互补还是替代：家庭照料与社区居家养老服务

文章使用国家卫生健康委2014年开展的中国计划生育家庭发展追踪调查数据，采用Probit模型和工具变量方法，实证检验家庭老年照料与社区上门生活护理服务和社区上门医疗服务之间的关系。研究发现：（1）家庭照料会显著减少老年人使用社区上门生活护理服务的概率，二者呈替代关系，但是在高龄和中、重度失能老人中，两者呈互补关系；（2）对于上门医疗服务则存在互补关系，家庭照料会显著增加老年人使用社区上门医疗服务的概率，但是在低收入老年人中，二者存在替代关系。文章建议社区居家养老服务体系建设要注重与家庭照料之间的协调发展，特别要关注高龄、中、重度失能和低收入老年人群体的照料需求，实现家庭照料与社区居家养老服务的优势互补。

Complement or substitution: family care and community home-based care services

Based on the data from 2014 China Family Development Survey conducted by the National Health Commission of the Pepole''s Republic of China, this paper used Probit model and instrumental variable method, and empirically investigated the relationship between family care and community home-based care services. The study found that:(1) Receiving family care significantly reduced the probability of using community homecare services among elderly people, reflecting a substitution relationship. However, among the eldest and the moderately and severely disabled sub-populations, these two modes of lifecare are mutually complementary. (2) Family care manifested a complementary relationship with community home-based medical services, so that receiving family care significantly increased the probability of using community home-based medical services among elderly people. However, among the low-income elderly, family care acted as a substitution for community home-based medical services. The research suggested that in the development of the community home-based elderly care service system, it is important to ensure its coordination with family care, and to pay special attention to the care needs of the eldest, moderately and severely disabled and low-income sub-populations, so as to join the complementary advantages of family care and community home-based care services.