| 引用本文：朱成燕,张苗,姚岚.多源流视角下我国长期护理保险制度的构建逻辑[J].中国卫生政策研究,2026,19(1):2-8 |
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| 多源流视角下我国长期护理保险制度的构建逻辑 |
| 投稿时间：2025-11-05 修订日期：2026-01-13 PDF全文浏览 HTML全文浏览 |
| 朱成燕1,2，张苗1，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:建立长期护理保险（以下简称“长护险”）制度是我国积极应对人口老龄化、健全社会保障体系的重要战略部署。我国长护险制度的构建可分为地方自主探索、中央授权试点、统一规范推进三个主要阶段。本研究基于多源流理论及我国长护险政策的发展实践建立分析框架，研究发现：每一阶段的制度演化都是诸多因素耦合作用的结果。其中，失能老人照护危机、医疗资源挤占及医保给付压力作为问题源流，积极应对人口老龄化和银发经济发展战略、国家医保局对长护险的集中管理作为政治源流，地方试点、跨部门政策联动作为政策源流，三条源流耦合共同推动长护险制度的构建。 |
| 关键词:长期护理保险 多源流 制度构建 动力机制 |
| 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” |
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| The construction logic of China's long-term care insurance system from a multi-stream perspective |
| ZHU Cheng-yan1,2, ZHANG Miao1, 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 Health Security， Wuhan Hubei 430030， China |
| Abstract:The establishment of a long-term care insurance（LTCI） system is a crucial strategic initiative for China to actively respond to population aging and improve the social security system. The construction of China's LTCI system can be divided into three main stages： local autonomous exploration， central authorized pilots， and nationwide unified establishment. This article establishes an analytical framework based on the multiple streams framework and the development of China's LTCI policy. it is found that the evolution of the LTCI system at each stage is the result of the coupling of multiple factors. Specifically， the crisis in care for the disabled elderly， the crowding out of medical resources serve as the problem stream. Actively responding to population aging and the strategy of the silver haired economy， and the centralized management of LTCI by the National Healthcare Security Administration serves as the political stream. Local pilots and cross-departmental policy linkages serve as the policy stream. The coupling of these three streams drives the construction and evolution of the LTCI system. |
| Key words:Long-term care insurance Multiple streams Institutional construction Driving mechanism |
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