研究背景：随着我国人口结构和家庭结构变化，以及老年人的生理、经济、健康、需求和生活环境状况等变化，地区养老服务需求亦存在着动态演变趋势。了解我国养老服务需求的影响因素和变动趋势对于有效配置养老资源、合理制定养老规划至关重要。近年来，失能老年人规模的增加和人口结构的改变，对切实满足老年人养老服务需求提出挑战，亟需针对养老服务需求开展系统研究。研究目的：（1）构建国内养老服务需求模型，分析不同养老服务需求的影响因素；（2）测算2020-2050年失能老年人口的变化趋势；（3）结合现有研究和上述研究结果，测算2020-2050年居家、社区、机构养老服务需求变化趋势；（4）结合国内养老资源供需现状，提出针对性的养老资源配置优化策略。研究方法：首先，基于国际功能、残疾和健康分类分析框架，构建分城乡的无序多元Logistic模型，探讨影响老年人养老服务需求的因素；之后，应用人口-发展-环境模型进行总体人口预测，并分别应用等比例法和马尔可夫模型对我国2020-2050年的失能老年人口进行分年龄段、分城乡、分健康状态的规模预测；第三，依据失能人口规模预测我国2020-2050年养老服务需求，并提出养老资源配置策略的建议。研究结果：无序多元Logistic模型结果显示影响老年人养老服务需求的主要影响因素包括个人层面如年龄和失能情况，以及家庭层面如婚姻状况、家庭规模（子女和儿子数量）和经济状况（子女经济支持和家庭收入）。老年人养老服务需求存在城乡差异。2020-2050年老年人养老服务需求呈现增长趋势，社区养老和机构养老的需求随时间推移占比逐步增大，而家庭养老占比呈现下降态势。2050年居家养老需求在35038.06-47844.02万之间，社区养老在2525.77-3150.34万之间，机构养老在1473.53-3168.58万之间。研究结论：2020-2050年我国养老服务需求呈现增长趋势，对社区养老和机构养老的需求随时间推移占比逐步增大。未来，应进一步加强养老保障制度体系建设，构建以家庭、社区和机构为主体的全方位、多层次的养老照护体系；加强重点地区和人群的关注，注重城乡养老服务需求差异，重视无配偶或子女以及低收入老年人群需求；重视失能老年人口健康状况，加快推动失能预防保健服务。
Background: With changes in demographic and family structures, as well as changes in the physiology, economy, health, needs, and living environment of the elderly in China, there is a dynamic trend in demand for elderly care services. Understanding the factors and trends affecting the demand for elderly care services in China is crucial to the effective allocation of elderly care resources and the rational formulation of elderly care planning. In recent years, the increase in the number of disabled elderly people and changes in the demographic structure have posed challenges to meeting the needs of elderly people for elderly services, and systematic research on the demand for elderly services is urgently needed.Objective: (1) to analyze the influencing factors of different demand for elderly care services through theoretical and empirical studies; (2) to estimate the changing trend of the disabled elderly population from 2020 to 2050; (3) to estimate the changing trend of the demand for home, community and institutional elderly care services from 2020 to 2050 by combining existing studies and the above research results; (4) to propose targeted strategies for optimizing the allocation of elderly care resources by combining the current situation of supply and demand of elderly care resources in China.Methods: First, based on the international framework of functional, disability and health classification, a disorderly multivariate Logistic model by urban and rural areas is constructed to explore the factors influencing the demand for elderly care services; second, the population-development-environment model is applied to forecast the overall population, and the equal proportion method and Markov model are applied to forecast the scale of the disabled elderly population in China in 2020-2050 by age group, urban and rural areas and health status respectively; third, the demand for elderly care services in China in 2020-2050 is forecast based on the scale of the disabled population, and suggestions for the allocation strategy of elderly care resources are made.Results: The main factors influencing the demand for elderly care services include the individual level such as age and disability, and the family level such as marital status, family size (number of children and sons) and economic status (financial support from children and family income). There are urban-rural differences in the demand for elderly care services. In 2020-2050, the demand for elderly care services shows a growing trend, with the demand for community-based and institutional care gradually increasing in proportion over time, while the proportion of home-based care shows a decreasing trend. The demand for home care in 2050 is between 35038.06 and 47844.02 million, community care between 2525.77 and 3150.34 million, and institutional care between 1473.53 and 3168.58 million. Conclusion: In the future, it is necessary to further strengthen the construction of the old-age security system, build an all-round and multi-level old-age care system with families, communities and institutions as the mainstay. Attention to key areas and groups of people should be strengthened, with emphasis on the differences in demand for elderly care services between urban and rural areas, and on the demand of elderly people without spouses or children and those with low incomes. Attention should be paid to the health status of the disabled elderly population, accelerating the promotion of preventive health care services for the disabled and establishing a multi-level care system for the disabled.
