基于精算模型对长期护理保险基金支出的研究——以上海市为例
Study on Long-Term Care Insurance Fund Expenditure Based on Actuarial Model—Taking Shanghai as an Example

目的：基金支出是长期护理保险可持续运行的关键问题，测算长期护理保险基金支出对于促进长期护理保险制度可持续性具有积极意义。方法：建立长期护理保险基金支出精算模型，利用中国上海市人口数据及长期护理保险实际运行数据，对2020~2040年长期护理保险基金支出进行预测及仿真研究。结果：低失能率方案下失能人口从50.14万人增长到2040年的111.15万人，总费用从2020年37.66亿元将增加至2040年83.48亿元；高失能率方案下失能人口从63.47万人增长到2040年的140.68万人，总费用从2020年的38.74亿元增加到2040年85.77亿元。结论：应扩大失能人群覆盖范围，优化失能评定量表，探索建立多元筹资体系，适当增加给付范围及辅具支持，促进长期护理保险制度可持续性发展。
Objective: Fund expenditure is the key problem of the sustainable operation of long-term nursing insurance. It is of positive significance to calculate the fund expenditure of Shanghai long-term nursing insurance for promoting the sustainability of long-term nursing insurance system. Methods: The actuarial model of long-term nursing insurance fund expenditure was established, and the long-term nursing fund expenditure in Shanghai from 2020 to 2040 was predicted and simulated by using the actual operation data of Shanghai long-term nursing insurance. Results: The total cost under the low energy loss rate scheme will increase from RMB 6.773 billion to 20.05 billion yuan in 2040, and the proportion of GDP will rise from 0.18% to 0.54%; the total cost under the high loss rate scheme will increase from RMB 8.573 billion in 2020 to RMB 25.954 billion in 2040, which will increase from 0.22% to 0.68% of GDP. Conclusion: Shanghai should expand the coverage of disabled people, optimize the disability assessment scale, explore the establishment of multi financing system, increase the scope of payment and support of auxiliary equipment, and promote the sustainable development of long-term nursing insurance system.