基于转移概率模型的老年人长期护理需求预测分析被引量：71

A Study of Long-Term-Care Demand of the Elderly in China: Based on Multistatus Transition Model

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摘要应对人口老龄化是我国的一项长期战略任务,为此国家应逐步建立长期护理保障制度。护理保障制度的精算基础建立在老年人健康状态,特别是长期护理状态的演变轨迹和转移概率模型之上。本文利用中国老年人健康长寿影响因素调查(2005年和2008年)数据,运用连续时间齐性Markov过程刻画老年人口健康状态的变化,建立转移概率矩阵模型,考察65岁及以上老人长期护理发生率和健康状态的转移运动,以及影响这些健康变动的因素;并预测需要护理的老年人口规模和老人处于护理状态的时间长度。研究发现,我国老年人护理需求增长迅猛,预计到2016年,我国需要长期护理的老人将超过1000万,约占老年人口的6.7%。女性老人在生存上的相对优势和在维持健康状态上的相对劣势,使得未来需要护理的女性老人数量将达到男性的1.8—2.4倍,而且同年龄、同健康状态的女性老人,在护理状态的生存时间是男性的2倍。因此年老体弱的女性无疑将成为长期护理服务的主要需求者。本研究旨在建立起长期护理发生率等本土化参数,为老年护理保障制度的建设积累基础资料,为政府制定老龄化战略提供决策依据。 Dealing with the population aging problem, as part of the national development strategy in the long run, Chinese government is exploring new long-term care (LTC) benefit programs for senior citizens. Effective actuarial analysis of such programs is based on the knowledge of older person's health statuses, especially the pathways and transitions of LTC status. Using the sample from the latest two waves of Chinese Longitudinal Healthy and Longevity Survey (CLHLS 2005 and 2008), we investigate the transition of individuals between health statuses and their determinants. We describe the evolution of health status by continuous-time Markov chains and model the transition matrices. We also apply this model to estimate the size of frail elderly and expected time they spent in LTC status. The needs for LTC services for the old Chinese are projected to grow substantially, with an estimate of over 10 million older persons, about 6.7% of the elderly population in 2016. Because the female elderly have the relative advantages in survival, but disadvantages in keeping in healthier status, women who need LTC services are 1.8 to 2.4 times of men in the same status. Moreover, women spend twice as much time in LTC status prior to death. Therefore, the frail older women become main demanders of LTC services. By establishing the local actuarial parameter, this study sheds lights on LTC program design and other aging policies.

作者黄枫吴纯杰

机构地区上海财经大学高等研究院上海财经大学统计与管理学院

出处《经济研究》 CSSCI 北大核心 2012年第S2期119-130,共12页 Economic Research Journal

基金国家自然科学基金青年项目(编号:71203133) 教育部人文社会科学研究青年基金(项目批准号:12YJC790067) 上海市教育委员会上海市教育发展基金会"晨光计划"(项目编号:11CG38) 上海市浦江人才计划资助

关键词长期护理多状态转移概率模型预测 Long-Term Care Multistatus Transition Model Projections

分类号 R47 [医药卫生—护理学]

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