资源配置视角下长期护理险15个城市服务供给模式分析

目的]总结15个开展长期护理保险试点城市在医疗和护理资源配置上的实践经验,探索适合我国国情的长期护理服务供给模式。方法]在资源配置的视角下通过政策文本分析,采用演绎性内容分析法和类型分析法,聚焦长护险设计的服务内容和项目,按照医疗和护理相关资源对15个城市的供给模式进行划分。结果]按照医护资源的配置,我国长护险试点城市服务供给模式可以分成高医疗低护理型、医护均衡型、低医疗高护理型3种。其中医疗服务资源供给占比最高的是石河子市(66.7%),护理服务资源供给占比最高的城市是南通市(72.0%),医护资源服务供给比较均衡的有上海、广州等。结论] 15个试点城市医护资源供给存在多元模式,但具体的模式选择和设计应结合本地区的财政能力、卫生资源基础条件和居民健康需求,调整医护资源的供给配置情况,在科学调研的基础上进行设计改革。

Analysis of service supply models of long-term care insurance in 15 cities from the perspective of resource allocation

Objective This paper summarizes practical experience on current medical and nursing resources allocation in 15 long-term care insurance pilot cities,and explore long-term care service supply model which is suitable for China's national conditions.Methods From the perspective of resource allocation,through policy text analysis,it used deductive content analysis and type analysis,focused on the service content and projects of long-term insurance design,and divided supply patterns of 15 cities according to medical-related and nursing-related resources.Results According to the allocation of medical and nursing resources,the service supply model of China's long-term insurance pilot cities could be divided into three categories such as high medical low nursing,balanced medical and nursing,and low medical and high nursing.Among these cities,Shihezi City had the highest proportion of medical service resources supply(66.7%),Nantong City had the highest proportion of nursing service resources supply(72.0%),Shanghai and Guangzhou were relatively balanced in supply of medical and nursing resources.Conclusions There are plural models for the supply of medical and nursing resources in the 15 pilot cities.However,the choice of specific model selection and design should be based on local financial capacity,basic conditions of health resources and the health needs of residents,adjust supply and allocation of medical and nursing resources,and conduct design reform on the basis of scientific research.