“一人失能，全家失衡”难题，这样破解（大健康观察）

Core Viewpoint - The long-term care insurance (LTCI) system in China is evolving to address the increasing demand for care services for the elderly, particularly those with disabilities or dementia, as the traditional family caregiving model weakens under modern societal pressures [4][5][6]. Group 1: Current Situation and Challenges - Over 45 million elderly individuals in China require long-term care, with one in six elderly people needing assistance [4]. - The traditional family structure, characterized by the "421" model, places significant caregiving burdens on younger generations, leading to increased stress and challenges in providing adequate care [4][5]. - Rural areas face acute challenges in elderly care due to a lack of resources and professional services, resulting in a situation where families struggle to provide care [6][9]. Group 2: Policy Implementation and Impact - Various regions are piloting LTCI programs to alleviate the burden of elderly care, with a focus on integrating care services into existing healthcare frameworks [5][8]. - In Kaifeng, the introduction of LTCI has led to significant financial relief for families, with reimbursements covering up to 65% of care costs, allowing access to professional care facilities [5][6]. - The LTCI system has been expanding since its initial pilot in 2016, with nearly 1.9 billion people enrolled and over 850 billion yuan spent on care services [13]. Group 3: Innovations in Care Delivery - The transformation of community health centers into LTCI service providers is gaining traction, allowing for better utilization of resources and addressing the dual challenges of underused hospital beds and the need for elderly care [7][8]. - In Xuzhou, the integration of LTCI services into local healthcare facilities has resulted in a significant increase in occupancy rates and service provision, demonstrating a successful model for rural healthcare [8][10]. - The establishment of home-based care services is becoming more common, with healthcare professionals providing regular visits to assist families in managing care for elderly relatives [9][10]. Group 4: Funding and Sustainability - The LTCI system relies on a multi-source funding model, combining contributions from individuals, government subsidies, and social funds to create a sustainable financial framework [11][12]. - In Longkou, the annual contribution for LTCI is as low as 30 yuan for workers, making it accessible while ensuring that over 1,300 disabled elderly individuals benefit from the program [11][12].