Time And Space Evolution Mechanism Of Long-term Care Insurance System

Since my country entered the ranks of countries with an aging population in 1999,the scale of the elderly population has continued to expand,and the number of disabled and demented elderly people has increased,which not only affects personal health and family harmony.,but also related to the healthy and sustainable development of my country’s economy.Since the 18 th National Congress of the Communist Party of China,the Party and the government have attached great importance to the development of aging work.The Fifth Plenary Session of the 18 th CPC Central Committee and the13 th Five-Year Plan clearly pointed out that "actively carry out actions to deal with population aging" and "implement the national strategy to actively deal with population aging".It is also highlighted in the 14 th Five-Year Plan.At the same time,local governments have innovatively introduced long-term care insurance systems when actively exploring and improving various social security systems,providing creative solutions for the care of disabled and demented elderly,and the collection and sharing of medical expenses.However,the practice of the long-term care insurance system in my country started relatively late.Although Qingdao became the first city in my country to pilot the system in 2012,some cities have also carried out a series of explorations since then.However,the relevant central documents are until the "Guiding Opinions on Launching the Long-term Care Insurance System" issued by the Ministry of Human Resources and Social Security in 2016 and the "Guiding Opinions on Expanding the Pilot Program of Long-term Care Insurance System" issued by the National Medical Insurance Administration and the Ministry of Finance in 2020 ” to promote the diffusion of the long-term care insurance system in my country.The number of pilot cities for the longterm care insurance system in my country has reached 62 at the beginning of 2022.At the same time,six provincial governments have issued guidelines for the long-term care insurance system at the provincial level.Generally speaking,there are fewer pilot cities for the long-term care insurance system.Still relatively unfamiliar to city governments in most regions.Therefore,exploring an effective path for the rapid diffusion of this system is of great significance for building a coordinated and effective health policy diffusion mechanism.Taking the policy innovation diffusion perspective as the breakthrough point,this paper analyzes the program details of 62 pilot cities in the country that implement longterm care insurance systems,and finds the diffusion laws of long-term care insurance systems from three aspects: space,content,and time,and combines the level of This paper explores the dynamic mechanism that promotes the diffusion of long-term care insurance system and the intergovernmental relationship in the vertical direction.The research shows that the long-term care insurance system shows an "S-shaped" curve growth trend over time;the spatial proximity effect interacts with the top-down vertical influence,and the hierarchical effect of "leader-follow-up" is significant;content diffusion It has the characteristics of policy imitation,localization innovation and "incremental" adjustment;under the combined force of learning,competition,imitation,social construction,administrative orders and other dynamic mechanisms,the rapid diffusion of long-term care insurance system in my country is promoted.In order to promote the wider spread of the long-term care insurance system in my country,in addition to paying attention to the existing system defects,the central government also needs to give local governments more autonomy,and use "absorption-radiation" to strengthen the interaction between the central and local governments.At the same time,the role of social forces cannot be ignored,so as to improve our country’s social security system.