我国深度老龄化地区长期护理保险政策的量化评价：基于PMC指数模型分析

doi:10.3969/j.issn.1006-9771.2025.03.008

Abstract

Abstract:

Objective To quantitatively evaluate the structure and content of the long-term care insurance (LTCI) policy in China's deeply aging areas.

Methods Using the Policy Modeling Consistency (PMC) index model indicator design method, a LTCI policy evaluation index system was constructed, consisting of nine primary indicators and 34 secondary indicators. A total of 123 provincial-level LTCI policies issued in deeply aging regions of China between June 1, 2014, and October 1, 2024 were analyzed. High-frequency word extraction was performed using ROSTCM 6.0, and a social network diagram of LTCI policies was created. The policy structure and content were quantitatively evaluated and analyzed based on the established policy evaluation index system.

Results The main content of LTCI policies in deeply aging areas of China covered services, institutions and assessment. The highest policy score was 7.28, and the lowest was 2.20, with an average score of 5.00. There were 25 perfect policies, 63 excellent policies, 28 good policies and seven qualified policies. In the dimension of policy content, the indexes of five primary indicators of policy evaluation, policy target groups, policy nature, policy perspective and policy tools were 0.60 or more; while the indexes of four primary indicators of policy content, incentives and constraints, policy timeliness, and policy level were 0.50 or less.

Conclusion LTCI policies issued in China's deeply aging areas provide comprehensive coverage in aspects such as policy evaluation, policy target groups and policy nature, and need to be improved in policy tool selection and the construction of incentive and constraint mechanisms.

Key words: aging, long-term care insurance, policy evaluation, Policy Modeling Consistency index model

CLC Number:

R197

LIU Jiahui, YANG Mengjiao, WANG Yifan, WANG Ruixuan, SONG Jing, LI Xiaochun, YANG Chunxiao, FENG Zhiqiang, XIE Yuwei, SANG Xin'gang, YIN Wenqiang. Quantitative evaluation of long-term care insurance policy in China's deeply aging areas: based on PMC index model[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(3): 314-323.

Figures/Tables 8

Table 1

Part of the long-term care insurance policy in China's deeply aging areas"

序号	时间	政策名称	发文机关
P₁	2014	山东省人民政府关于加快发展养老服务业的意见	山东省人民政府
P₂	2014	山东省人民政府办公厅关于开展职工长期护理保险试点工作的指导意见	山东省人民政府办公厅
P₃	2016	湖北省人民政府关于印发湖北省人力资源和社会保障事业发展“十三五”规划的通知	湖北省人民政府
P₄	2016	上海市民政局关于明确养老服务机构开展长期护理保险服务有关事项的通知	上海市民政局
P₅	2016	上海市民政局、上海市卫生和计划生育委员会、上海市人力资源和社会保障局、上海市医疗保险办公室关于印发长期护理保险服务项目清单和相关服务标准、规范(试行)的通知	上海市民政局、上海市卫生和计划生育委员会、上海市人力资源和社会保障局、上海市医疗保险办公室
…	…	…	…
P₁₁₉	2024	山东省医疗保障局关于做好异地长期居住失能人员长期护理保险待遇支付工作的通知	山东省医疗保障局
P₁₂₀	2024	山东省医疗保险事业中心关于开展省直异地长期居住失能人员长期护理保险待遇支付工作的通知	山东省医疗保险事业中心
P₁₂₁	2024	山东省医疗保障局关于落实《国家医疗保障局关于印发<长期护理保险失能等级评估机构定点管理办法(试行)>的通知》的通知	山东省医疗保障局
P₁₂₂	2024	山东省医疗保障局、山东省发展和改革委员会、山东省教育厅、山东省工业和信息化厅、山东省民政厅、山东省财政厅、山东省人力资源和社会保障厅、山东省卫生健康委员会、山东省大数据局、国家金融监督管理总局山东监管局、山东省总工会、山东省妇女联合会、山东省残疾人联合会关于推进长期护理保险扩面提质助力银发经济发展的若干措施	山东省医疗保障局、山东省发展和改革委员会、山东省教育厅、山东省工业和信息化厅、山东省民政厅、山东省财政厅、山东省人力资源和社会保障厅、山东省卫生健康委员会、山东省大数据局、国家金融监督管理总局山东监管局、山东省总工会、山东省妇女联合会、山东省残疾人联合会
P₁₂₃	2024	重庆市医疗保障局关于印发重庆市长期护理保险失能等级评估机构定点管理暂行办法的通知	重庆市医疗保障局

Table 1

Table 2

The primary variable and corresponding secondary variable settings"

一级变量	二级变量	二级变量评价标准	变量设置来源或依据
政策性质X₁	建议X_1.1	政策是否为长期护理服务发展提供意见或建议	Estrada^[15](2011)
	描述X_1.2	政策是否涉及待遇保障等细节内容
	预测X_1.3	政策是否体现前瞻性内容
	监督X_1.4	政策是否体现协议管理、考核等内容
政策时效X₂	长期X_2.1	政策时效是否> 5年	薛惠元等^[16](2023)
	中期X_2.2	政策时效是否3~5年
	短期X_2.3	政策时效是否< 3年
政策级别X₃	规划类X_3.1	战略、法律、纲要、规划、规定	吕倩鹏等^[17](2024)
	方案类X_3.2	方案、细则、指南
	通知类X_3.3	通知、公告
	意见类X_3.4	意见、决定
	办法类X_3.5	办法、措施、条例
政策视角X₄	宏观X_4.1	政策是否涉及总体政策架构内容	郭桐桐等^[18](2024)
	中观X_4.2	政策是否涉及行动战略内容
	微观X_4.3	政策是否涉及具体实施细则和方法
政策对象X₅	政府部门X_5.1	政策是否涉及政府部门	基于文本挖掘和政策内容确定
	医疗机构X_5.2	政策是否涉及医疗机构
	企业X_5.3	政策是否涉及企业
	其他X_5.4	政策是否涉及个人、家庭、社区等其他对象
政策内容X₆	服务内容X_6.1	政策是否涉及长期护理保险的服务内容	基于文本挖掘和政策内容确定
	护理机构X_6.2	政策是否涉及失能、半失能人员的护理机构
	失能评估X_6.3	政策是否涉及失能评估标准
	待遇享受X_6.4	政策是否涉及长期护理保险待遇享受
政策工具X₇	需求型X_7.1	政策是否涉及试点建设、采购招标等内容	吕倩鹏等^[17](2024)
	供给型X_7.2	政策是否涉及资金支持、人才培养、基础设施建设、教育培训等内容
	环境型X_7.3	政策是否涉及法规管制、监督考核、金融税收、目标规划等内容
激励约束X₈	法律保障X_8.1	政策是否涉及法律保障内容	周立芳等^[19](2024)
	财政投入X_8.2	政策是否涉及财政补贴内容
	市场准入X_8.3	政策是否涉及市场准入内容
	监督考核X_8.4	政策是否涉及监督考核内容
政策评价X₉	目标明确X_9.1	政策是否有明确的目标导向	张永安等^[20](2017)
	依据充分X_9.2	政策是否有足够的制定依据
	规划详实X_9.3	政策是否有详实的规划安排
	方案科学X_9.4	政策是否有科学的方案设计

Table 2

Table 3

Figure 1

Table 4

Figure 2

Figure 3

Figure 4

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政策	X₁	X₂	X₃	X₄	X₅	X₆	X₇	X₈	X₉	PMC	排名	等级
P₁	0.50	0.33	0.20	0.33	0.75	0.50	0.67	0.25	0.75	4.28	91	良好
P₂	1.00	0.33	0.20	1.00	1.00	0.75	1.00	0.75	1.00	6.45	13	完美
P₃	0.50	0.33	0.20	0.33	0.25	0.00	0.33	0.00	0.50	2.45	122	合格
P₄	0.50	0.33	0.20	0.67	0.75	0.25	1.00	0.25	0.75	4.70	75	良好
P₅	0.50	0.33	0.20	0.67	1.00	0.50	0.67	0.50	1.00	5.37	43	优秀
…	…	…	…	…	…	…	…	…	…	…	…	…
P₁₁₉	1.00	0.33	0.20	1.00	1.00	0.75	0.33	0.50	1.00	6.12	23	完美
P₁₂₀	0.75	0.33	0.20	0.67	1.00	0.50	0.33	0.25	1.00	5.03	58	优秀
P₁₂₁	0.75	0.33	0.20	0.33	0.75	0.25	0.33	0.50	1.00	4.45	71	良好
P₁₂₂	1.00	0.33	0.20	1.00	1.00	1.00	1.00	0.50	1.00	7.03	2	完美
P₁₂₃	1.00	0.33	0.20	0.67	0.75	0.25	0.67	0.50	1.00	5.37	43	优秀
均值	0.67	0.33	0.20	0.64	0.76	0.49	0.63	0.36	0.90	5.00	-	-

Quantitative evaluation of long-term care insurance policy in China's deeply aging areas: based on PMC index model

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序号	词汇	频次	序号	词汇	频次	序号	词汇	频次
1	服务	2620	11	参保	546	21	制度	391
2	机构	2515	12	经办	544	22	结算	389
3	长期护理保险	1457	13	规定	505	23	中心	380
4	评估	1129	14	试点	494	24	标准	372
5	人员	1126	15	基金	471	25	费用	334
6	定点	983	16	协议	455	26	社会	333
7	医疗	958	17	申请	453	27	居家	325
8	管理	873	18	待遇	443	28	部门	302
9	保障	710	19	支付	429	29	办法	299
10	养老	603	20	照护	423	30	职工	273

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