中國老年護(hù)理的選擇非正式護(hù)理抑或正式護(hù)理基于CLHLS和CHARLS數(shù)據(jù)的實證分析

中國老年護(hù)理的選擇非正式護(hù)理抑或正式護(hù)理基于CLHLS和CHARLS數(shù)據(jù)的實證分析一、本文概述Overviewofthisarticle隨著中國社會的老齡化趨勢日益顯著，老年護(hù)理問題已成為社會關(guān)注的焦點(diǎn)。老年護(hù)理不僅關(guān)乎老年人的生活質(zhì)量和健康狀況，也是社會發(fā)展和公共衛(wèi)生體系建設(shè)的重要組成部分。然而，在老年護(hù)理領(lǐng)域，非正式護(hù)理與正式護(hù)理之間的選擇及其影響因素仍然是一個值得深入探討的問題。本文旨在利用中國健康與養(yǎng)老追蹤調(diào)查（CLHLS）和中國家庭金融調(diào)查（CHARLS）的豐富數(shù)據(jù)，對中國老年護(hù)理的選擇進(jìn)行實證分析，以期為相關(guān)政策制定和實踐操作提供科學(xué)依據(jù)。WiththeincreasinglysignificanttrendofaginginChinesesociety,elderlycarehasbecomeafocusofsocialattention.Elderlycareisnotonlyrelatedtothequalityoflifeandhealthstatusoftheelderly,butalsoanimportantcomponentofsocialdevelopmentandpublichealthsystemconstruction.However,inthefieldofelderlycare,thechoicebetweeninformalcareandformalcare,aswellasitsinfluencingfactors,remainsatopicworthyofin-depthexploration.ThisarticleaimstousetherichdatafromtheChinaHealthandRetirementLongitudinalSurvey(CLHLS)andtheChinaFamilyFinanceSurvey(CHARLS)toempiricallyanalyzetheselectionofelderlycareinChina,inordertoprovidescientificbasisforrelevantpolicyformulationandpracticaloperation.具體而言，本文將首先梳理非正式護(hù)理與正式護(hù)理的相關(guān)概念和理論基礎(chǔ)，明確研究問題的背景和意義。然后，利用CLHLS和CHARLS的數(shù)據(jù)，描述中國老年護(hù)理的現(xiàn)狀和特征，包括老年護(hù)理的需求、供給以及非正式護(hù)理與正式護(hù)理的分布情況。在此基礎(chǔ)上，本文將構(gòu)建計量經(jīng)濟(jì)學(xué)模型，分析影響老年護(hù)理選擇的因素，包括個人特征、家庭經(jīng)濟(jì)狀況、社區(qū)環(huán)境、政策支持等多個方面。通過實證分析，本文旨在揭示不同因素對老年護(hù)理選擇的影響機(jī)制和程度，為優(yōu)化老年護(hù)理資源配置、提高老年護(hù)理服務(wù)質(zhì)量提供有益參考。Specifically,thisarticlewillfirstoutlinetherelevantconceptsandtheoreticalfoundationsofinformalnursingandformalnursing,andclarifythebackgroundandsignificanceoftheresearchquestion.Then,usingdatafromCLHLSandCHARLS,describethecurrentsituationandcharacteristicsofelderlycareinChina,includingthedemandandsupplyofelderlycare,aswellasthedistributionofinformalandformalcare.Onthisbasis,thisarticlewillconstructaneconometricmodeltoanalyzethefactorsthataffectelderlycarechoices,includingpersonalcharacteristics,familyeconomicstatus,communityenvironment,policysupport,andotheraspects.Throughempiricalanalysis,thisarticleaimstorevealthemechanismsanddegreesofinfluenceofdifferentfactorsonelderlycarechoices,providingusefulreferencesforoptimizingtheallocationofelderlycareresourcesandimprovingthequalityofelderlycareservices.本文的研究不僅有助于深入理解中國老年護(hù)理問題的本質(zhì)和現(xiàn)狀，也有助于為政府和社會各界制定相關(guān)政策提供科學(xué)依據(jù)。通過本文的研究，我們期望能夠為推動中國老年護(hù)理事業(yè)的健康發(fā)展，提高老年人的生活質(zhì)量和健康福祉貢獻(xiàn)一份力量。ThisstudynotonlyhelpstogainadeeperunderstandingoftheessenceandcurrentsituationofelderlycareissuesinChina,butalsoprovidesscientificbasisforthegovernmentandvarioussectorsofsocietytoformulaterelevantpolicies.Throughthisstudy,wehopetocontributetothehealthydevelopmentofelderlycareinChina,improvethequalityoflifeandhealthwell-beingoftheelderly.二、理論基礎(chǔ)與分析框架Theoreticalfoundationandanalyticalframework在探討中國老年護(hù)理的選擇問題時，本文基于非正式護(hù)理與正式護(hù)理兩種護(hù)理模式的理論基礎(chǔ)進(jìn)行深入研究。非正式護(hù)理主要指由家庭成員、朋友或鄰居等非專業(yè)護(hù)理人員提供的護(hù)理服務(wù)，它強(qiáng)調(diào)家庭與社區(qū)在老年護(hù)理中的重要角色。正式護(hù)理則是由專業(yè)護(hù)理機(jī)構(gòu)或護(hù)理人員（如養(yǎng)老院、護(hù)士等）提供的護(hù)理服務(wù)，具有標(biāo)準(zhǔn)化、專業(yè)化的特點(diǎn)。WhenexploringtheselectionofelderlycareinChina,thisarticleconductsin-depthresearchbasedonthetheoreticalfoundationsofinformalandformalnursingmodels.Informalcaremainlyreferstonursingservicesprovidedbynonprofessionalcaregiverssuchasfamilymembers,friends,orneighbors,emphasizingtheimportantroleoffamiliesandcommunitiesinelderlycare.Formalnursingisanursingserviceprovidedbyprofessionalnursinginstitutionsornursingstaff(suchasnursinghomes,nurses,etc.),withthecharacteristicsofstandardizationandspecialization.本文的理論基礎(chǔ)還涉及社會學(xué)、人口學(xué)、醫(yī)學(xué)和經(jīng)濟(jì)學(xué)等多個學(xué)科領(lǐng)域。社會學(xué)和人口學(xué)提供了老年人口結(jié)構(gòu)變化和社會支持網(wǎng)絡(luò)的理論框架，有助于分析老年護(hù)理需求的社會背景。醫(yī)學(xué)領(lǐng)域的研究則關(guān)注老年人的健康狀況和疾病譜變化，為護(hù)理服務(wù)的專業(yè)性和針對性提供指導(dǎo)。經(jīng)濟(jì)學(xué)視角則側(cè)重于成本效益分析，探討不同護(hù)理模式對老年人和社會的經(jīng)濟(jì)負(fù)擔(dān)。Thetheoreticalfoundationofthisarticlealsoinvolvesmultipledisciplinessuchassociology,demography,medicine,andeconomics.Sociologyanddemographyprovideatheoreticalframeworkforchangesintheelderlypopulationstructureandsocialsupportnetworks,whichhelpstoanalyzethesocialbackgroundofelderlycareneeds.Researchinthemedicalfieldfocusesonthehealthstatusanddiseasespectrumchangesoftheelderly,providingguidancefortheprofessionalismandtargetingofnursingservices.Theeconomicperspectivefocusesoncost-benefitanalysis,exploringtheeconomicburdenofdifferentnursingmodelsontheelderlyandsociety.本文的分析框架主要包括以下幾個步驟：通過文獻(xiàn)回顧和實地調(diào)查，明確中國老年護(hù)理的現(xiàn)狀和問題，為后續(xù)的實證分析奠定基礎(chǔ)。利用CLHLS（中國老年健康影響因素跟蹤調(diào)查）和CHARLS（中國健康與養(yǎng)老追蹤調(diào)查）等大型數(shù)據(jù)庫，對老年護(hù)理的需求、供給和滿意度等方面進(jìn)行量化分析，揭示非正式護(hù)理與正式護(hù)理的優(yōu)缺點(diǎn)。接著，通過構(gòu)建多元回歸模型等方法，探討影響老年人選擇護(hù)理模式的因素，包括個人特征、家庭結(jié)構(gòu)、經(jīng)濟(jì)狀況、社區(qū)環(huán)境等。結(jié)合中國的實際情況，提出優(yōu)化老年護(hù)理模式的政策建議，以促進(jìn)非正式護(hù)理與正式護(hù)理的協(xié)調(diào)發(fā)展，滿足老年人多樣化的護(hù)理需求。Theanalysisframeworkofthisarticlemainlyincludesthefollowingsteps:throughliteraturereviewandfieldinvestigation,clarifythecurrentsituationandproblemsofelderlycareinChina,andlaythefoundationforsubsequentempiricalanalysis.UsinglargedatabasessuchasCLHLS(ChinaElderlyHealthImpactFactorsTrackingSurvey)andCHARLS(ChinaHealthandElderlyCareTrackingSurvey),quantitativeanalysisisconductedonthedemand,supply,andsatisfactionofelderlycare,revealingtheadvantagesanddisadvantagesofinformalcareandformalcare.Next,byconstructingmultipleregressionmodelsandothermethods,thisstudyexploresthefactorsthatinfluencethechoiceofnursingmodesamongtheelderly,includingpersonalcharacteristics,familystructure,economicstatus,communityenvironment,etc.BasedontheactualsituationinChina,policyrecommendationsareproposedtooptimizetheelderlycaremodel,inordertopromotethecoordinateddevelopmentofinformalandformalcare,andmeetthediversenursingneedsoftheelderly.在分析過程中，本文將注重數(shù)據(jù)的準(zhǔn)確性和方法的科學(xué)性，力求得出客觀、可靠的結(jié)論。本文還將關(guān)注不同區(qū)域、不同社會經(jīng)濟(jì)背景下老年護(hù)理模式的差異性和共性，以期為中國老年護(hù)理事業(yè)的健康發(fā)展提供有益的參考。Intheanalysisprocess,thisarticlewillfocusontheaccuracyofdataandthescientificityofmethods,strivingtodrawobjectiveandreliableconclusions.Thisarticlewillalsofocusonthedifferencesandcommonalitiesofelderlycaremodelsindifferentregionsandsocio-economicbackgrounds,inordertoprovideusefulreferencesforthehealthydevelopmentofelderlycareinChina.三、數(shù)據(jù)來源與變量選擇Datasourcesandvariableselection本研究主要基于中國健康與養(yǎng)老追蹤調(diào)查（CLHLS）和中國家庭追蹤調(diào)查（CHARLS）兩項大型數(shù)據(jù)集進(jìn)行實證分析。CLHLS是一項專門針對中國老年人口健康狀況的追蹤調(diào)查，自1998年開始，每兩年進(jìn)行一次全國范圍內(nèi)的抽樣調(diào)查，旨在了解中國老年人的健康狀況、生活質(zhì)量和社會支持等情況。CHARLS則是一項覆蓋全國家庭的大型追蹤調(diào)查，旨在收集關(guān)于中國家庭及個人在經(jīng)濟(jì)、健康、教育、就業(yè)和社會參與等多方面的詳細(xì)數(shù)據(jù)。Thisstudyismainlybasedonempiricalanalysisoftwolargedatasets,theChinaHealthandRetirementLongitudinalSurvey(CLHLS)andtheChinaFamilyLongitudinalSurvey(CHARLS).CLHLSisatrackingsurveyspecificallytargetingthehealthstatusoftheelderlypopulationinChina.Since1998,anationwidesamplingsurveyhasbeenconductedeverytwoyearstounderstandthehealthstatus,qualityoflife,andsocialsupportoftheelderlypopulationinChina.CHARLSisalarge-scaletrackingsurveycoveringhouseholdsacrossthecountry,aimedatcollectingdetaileddataonChinesehouseholdsandindividualsinvariousaspectssuchaseconomy,health,education,employment,andsocialparticipation.在變量選擇上，我們主要考慮了以下幾個方面：我們根據(jù)研究目的，選擇了反映老年人護(hù)理需求的變量，包括身體健康狀況、慢性疾病情況、日常生活自理能力等；我們選擇了反映非正式護(hù)理和正式護(hù)理情況的變量，如子女?dāng)?shù)量、子女居住情況、是否接受家庭護(hù)理服務(wù)等；我們還考慮了一些可能影響老年人護(hù)理選擇的社會經(jīng)濟(jì)因素，如年齡、性別、受教育程度、家庭收入等。Intermsofvariableselection,wemainlyconsideredthefollowingaspects:basedontheresearchpurpose,weselectedvariablesthatreflectthenursingneedsoftheelderly,includingphysicalhealthstatus,chronicdiseasesituation,dailyself-careability,etc;Wehaveselectedvariablesthatreflectthesituationofinformalandformalcare,suchasthenumberofchildren,theirlivingconditions,andwhethertheyreceivehomecareservices;Wealsoconsideredsomesocio-economicfactorsthatmayaffectelderlycarechoices,suchasage,gender,educationlevel,familyincome,etc.通過對CLHLS和CHARLS數(shù)據(jù)的整合和分析，我們可以更全面地了解中國老年人護(hù)理需求的特點(diǎn)和現(xiàn)狀，以及非正式護(hù)理和正式護(hù)理在老年人護(hù)理中的實際作用。我們還可以進(jìn)一步探討影響老年人護(hù)理選擇的各種因素，為制定更加科學(xué)合理的老年護(hù)理政策提供實證支持。ByintegratingandanalyzingCLHLSandCHARLSdata,wecangainamorecomprehensiveunderstandingofthecharacteristicsandcurrentsituationofelderlycareneedsinChina,aswellasthepracticalroleofinformalandformalcareinelderlycare.Wecanfurtherexplorevariousfactorsthataffectelderlycarechoices,providingempiricalsupportforformulatingmorescientificandreasonableelderlycarepolicies.四、實證分析Empiricalanalysis本文利用中國老年健康長壽影響因素跟蹤調(diào)查（CLHLS）和中國健康與養(yǎng)老追蹤調(diào)查（CHARLS）的數(shù)據(jù)，對中國老年護(hù)理的選擇進(jìn)行了實證分析。通過對比非正式護(hù)理與正式護(hù)理的使用情況，以及影響老年護(hù)理選擇的因素，我們試圖揭示中國老年護(hù)理的現(xiàn)狀與未來發(fā)展趨勢。ThisarticleempiricallyanalyzestheselectionofelderlycareinChinausingdatafromtheChinaElderlyHealthandLongevityTrackingSurvey(CLHLS)andtheChinaHealthandRetirementTrackingSurvey(CHARLS).Bycomparingtheuseofinformalcareandformalcare,aswellasthefactorsinfluencingelderlycarechoices,weattempttorevealthecurrentsituationandfuturedevelopmenttrendsofelderlycareinChina.我們利用描述性統(tǒng)計方法，對CLHLS和CHARLS數(shù)據(jù)中關(guān)于老年護(hù)理選擇的部分進(jìn)行了初步分析。通過對比非正式護(hù)理（如家庭護(hù)理、社區(qū)互助等）與正式護(hù)理（如養(yǎng)老院、專業(yè)護(hù)理機(jī)構(gòu)等）的使用率，我們發(fā)現(xiàn)非正式護(hù)理在中國的老年護(hù)理中占據(jù)了主導(dǎo)地位。這一現(xiàn)象可能與中國的傳統(tǒng)文化、家庭觀念以及社會養(yǎng)老保障制度的不完善有關(guān)。WeuseddescriptivestatisticalmethodstoconductapreliminaryanalysisoftheelderlycarechoicesintheCLHLSandCHARLSdata.Bycomparingtheusageratesofinformalcare(suchashomecare,communitymutualassistance,etc.)withformalcare(suchasnursinghomes,professionalnursinginstitutions,etc.),wefoundthatinformalcaredominatesinelderlycareinChina.ThisphenomenonmayberelatedtoChina'straditionalculture,familyvalues,andtheimperfectsocialpensionsystem.我們運(yùn)用多元線性回歸模型，對影響老年護(hù)理選擇的因素進(jìn)行了深入分析。結(jié)果表明，年齡、性別、健康狀況、經(jīng)濟(jì)狀況、家庭結(jié)構(gòu)等因素均對老年護(hù)理選擇有顯著影響。其中，年齡越大、健康狀況越差的老年人更傾向于選擇正式護(hù)理；而女性、經(jīng)濟(jì)狀況較差、家庭結(jié)構(gòu)較簡單的老年人則更傾向于選擇非正式護(hù)理。這些發(fā)現(xiàn)為我們理解老年護(hù)理選擇提供了重要依據(jù)。Weusedamultiplelinearregressionmodeltoconductanin-depthanalysisofthefactorsthataffectelderlycarechoices.Theresultsindicatethatfactorssuchasage,gender,healthstatus,economicstatus,andfamilystructurehaveasignificantimpactonthechoiceofelderlycare.Amongthem,olderadultswithpoorerhealthconditionsaremoreinclinedtochooseformalcare;Women,elderlypeoplewithpoorereconomicconditions,andsimplerfamilystructuresaremoreinclinedtochooseinformalcare.Thesefindingsprovideimportantevidenceforourunderstandingofelderlycarechoices.我們結(jié)合中國的實際情況，對非正式護(hù)理與正式護(hù)理的優(yōu)缺點(diǎn)進(jìn)行了比較分析。非正式護(hù)理雖然具有親情關(guān)懷、低成本等優(yōu)勢，但隨著家庭結(jié)構(gòu)的變化和社會老齡化程度的加深，其可持續(xù)性面臨挑戰(zhàn)。而正式護(hù)理雖然能夠提供專業(yè)、全面的護(hù)理服務(wù)，但高昂的費(fèi)用和可能的情感缺失也是其不可忽視的問題。因此，我們需要綜合考慮非正式護(hù)理與正式護(hù)理的優(yōu)缺點(diǎn)，結(jié)合中國的國情，制定更加合理、有效的老年護(hù)理政策。WecomparedandanalyzedtheadvantagesanddisadvantagesofinformalnursingandformalnursingbasedontheactualsituationinChina.Althoughinformalcarehasadvantagessuchasfamilycareandlowcost,itssustainabilityisfacingchallengeswithchangesinfamilystructureanddeepeningsocialaging.Althoughformalnursingcanprovideprofessionalandcomprehensivenursingservices,thehighcostandpotentialemotionallossarealsoissuesthatcannotbeignored.Therefore,weneedtocomprehensivelyconsidertheadvantagesanddisadvantagesofinformalcareandformalcare,andformulatemorereasonableandeffectiveelderlycarepoliciesbasedonChina'snationalconditions.本文的實證分析表明，非正式護(hù)理在中國老年護(hù)理中占據(jù)主導(dǎo)地位，但正式護(hù)理的需求也在逐漸增長。未來，我們需要進(jìn)一步完善社會養(yǎng)老保障制度，提高正式護(hù)理的服務(wù)質(zhì)量和可及性，同時鼓勵和支持非正式護(hù)理的發(fā)展，以滿足不同老年人的多樣化需求。TheempiricalanalysisinthisarticleindicatesthatinformalcaredominatesinelderlycareinChina,butthedemandforformalcareisalsograduallyincreasing.Inthefuture,weneedtofurtherimprovethesocialpensionsecuritysystem,improvethequalityandaccessibilityofformalcareservices,andencourageandsupportthedevelopmentofinformalcaretomeetthediverseneedsofdifferentelderlypeople.五、結(jié)論與建議Conclusionandrecommendations經(jīng)過基于CLHLS和CHARLS數(shù)據(jù)的實證分析，我們發(fā)現(xiàn)中國老年護(hù)理在非正式護(hù)理與正式護(hù)理之間存在顯著的選擇差異。非正式護(hù)理，主要由家庭成員提供的日常照料和情感支持，在老年護(hù)理中占據(jù)了主導(dǎo)地位。然而，隨著老齡化的加劇和家庭結(jié)構(gòu)的轉(zhuǎn)變，非正式護(hù)理的壓力逐漸增大，其可持續(xù)性和質(zhì)量也面臨挑戰(zhàn)。AfterempiricalanalysisbasedonCLHLSandCHARLSdata,wefoundthatthereisasignificantselectiondifferencebetweeninformalcareandformalcareinelderlycareinChina.Informalcare,mainlyprovidedbyfamilymembersfordailycareandemotionalsupport,occupiesadominantpositioninelderlycare.However,withtheintensificationofagingandthetransformationoffamilystructure,thepressureofinformalcareisgraduallyincreasing,anditssustainabilityandqualityarealsofacingchallenges.正式護(hù)理，包括機(jī)構(gòu)養(yǎng)老和社區(qū)服務(wù)等，雖然在一定程度上緩解了非正式護(hù)理的壓力，但其在老年護(hù)理市場中的份額仍然較小。這主要是由于正式護(hù)理服務(wù)的可及性、可負(fù)擔(dān)性以及服務(wù)質(zhì)量等問題，使得許多老年人及其家庭對正式護(hù)理持保守態(tài)度。Formalcare,includinginstitutionalelderlycareandcommunityservices,althoughtosomeextentalleviatesthepressureofinformalcare,itsshareintheelderlycaremarketisstillrelativelysmall.Thisismainlyduetoissuessuchasaccessibility,affordability,andservicequalityofformalcareservices,whichhaveledmanyelderlypeopleandtheirfamiliestoadoptaconservativeattitudetowardsformalcare.因此，我們建議政府在制定老年護(hù)理政策時，應(yīng)充分考慮非正式護(hù)理與正式護(hù)理的平衡發(fā)展。一方面，通過完善家庭護(hù)理政策、提高家庭成員的護(hù)理能力，鼓勵和支持非