“医养融合”养老服务:概念内涵、掣肘因素及推动路径

"医养融合"养老模式是社会养老服务体系发展新动向,是医疗服务和养老服务发展的契合,是把老年群体日常照料和医疗关怀相融合的新型"养老—护理"服务模式,其理论核心是福利多元主义理论。"医养融合"养老服务内涵由内容体系、结构体系、层次体系及服务体系构成。而管理结构分离、功能定位迷茫、主体参与动力不足及专业基础缺乏是制约"医养融合"养老服务发展的因素。因此,要理顺"医养融合"养老服务关系,理性开展"医养融合"养老服务方式,逐步建立"医养融合"养老服务的政策支持体系,不断改善"医养融合"养老服务的专业环境。     

我国现阶段城郊地区养老服务问题研究北大核心CSSCI

城郊农村经济发展水平较高,发展社区养老服务不仅具有老年群体的强烈现实需求,而且也有良好的经济条件和适宜的人文社会环境支持。但是,城郊农村社区养老服务存在供需之间不平衡的现象,反映了我国在养老服务领域的缺乏必要的思想准备和政策支持。要促进城郊农村社区养老服务的发展,首先需要对社区养老服务从理论和政策以及运行机制进行深入研究,在全社会形成一个科学的共识,消除对社会养老服务发展的思想障碍。其次,政府应承担推进和引导社区养老服务发展的责任。社区养老服务具有公共产品的性质,政府不仅要为此提供法律保障的环境,而且需要拿出相应的财政资金给予支持,并及时地总结城郊农村社区的经验,为更加广泛的扩大推广营造氛围。再次,从市场经济的效率原则出发,还必须充分利用家庭、社区、社会等各种资源,给农村居民提供多层次、多形式、多渠道的养老服务。最后,需要大力培养相关领域的专业人才。     

社会分层视角下城市社区养老需求探析

老年人群不是一个同质性的群体,其内部具有很大的差异性,不同老年群体阶层受其主客观条件的限制,对社区养老服务的需求自然也不同.本文以社会分层为视角,尝试将老年社会分层与社区养老服务相结合,根据我国国情和老年人口的特征,将其分为四个阶层,以实证研究的研究方法来探究不同阶层老年群体的需求.     

完善社会养老服务体系的五个重点问题

我国社会养老服务体系建设仍处于起步阶段,存在服务供需矛盾突出、设施布局规划不合理、管理运行机制不规范、优惠政策执行落实乏力等问题。随着老龄化问题日益加深,应建立健全以服务主体、设施、管理、人才队伍和政策为五大支撑的体系,更新传统养老方式,创新养老内涵,发展多方位、多层次的、满足不同需要的、可持续发展的社会养老服务体系,形成产业服务与个性服务、市场服务与福利服务、营利性服务与公益性服务互为补充的格局,满足老年群体的实际需求。     

城市独居老人"邻里守望"助老机制研究

自2000年迈入老龄化社会之后,我国人口老龄化的程度持续加深.独居老人作为老龄人口中的特殊群体,其养老问题变得日益严峻."邻里守望"助老机制是城市独居老人养老照料的辅助形式,主张邻里之间及志愿者为独居老人提供养老志愿服务.文章通过分析城市独居老人"邻里守望"助老机制发展的可行性,倡导在全国范围内推广该养老形式.由于当前...     

中国政府养老服务发展历程及经验启示

养老服务是近年社会广泛关注的一个重要话题,但各方对养老服务还缺乏统一的认知,学术界对此少有明确定义。政府提出构建"以居家为基础、社区为依托、机构为补充"的养老服务体系,是从宏观上概述养老服务,接近于整个养老的制度安排;社会群众希望的养老服务,是对老年人的照料护理,以缓解家庭无力照顾的困难。中国政府发展养老服务的历程表明,只有从宏观上推进体系化建设,从微观上加强专业化建设,才能认清养老服务的本质,促进养老服务事业的发展,进而满足社会日益增长的养老服务需求。     

空巢老人居家养老服务中心策划案——为连云港馨缘居家养老社会工作服务中心制作

随着中国老龄化程度的加深,传统的家庭养老已面临重重挑战。社会化养老已成为现代社会文明的标志。空巢老人作为老年人群中的特殊群体,他们的生活照料和心理抚慰更应得到全社会的高度重视。本策划案为连云港馨缘居家养老社会工作服务中心特别制作,运用SWOT分析方法,针对目前空巢老人居家养老社会服务的社会需求、市场运作特点、一般财务分析,特别是该中心的专业竞争优势进行系统分析,强调指出:空巢老人居家养老社会服务功在当代、利在千秋。通过科学管理,确保在取得巨大社会效益的同时获得相应经济效益,使中心能够步入稳健的良性发展之路。     

老年照料的相对报酬:对“护工荒”的一个解释

随着我国传统家庭照料功能的弱化,市场化的劳动力供给成为关键,但近年来"护工荒"愈演愈烈。文章利用2007年中国住户收入分配调查数据(CHIP)和上海家政服务调查数据(DWS),研究了城市居家养老生活照料的相对报酬,为"护工荒"提供了一种解释。研究结果表明:(1)老年照料的工资报酬分别比服务业和其他家政低34.5%和28%,在解决遗漏变量问题后,老年照料的相对报酬仍较低,对从业者缺乏吸引力;(2)老年照料雇主收入较低在一定程度上可以解释为何老年照料的工资报酬低于其他家政服务(可以解释约11%的工资报酬差异),表明老年照料雇主的支付能力显著影响老年照料报酬。文章提出未来有效解决"护工荒"的途径在于提高从业者的社保待遇、补贴以及增强家庭雇主(老人)的支付能力。     

成年子女照料者角色经历的性别差异研究

通过对15名成年子女照料者的质性研究,"养儿防老"、"嫁夫随夫"、"男主外、女主内"和"女儿也是传后人"等新旧观念相互交织,成年子女在养老责任担当方面"性别差异"发生了新变化;儿子、女儿和儿媳照料经历也因此各不相同。成年子女的种种照料负担和压力反映了当前老龄化社会中独生子女家庭面临的照料困境,为家庭照料者提供各种社会支持服务是十分必要的。     

武汉市开展居家养老服务的现状探究

近年来,养老金和老年人口医疗费用负担压力越来越大,高龄、空巢和失能老人越来越多,老年人的社会服务需求日益扩大。而就我国现状来看,由于存在各方面的问题,机构养老并不是老年人的理想选择,学者和政府提出了以居家养老为基础,社区服务为依托,机构照料为补充的养老服务体系。文章以武汉市为例,通过深入多个社区进行大范围的调查与访谈,对武汉市开展居家养老服务的现状及问题进行了探究。     

政府制度供给与乡村合作运动——基于20世纪前半期中国乡村社会经济史视阈分析

20世纪前半期,为挽救行将崩溃的农村经济,国民政府推行了以乡村合作运动为中心的"供给主导型"制度变迁,促使了合作社大量快速设立。但是合作社发展受到了来自于财政金融体制的制约,根源在于政府有效制度供给能力不足及制度建设协调性缺失。实际上,同时作用于乡村的各种制度共同组成了社会的"制度系统"(如与合作社相关的行政、财政金融、土地等制度),制度间耦合关系决定了任何一项制度都必须与其他制度相结合才能发挥作用。此外,制度供给还要与政府的"社会动员"相结合,以形成政府力量与乡村民众之间的"共振"。否则,社会经济变迁极有可能会陷入"头重脚轻"的困境。     

Economic–social interaction in China1

This paper analyzes economic–social interaction in China in connection with the country's change of economic system. I define an economic system in terms of a multi‐dimensional vector of broad institutional characteristics, and I emphasize that important features of the social development are closely related to specific changes in these various dimensions. I classify China's options for future social improvements into three broad categories: (i) policies that improve the stability and distribution of factor income; (ii) government‐created wedges between factor income and disposable income; and (iii) improvements in the quantity, quality and distribution of human services, such as education and healthcare.     

养老机构发展呼唤创新——基于北京市海淀区养老机构的调研

由于老龄人口剧增,加之社会转型、政府职能转变和家庭养老功能弱化,老年人群,特别是高龄和带病老年人对于社会服务的需求迅速增长,这无疑给现存的养老服务体系带来巨大的冲击和压力。通过对北京市海淀区养老机构长达数月的调研,我们了解到目前入住老人大多身患多种疾病,身体状况普遍较差,大部分老人选择入住养老机构是出于自己的意愿,但是,老人的收入水平限制了其对机构养老方式的选择。通过调研我们还发现,现存养老机构发展面临着资金不足、经营困难以及许多体制性障碍,为促进养老机构发展,在加大投入力度、加快投入步伐、创新投入方式满足社会对养老机构的需求外,应强化保障性养老机构中政府的作用和理顺养老机构的管理体制。此外,由于短时间内,大幅度增加养老机构确有困难,可以规范管理社会化居家养老服务,起到一定的补充、替代作用。     

When Can Public Policy Makers Rely on Private Markets? The Effective Provision of Social Services

The privatisation of social services is being increasingly discussed. The social services market is characterised by multiple market failures, including informational asymmetries, agency problems, externalities, and distributional concerns. Consumers may care as much or more about quality of services than about price. If quality is readily observable, the government can regulate private providers to assure standards are met. But when standards are difficult to observe or when the recipient is not the agent who makes the decisions, government ownership may be preferable. This paper categorises the market situations in which government provision of social services is likely to be most versus least attractive.     

社区社会组织在社会管理中的协同作用——以杭州市为例

社区社会组织是基层社会领域中最为重要的组织形式之一,在社会管理中可以发挥积极的协同作用。杭州市社区社会组织发展的案例表明,它们在社会资本、制度设计与技术平台方面具有较好的协同动因,并在集结公民意愿、促进居民融合、提供社会服务、调处社会矛盾等方面发挥了积极的协同作用,从而推动了社会管理新格局的形成。政府需要建立健全制度框架和政策法规,为社区社会组织营造良好制度环境,而社区社会组织则需要提高自身能力,拓宽与政府、市场之间的协同领域,并且创新协同方式。     

‘Social enterprise spin-outs’: an institutional analysis of their emergence and potential

The recent phenomenon of public sector ‘social enterprise spin-outs’ is examined in order to critically assess their nature and innovative potential as providers of public services. The study utilises a theoretical model of institutional creation and change which incorporates key characteristics of ‘corporate spin-outs’ and ‘university spin-outs’ to facilitate the examination of their public sector counterparts, drawing on interview evidence from 30 newly-established social enterprise providers of health and care services in England. A main contribution of the paper is to provide a conceptual framework which sheds light on the strengths and potential vulnerabilities of social enterprise spin-outs as novel organisations that span the public, private and civil society sectors.     

TREATMENT OF SUBSIDIES IN NATIONAL ACCOUNTS*

This document contains a critical analysis of some aspects of the treatment of subsidies in the present system of national accounts (United Nations SNA and the ESA, i.e. the European System of Integrated Economic Accounts) as background to the current discussion of their revision. One of the conventions used is that subsidies are recorded as a resource in the accounts of the market producer units which actually receive them. Should this rule of the receiver be applied in every case? The paper suggests that it would be preferable to attribute subsidies to the beneficiary in those cases where a subsidy received by one unit is the counterpart of a reduction in price which he grants to another unit which buys something from him (and which is the real beneficiary), so long as the discount is only granted to specific categories of purchasers. Recording in the accounts of the beneficiary results in a better distribution in the branch accounts and moreover greater stability of the national accounts in the face of minor institutional changes. The problem of allocation arises also for transfers designed to cover social risks or needs (illness, invalidism, old age, maternity). For this category of “social” goods and services for which general government wholly or partially assumes the costs to households, the transfer is treated either as a subsidy to collective consumption or a social benefit. The institutional arrangements, which vary from country to country, product to product and over time, give rise to profoundly different recording in the accounts. In order to restrict these differences, improve comparability between countries, permit analysis of trends over time, make the accounts less sensitive to different institutional arrangements and obtain a figure for household consumption which does not depend on the particular way in which the costs of such consumption is borne, the present document suggests that consumption subsidies should be treated as individual consumption expenditure of general government.     

浅议发展社会工作对社会管理创新的意义

在欧美国家社会工作在社会管理方面担任着重要的角色。当前中国社会转型时期是把社会工作引入到社会管理创新的极好契机。应当通过传播社会工作理念、建设社会工作人才队伍、培育民间社工组织机构、推行政府购买服务等途径推动社会工作发展,充分发挥社会工作具有亲和力和实效性、整合社会资源、调整社会心理和社会关系、推动党的群众工作变革等方面的优势和作用,为社会群体与居民提供专业化、个体化的优质社会服务,从而有力地推动了社会管理创新。     

Social and family load of Alzheimer’s disease

As the World Health Organization reports, mental illnesses have a serious impact on more than 25% of all population people worldwide at some time during their lives. Mental illnesses are universal; they affect people of any age, both women and men, the rich and the poor, no matter from which urban and rural environment they come from. Mental illnesses have an enormous economic effect on societies and on the quality of people’s life, including their families. The purpose of this study is to describe social and economic aspects of Alzheimer’s disease (AD) with respect to the early diagnosis. The authors provide an analysis of costs of treatment and care in the selected countries where the data from the available studies are recalculated into comparable quantities. Furthermore, the authors analyse aspects and possibilities of care for patients with AD in the informal (home) environment in compliance with individual phases of this disease. In the article, the method of research of available sources focusing on social and economic issues of AD is used. In order to compare costs of treatment and care of the AD patients, the Qualitative Comparative Analysis Method is exploited. The analyses have shown that the metric systems for monitoring the direct and indirect costs for the individual phases of AD are different.     

论市场经济体制下的政府与社会保障

社会保障是社会主义市场经济体制下的重要支柱,被称为社会的“安全网”和“减震器”,而政府是社会保障中十分重要的角色,是社会保障中的制度主体。从经济理论上进行分析,市场失灵决定了政府必须对社会保障进行干预,同时也存在政府失灵的问题,在社会保障中政府与市场应密切结合。提出：目前发挥我国政府在社会保障的作用,有利于维持社会经济生活的正常运行和推动我国社会保障事业的发展。