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公利与私利如何平衡:长期照护服务体系的整合困境及应对策略

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随着高龄化社会的到来,失能失智老人长期照护服务体系正朝着整合的方向发展.然而,长期照护服务体系的碎片化现象仍然较为明显.从制度逻辑的视角来看,整合困境产生的原因在于养老机构所遵循的市场利益逻辑与政府所遵循的公共利益逻辑之间形成的张力.这种张力导致长期照护服务体系在整合过程中出现四重困境:第一是公私合作困境,政府鼓励进入但市场可能退出;第二是服务网络建设困境,有产业链但无服务链;第三是资源使用困境,政府提供支持但市场反应冷淡;第四是服务整合困境,保障措施制度化但市场"脱耦".对此,有必要从提升政府行政效能、建立个案管理组织、创新资源提供方式、发挥价值认同的作用等角度入手,寻找"公利"与"私利"之间的平衡点,以促进长期照护服务体系的整合与完善.
Balancing Public Interest and Private Gain:Challenges and Strategies for the Integration of Long-term Care Service Systems
With the advent of an aging society,the long-term care service system for disabled and elderly individuals is increasingly integrating.However,fragmentation within the long-term care service system is still evident.From an institutional logic perspective,integration challenges stem from the tensions between the market-driven logic of elderly care institutions and the public interest logic of the government.These tensions result in four main challenges for integration:the dilemma of public-private cooperation,where the government encourages market entry while the market may withdraw;the dilemma of service network construction,where the government builds service chains while the market develops industry chains;the dilemma of resource utilization,where the government provides support while the market response is lukewarm;and the dilemma of service integration,where government safeguards tend to institutionalize while the market experiences"decoupling".To address these,it is necessary to enhance government administrative efficiency,establish case management organizations,innovate resource provision methods,and leverage the role of value identification to strike a balance between"public interest"and"private interest",thereby promoting the integration and improvement of the long-term care service system.

long-term care service systeminstitutional logicfragmentationintegration

郑悦、黄晨熹

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浙江万里学院法学院

华东师范大学社会发展学院

长期照护服务体系 制度逻辑 碎片化 整合

2024

社会建设

社会建设

ISSN:
年,卷(期):2024.11(5)