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    迈向“十四五”时期的积极健康老龄化:形势、现状与策略

    摘要

    随着“十三五”的完满收官,中国快速迈进了“十四五”的发展阶段。在该阶段,人口老龄化形势更加严峻,主要表现在:人口结构趋向“倒梯形”,人口老龄化趋势将快速演进,老龄化人口呈现超大规模、超快速度和超高水平的特点,高龄人口的增加伴随失能、半失能人口比例的增长,以及老龄化呈现城乡之间、地区之间的发展不平衡。同时,新形势下老年人群的需求呈现以下变化:传统家庭照料功能弱化,亟待模式创新和价值重构;居家养老仍是主要需求,但服务的创新和服务质量仍难达到要求;慢性病是影响老年人群健康的主要因素,新的疾病挑战不容忽视;老年人群的收入水平差异较大,服务可及性受到影响。为了更好地应对挑战,本报告梳理了国际健康老龄化的相关经验,比如:倡导健康老龄化与积极老龄化理念;平衡机构、居家和社区养老服务;制度型和补缺型长照保险制度并存;整合医疗与养老的服务模式;充分利用现代信息技术,发展智慧养老。中国需要基于老龄化趋势和经济社会与服务体系的现状,探索建立具有中国特色的健康老龄化发展路径。

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    Abstract

    With the achievement of the 13th Five-Year Plan,China has quickly entered the development stage of the 14th Five-Year Plan. At this stage,the situation of population aging is more severe,including:the trend of population aging will evolve rapidly which the demographic structure tends to “inverted trapezoid”. The aging population presents an ultra-large-scale,ultra-fast and ultra-high level. The increase of the elderly population with the increase in the proportion of disabled and semi-disabled population and the aging population. There is an imbalance in development between urban and rural areas and between regions in aging. At the same time,the needs of the elderly under the new situation have shown the following changes:the traditional family care function is weakened,and model innovation and value reconstruction are urgently needed. Home care is still the main demand,but service innovation and service quality are still difficult to meet the requirements. Chronic diseases affect the elderly the main factors of population health,and the challenges of new diseases cannot be ignored. The income level of the elderly is quite different,that the accessibility of services is affected. In order to better cope with it,the article sorts out the relevant experience of international healthy aging,such as advocating the concept of healthy aging and active aging. Balancing the combination of institutions,home and community elderly care services. The coexistence of institutional and supplementary long-term insurance systems. Integrating the service model of medical and elderly care,making full use of modern information technology to develop smart elderly care. China needs to explore the establishment of a healthy aging development path with Chinese characteristics based on the aging trend and the current economic society and service system.

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    作者简介
    刘远立:刘远立,教授,北京协和医学院卫生健康管理政策学院,研究方向为卫生政策与卫生事业管理。
    谢宇:谢宇,副研究员,中国药学会科技开发中心,研究方向为卫生政策。
    齐颖:齐颖,助理研究员,北京协和医学院卫生健康管理政策学院,研究方向为老年健康政策和公共卫生。
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