【作者】 胡平；

【导师】 徐家良；

【作者基本信息】 上海交通大学 ， 公共管理， 2013， 硕士

【摘要】 构建老有所养的社会是全面建设小康社会的重要内容之一，机构养老是构成养老格局的重要支撑。在政府财力有限的情况下，促进民办养老机构的发展是解决养老难题的有效措施。对于上海这种老龄化人口总量和速度非常高的城市，尤为如此。然而目前上海养老市场需求非常巨大，但民办养老机构的入住率却不高。这其中的反差即民办养老机构为什么不能吸引老年人入住，民办养老机构的发展存在哪些困境，解决困境促进上海民办养老机构发展需要哪些政策创新随即构成了本文的研究主题。在研究进路上，本文遵循了提出问题—分析问题—解决问题的行文逻辑。结合福利社会化理论和第三方治理理论，采用文献分析和实地访谈相结合的研究方法，在总结上海市人口老龄化现状、上海市政府养老事业格局和民办养老机构发展现状的基础上，指出积极发展民办养老机构的必要性和紧迫性。按照登记注册机关不同，将民办养老机构划分为民非型和企业型两类民办养老机构。通过实地访谈调研民非型的A和B、企业型的C和D这四家养老机构，深入阐述了两种类型养老机构的运行模式和存在的困境。民非型养老机构的困境为：盈利能力较弱，导致民营性型养老机构发展受阻；专业人才缺乏，员工队伍不稳定；老人心理寂寞，缺乏家庭关爱和亲情滋养；养老院运作主要以营利为导向，公益导向难以保障。企业型养老机构的困境原因为：入住率不高，床位闲置较多；资金运作困难；产权隐患；注册登记困难，管理服务缺位。然后总结出两类民办养老机构的共同困境：入住率不高，资金周转困境；养老服务的专业化程度偏低困境；养老扶持政策缺位和执行不力困境；民办养老机构的信息化系统滞后困境。最后根据政策的统一性、配套性和可行性原则，提出了促进民办养老机构发展的五条政策建议：调整目标，合理布局，盘活存量。走“民非型”和“企业型”双向发展道路；落实优惠政策，加大扶持力度，主要包括简化注册流程，提供优质服务；完善投融资政策；完善相关补贴、税费减免政策；提升养老服务的专业化水平，促进医疗机构与养老产业的融合；加强敬老爱老宣传，倡导慈善公益活动，构建良性的养老支撑体系；加强监管，引导公益化导向。更多还原

【Abstract】 Let seniors have decent places to live is part of building a well-off society inan all-round way in China, and institution-based care of the elderly constitutesan important part in China’s supporting system for the elderly. Because ofgovernment’s limited budget, to promote the development of private seniorhomes is crucial in solving this social problem. This is especially importantwhen it comes to big cities like Shanghai with higher rate of aging. The reality isthat the occupancy rate of private senior homes is not high while there is strongdemand in this market. Then why the private senior homes cannot attract theelderly? What specific problems those senior homes come into? What kind ofpolicy innovations could be made to promote its fast development? Those arethe research questions of this paper.The basic framework of the paper is to put forward the question, analyze itin details with cases and finally some suggestions have been made for the policyimprovement and innovation. The research methods used in the paper areliterature analysis and in-depth interviews and the theories are social welfaresocialization and third-party government. With the theories and methods, we analyze the aging issue, government’s policy plan for the cause of supporting theelderly, and the current situation of private senior homes in Shanghai, and find itis high time to promote the development of private senior homes. According todifferent registration departments, private senior homes can be categorized intoprivate and profitable institution (企业型养老机构) and private but nonprofitinstitution （民非型养老机构）.We analyze the operating models and existing problems of these two typesof private senior homes by studying private but nonprofit institution with caseA and B, and private and profitable institution and with case C and D. Theproblems of the former type include weak capacity in earning leading its slowdevelopment; lack of professional staff leading its instability; lack of familymember’s love and care leading loneliness of the elderly; the profit-orientedoperation influencing its initial orientation. The problems of the latter typeinclude low occupancy rate; financial difficulty; potential factor of propertyright; difficulty in registration. There are some problems in common for thesetwo types including low level of professionalism; government’s absence inpolicy supporting and inefficient in policy implementation; the backwardinformation system of private senior homes in Shanghai.According to policy making rule, finally I provide following policies topromote the development of private senior homes based on the above-mentionedanalysis. These two types of senior homes should develop at the same time. Thefavorable policy should be implemented and government should encourage its development. Improve the environment of investment and finance. Improvesubsidy policy, and tax deduction and exemption policy. Improve theprofessional level, and combine the medical institution and senior home industry.Greatly encourage people to love and respect the elderly, advocacy philanthropyand construct the supporting system in this industry. Strengthen the supervisionand lead in direction of philanthropy.更多还原