A Study On The Operating Mechanism Of Government 's Purchase Of Home Care Service

With the development of national economy,the improvement of health conditions and people’s living standard, China’s average life expectancy has extended.Problem of population aging is becoming more and more severe. On the one hand, the cardinal number of old population is huge, and the features of fast growing and unbalanced development between regions are still prominent.On the other hand, the increasing number of the oldest old,disability and empty nest elderly brings new challenges to us. How to solve the aging problem in order to make 200 million "silver people" well-cared,is the urgent task of our society.The model of aging in place takes family as its core and community as its base,which shows its advantages in cheap price,flexible services and extensive clientele.It is now widely recognized as an important basis at the present stage.However,under the circumstances of "aging preceding richness",we are facing with the difficulties between aging population and limited resources.Model of aging in place has just started in China,inadequate service delivery and low level specialization call for more attention and action to this model.In 2003, Gulou District of Nanjing invested 150 thousand yuan to explore the "home-based care services network".The government purchased home-based services for 100 people who lived alone.This initiative helps to optimize the use of funds,helps to realize the socialization of public service,and helps to improve the professionalism of pension service.In 2013,Nanjing Municipal Government issued the "Nanjing community home care service implement",which was the milestone of this policy.Besides,the general spirit of the nation provides an institutional guarantee for it.Based on the above background,this paper focuses on the operating mechanism that Nanjing Government purchasing home-based services for difficult elderly.Adhering to the premise of demand-oriented,this paper analyzes four important elements-----provider,producer,consumer,supervisor.According to the interviews and literature review,the paper gives an empirical analysis to the effect of five districts in Nanjing.After analyzing the reporting mechanism,the payment mechanism,the purchase mechanism and the supervision mechanism,this paper summarizes the following characteristics,such as socialization of the main functions,preferring entrusted purchase and intelligent management platform.In addition to affirming Nanjing’s remarkable achievements,it points out the problems existing in the present stage from many aspects,as the small coverage,low price,long settlement time,non competitive phenomenon and so on.In the end,the paper puts forward to some suggestions theoretically and practically.