| 引用本文：张韦,江世星,吴泰来,等.长期护理保险基金结构性失衡与筹资优化研究基于青岛市的精算分析[J].中国卫生政策研究,2026,19(1):17-24 |
|
| 长期护理保险基金结构性失衡与筹资优化研究基于青岛市的精算分析 |
| 投稿时间：2025-11-05 修订日期：2025-12-31 PDF全文浏览 HTML全文浏览 |
| 张韦1,2，江世星1,2，吴泰来1,2，姚岚1,2 |
| 1华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030;2国家医保研究院华科基地 湖北武汉 430030 |
| 摘要:目的 评估长期护理保险基金的长期可持续性，揭示基金结构性失衡风险，探索多渠道筹资机制优化的可行路径。方法 基于社会保险精算理论构建精算平衡模型，以2023年为基期，结合PADIS-INT软件预测2024—2035年青岛市人口结构，测算长期护理保险基金收入与支出，并模拟财政补贴退出、费率调整和调剂金注入的组合政策效应。结果 现行模式下城镇职工基金具备内生可持续性，城乡居民基金预计自2026年起出现赤字且缺口呈扩大趋势。当财政补贴退出职工筹资时，需通过调整医保划转比例并配合调剂金注入来填补资金缺口。讨论与建议：城乡居民基金面临定额筹资机制导致的运行风险，建议建立与居民可支配收入挂钩的动态筹资机制，制度化落实外部调剂金注入机制。 |
| 关键词:长期护理保险 可持续性 精算平衡 青岛 |
| 基金项目:国家社会科学基金重大项目（25&ZD142）；国家医疗保障局委托项目“全国统一长护险制度建设背景下定点城市转型效果追踪” |
|
| Structural imbalance and financing optimization of long-term care insurance fund： An actuarial analysis of Qingdao city |
| ZHANG Wei1,2, JIANG Shi-xing1,2, WU Tai-lai1,2, YAO Lan1,2 |
| 1School of Medicine and Health Management of Tongji College， Huazhong University of Science and Technology， Wuhan Hubei 430030， China;2HUST Base of National Institute of Healthcare Security， Wuhan Hubei 430030， China |
| Abstract:Objective To assess the long-term sustainability of the Long-term Care Insurance （LTCI） fund， identify the risks of structural imbalance， and explore feasible pathways for optimizing multi-channel financing mechanisms.Methods An actuarial balance model was constructed based on social insurance actuarial theory. Taking 2023 as the base year， the PADIS-INT software was employed to project the population structure of Qingdao from 2024 to 2035， enabling the estimation of LTCI fund revenue and expenditure. Furthermore， policy simulations were conducted to analyze the combined effects of fiscal subsidy withdrawal， premium rate adjustments， and the injection of adjustment funds.Results Under the current framework， the fund for urban employee participants demonstrates endogenous sustainability， whereas the fund for resident participants is projected to incur deficits starting in 2026， with the funding gap widening annually. In the scenario of fiscal subsidy withdrawal from the urban employee fund， adjusting the medical insurance transfer ratio combined with the injection of adjustment funds can bridge the funding gap. Discussion and Suggestions： The resident fund faces operational risks stemming from the fixed financing mechanism. It is recommended to establish a dynamic financing mechanism linked to residents' disposable income and to institutionalize the injection of external adjustment funds. |
| Key words:Long-term care insurance Sustainability Actuarial balance Qingdao |
| 摘要点击次数: 76 全文下载次数: 45 |
|
|
|
