should be accelerated to ensure its effective promotion in various regions. On this basis, to further strengthen the long-term care of rural residents to ensure that the majority of rural elderly can enjoy the proper care services. Finally, in order to ensure the sustainable development of long-term care insurance, it is necessary to explore diversified and sustainable financing paths. By broadening the financing channels and optimizing the financing structure, we can ensure that long-term care insurance has sufficient financial support to meet the growing demand for care.