Abstract:

Objective To analyze the disability level and long-term care needs assessment policies issued by 49 pilot cities in China’s long-term care insurance system，providing insights for further improvement of the system. Methods Policy documents related to long-term care insurance，published between June 2016 and December 2024 on official platforms of local governments，the Ministry of Human Resources and Social Security，the National Healthcare Security Administration，and the National Public Service Platform for Standards Information，were retrieved. A comparative analysis was used to summarize and compare the content of these policy texts. Results Currently，there are 49 pilot cities implementing the long-term care insurance system in China. 47 cities have issued disability level assessment standards，with 38 cities adopting the trial standards issued by the National Healthcare Security Administration. In 42 pilot cities，the disability level assessment includes indicators such as activities of daily living，cognitive function，and sensory and communication abilities. 22 cities have issued policies related to care needs assessment. In most cities，the care needs assessment partially or fully includes indicators from the disability level assessment. Conclusion There is no national uniformity in disability level assessment standards，and the care needs assessment framework needs further improvement. It is recommended to standardize disability level assessment criteria，clearly delineate the boundaries and content of disability level and care needs assessments，and enhance the development of the care needs assessment system.

Key words: Long-Term Care Insurance, Aged, Disability, Care Needs, Assessment

摘要：

目的 分析国内长期护理保险制度试点城市发布的失能等级评估和长期照护需求评估政策文件，为进一步完善长期护理保险制度提供参考。 方法 检索各地人民政府、人力资源和社会保障部、医疗保障局、全国标准信息公共服务平台等官网中2016年6月—2024年12月发布的关于长期护理保险的相关政策文件，采用对比分析法对相关政策文本进行总结和比较。 结果 国内有49个长期护理保险制度试点城市，47个城市发布了失能等级评估标准，其中38个城市采用国家医疗保障局发布的试行标准，42个试点城市的失能等级评估指标均包括日常生活活动能力、认知能力/精神状态与社会参与能力、感知觉与沟通能力；22个城市发布了照护需求评估相关文件，大部分城市的照护需求评估指标部分或完全包含失能等级评估指标。 结论 失能等级评估标准在全国尚未统一，照护需求评估体系有待完善。建议进一步统一失能等级评估标准，明确失能等级评估和照护需求评估的界限和内容，完善照护需求评估体系建设。

关键词: 长期护理保险, 老年人, 失能, 照护需求, 评估