基于政策工具的我国国家级试点城市长期护理保险政策分析

目的:分析我国国家级试点城市在推进长期护理保险中政策工具的使用情况,揭示现有政策工具在应用中的特点与问题,并提出相应的政策建议,以期为推动形成国家层面的长期护理保险政策提供参考。方法:基于政策工具和利益相关者两个维度构建二维分析框架,采用内容分析法,对96项长期护理保险政策文本、359条政策工具进行分析。结果:政策工具结构不均衡,供给型政策工具占25.90%、需求型政策工具占17.00%、环境型政策工具占57.1%;利益相关者不协调,政府占41.23%、定点护理机构占19.22%、商业保险公司占19.78%、参保人占12.53%、社会组织占7.24%。结论:试点城市现有长期护理保险政策在政策工具应用上以环境型为主,应结合发展趋势优化三种政策工具使用比例;在利益相关者维度,政策工具使用时应均衡各方利益,引导和鼓励各方参与到长期护理保险中。

Analysis of Long-Term Care Insurance Policy in Pilot Cities of China Based on Policy Tools

Objective:To analyze the use of policy tools in promoting long-term care insurance in China’s national pilot cities,reveal the characteristics and problems of existing policy tools in the application,and put forward corresponding policy suggestions so as to provide references for promoting the formation of long-term care insurance policies at the national level.Methods:Based on the two dimensions of policy tools and stakeholders,a two-dimensional analysis framework is constructed.Using content analysis method,96 long-term care insurance policy texts and 359 policy instruments are analyzed.Results:The structure of policy tools is unbalanced,supply-oriented policy tool accounts for 25.90%,demand-oriented policy tool accounts for 17.00%,and environmental policy tool accounts for 57.1%.The government accounts for 41.23%,designated nursing institutions account for 19.22%,commercial insurance companies account for 19.78%,insured persons account for 12.53%,and social organizations account for 7.24%.Conclusion:The existing long-term care insurance policies in the pilot cities are mainly based on the environment.The proportion of these three policy tools should be optimized according to the reality and future development trend.In the stakeholder dimension,policy tools should balance the interests of all parties,guide and encourage all parties to participate in long-term care insurance.