摘要：当前，我国围绕重度残疾人护理问题加大制度供给，取得了一定的社会成效。但护理补贴有限，在符合残疾人家庭期望、满足残疾人护理需求以及瞄准偏误等方面仍存在问题。通过梳理日本、德国两国在残疾人福利补贴制度和残疾人长期护理保险制度方面的做法，旨在为我国建立重度残疾人长期护理保险制度提供借鉴和参考：（一）促进老年人与残疾人两个护理人群的覆盖与制度融合，建立科学的护理需求评估办法；（二）促进非正式护理发展，重视对家庭护理的支持；（三）建立独立的筹资体系，避免过度依赖医疗保险进行筹资；（四）促进护理服务业的发展。

关键词：残疾人护理；长期护理保险；残疾人福利；德国；日本

中图分类号：D669.69;F842.6文献标识码：A文章编号：2095-6916（2024）12-0059-04

From Care Subsidies for Persons with Severe Disabilities to Long-term Care Insurance

—Research Based on Japanese and German Experience

Wang Rui

（School of Public Administration， Southwest Jiaotong University， Chengdu 610031）

Abstract： At present， China has increased its institutional provision for the nursing of severely disabled persons and has achieved certain social outcomes. However， care subsidies are limited， and there are still problems in aspects such as meeting the expectations of families of persons with disabilities， satisfying their care needs and targeting bias. By summarizing the practices of Japan and Germany with regard to the welfare subsidy system and the care insurance for the disabled， aiming to provide reference for the establishment of a long-term care insurance system for the severely disabled in China： （1） promoting the coverage and institutional integration of the groups of the elderly and the disabled who need care and establishing a scientific method for care needs assessment; （2） promoting the development of informal nursing and emphasize support for home-based nursing; （3） establish an independent financing system to avoid over-reliance on health insurance for financing; （4） promoting the development of the nursing services industry.

Keywords： care for persons with disabilities; long term care insurance; welfare for people with disabilities; Germany; Japan

随着社会工业化程度与中国人口老龄化加深，我国的残疾人口不断增多。根据中国残疾人联合会发布的全国持证残疾人人口基础库主要数据，截至2022年12月31日，我国持有残疾人证的残疾人总数达3 768万人。其中重度残疾1 693万人，占残疾人口总数的44.93%［1］。而由于残疾人的相对弱势性使得残疾人群体更易陷入相对贫困中，相应的生活与护理需求难以得到满足。2015年，国务院发布《关于全面建立困难残疾人生活补贴和重度残疾人护理补贴制度的意见》（国发〔2015〕52号），并于次年1月开始实施，为重度残疾人及其家庭在生活及护理需求的满足上提供了制度支持，充分体现了国家对残疾人的需求高度重视。……