《保险研究》20200506-《长期护理保险制度中老年人的失能风险和照料时间——基于Barthel指数的分析》（张文娟、付敏）

［摘   要］文章采用我国长期护理保险试点地区普遍使用的失能评估工具Barthel指数作为老年人的失能评估标准,以2014年的CLASS和CLHLS数据为基础,在将两项数据合并后,综合运用多重填补法、生命表技术、沙利文法,对老年人的失能水平及其长期照料需求时间进行评估。分析结果表明:第一,老年人失能水平随年龄增加而快速增长,且存在明显的性别差异,女性老年人的生活自理预期寿命及其带残存活时间均高于男性,应将其作为重点关注人群；第二,轻中、重度失能人群中受损的活动能力项目存在差异,在提供照料时应加以区分；第三,60岁的老年人在重度失能状态下需要照料的时间约为0.42年,中重度状态下为0.79年,但是如果将轻度失能也考虑在内,需要照料的时间将增至5.01年。因此,将项目的受益人群扩大到轻度失能人群会导致照料成本大幅度上升。

［关键词］长期护理保险；失能风险；自理预期寿命；老年人

［基金项目］中国人民大学科学研究基金重大规划项目“健康老龄化视域下的中国老年照护体系研究”(17XNLG08)。

［作者简介］张文娟,中国人民大学人口与发展研究中心、老年学研究所副教授,博士生导师,研究方向:老龄健康与社会政策；付敏,中国人民大学老年学研究所硕士研究生。

Disability Risk and Time Duration for Long-term Care of the Elderly in Long-term Care Insurance System:An Estimation Based on the Barthel Index

ZHANG Wen-juan,FU Min

Abstract：Employing the Barthel Index Scale which is adopted as the criteria for disability assessment of the elderly in most of the pilot areas of long-term care insurance,and using the pooled data of CLASS and CLHLS in 2014,this study estimated the disability risk and time duration of care of the elderly with the methods of multiple imputation,life table and Sullivan. The results show that the disability level of the elderly increases rapidly with age. Significant gender differences have been found,and the disability-free life expectancy as well as the survival duration with disability of the female elderly is higher than those of the male,and more attention should be paid to the female groups. The analysis also reveals that the limitations in functional activities are different among the elderly with mild,moderate and severe disabilities,and therefore diverse mode of long-term care should be provided for them respectively. The time duration of care of the elderly with severe disability is about 0.42 years,and 0.79 years for those with severe or moderate disability. The time duration will extend to 5.01 years if the mild disability status is included,and we deduce that there should be a great increase in the cost of long-term care if the elderly with mild disability is coverd by the insurance.

Key words：long-term care insurance;disability risk;disability-free life expectancy;elderly people