当前全球进入人口老龄化，中国老年人口总量世界第一，养老体制建设刻不容缓。近年在政府的积极推动下，养老设施配置作为养老体系建设的重要一环，在发展规模上取得了斐然成就。但分析目前状况，还存在设施配置欠缺系统化发展等问题。作为发展中国家，中国在养老设施的建设上，还必须重视社会资本的精准利用，切实满足老年人的养老服务需求。作为人口老龄化程度世界第一的国家，日本的老龄化发展进程与中国高度相似，成为中国在发展养老体系上的多方借鉴对象。近年日本在政策上明确以构建地区统合照料体系为应对老龄化问题的对策，以介护保险制度为基础提供标准化的养老服务，养老设施配置发展趋向系统化。要从借鉴日本总结出符合中国国情的发展模式，必须以全面解读日本的相关内容为基础。本论文以日本养老设施配置和发展状况为研究命题，以笔者长年的日本工作经验和所属研究室的对日研究积累为基础，从梳理日本的养老设施配置的源头政策制度入手，明确其中对设施配置的理论指向和要求，结合对设施配置发展状况数据的深入分析，总结其中的发展规律和对中国的借鉴经验。基于上述研究框架，在本论文的第2和第3章，通过全面梳理日本的介护保险制度和地区统合照料体系的内容和沿革，明确其中对设施配置的理论要求，总结出设施配置的框架模型。在论文第4、5、6章，利用日本官方的开放数据，分别从日本全国、东京都、东京都属下的世田谷区这3个不同地区层面，对设施的配置发展状况进行全面的梳理和分析。在论文的第7章，以前述研究为基础，总结出日本在发展区域化照料体系下养老设施配置的发展特征，同时针对中国目前在养老设施配置上存在的主要问题展开以借鉴为目的的探讨。研究表明：日本通过发展地区统合照料体系，实现了“在地养老”的理念。在设施配置上通过系统化配置和积极发展小型化设施等战略，令设施得以向地区内渗透发展，为地区老年人提供了多元化的近接服务。针对中国目前在养老设施配置上的主要问题，结合对日本的研究成果，提出注重发展具有现实意义指标的工作模式、发展养老保险和区域化服务体系并举的体制构建战略、弹性设定设施配置指标来提高设施对社区的渗透力、通过补充生活支援功能模块来完善居家养老服务体系等一系列对中国的解题具有现实意义和价值的借鉴经验。
Population ageing has become a global problem. China owns the largest elderly population in the world, it is important to build up an elderly care system. As a key part of this task, under the active promotion of the government, China has been making great achievements in scale expansion. However, there are still problems such as the lack of systematic development of facilities. As a developing country, China must emphasize on the accurate use of social capital in order to meet the exact needs of the elderly.As the world's number one population ageing country, Japan's population ageing process is highly comparable with China and has become a multi-faceted reference on China's development of the elderly care system. In recent years, Japan has set up the countermeasure by establishing the community-based integrated-care system, and provides standardized long-term care services based on the long-term care insurance system. The deployment of elderly facilities has become systematic.To Summarize the development model in line with China's domestic conditions by learning from Japan, it must base on a comprehensive interpretation of Japan's relevant contents. This thesis focuses on the deployment and development of elderly facilities in Japan, based on the author's long-term work experience in Japan and the research accumulation of the studio. It starts from sorting out the basic theory on the elderly facilities deployment in Japan. define the policy requirements inside, combined with the analysis of the data on the development status of the facility deployment, summarize the development rules and experiences for China.Based on the above research framework, in Chapters 2 and 3 of this thesis, the research revealed the theoretical requirements for facility deployment by comprehensively combing the content and development process of Japan's long-term care insurance system and the community-based integrated-care system, and summarized the framework program.In Chapters 4, 5 and 6, using the official open data of Japan, the research comprehensively sorted out the development status of facilities from three selected different area-levels, which include the whole area of Japan, Tokyo and Setagayaku, a district of Tokyo. In the 7th chapter, based on the research above, it summarizes the development characteristics of the deployment of elderly facilities in Japan under the regional care system, while post a discussion about mainly existing problems of elderly facilities in China, aims at learning from Japan.Studies show that Japan has realized the concept of “ageing in place” by developing the community-based integrated-care system., successfully infiltrated the facilities into communities through strategies such as systematic configuration and small-scale facilities, provide a wide range of services for the elderly.In view of China's current major problems in the deployment of elderly facilities, referred to the experiences of Japan, this thesis express a series of points with realistic value and meaning in solving problems for China, such as a developing mode based on realistic indicators, system construction strategy that focuses on an integrated system which combined the long-term care insurance and the community-based service system, to install facilities into communities by setting flexible indicators, and to make the home-service as a part of the care system.
