Article(id=1322929589684675363, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322929431592972373, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.15.013, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1763568000000, receivedDateStr=2025-11-20, revisedDate=1778169600000, revisedDateStr=2026-05-08, acceptedDate=null, acceptedDateStr=null, onlineDate=1793340593023, onlineDateStr=2026-10-30, pubDate=1786291200000, pubDateStr=2026-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793340593023, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793340593023, creator=13701087609, updateTime=1793340593023, updator=13701087609, issue=Issue{id=1322929431592972373, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='15', pageStart='2577', pageEnd='2768', issueExtLink='null', onlineDate='null', pubDate='1786291200000', pubDateStr='2026-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793340555332, creator='13701087609', updateTime=1793343107287, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940135335145743, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322929431592972373, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940135335145744, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322929431592972373, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2675, endPage=2680, ext={EN=ArticleExt(id=1322929589894390564, articleId=1322929589684675363, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Enlightenment of Singapore's 3Ms system to China's multi-scenario collaborative long-term care model, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=

This study systematically sorted out the development background of the 3Ms system in Singapore's long-term care model,analyzed its multi-scenario collaborative practice paths and technology empowerment mechanisms,and proposed targeted inspirations for the existing problems in long-term care services in China,in order to provide reference for building a high-quality long-term care service system that is in line with China's national conditions.

, authors=Ruikang HUI, Fan YANG, Wenyan WANG, Xiaodong XING, Enhui LIU, authorsList=Ruikang HUI, Fan YANG, Wenyan WANG, Xiaodong XING, Enhui LIU, authorCompany=null, correspAuthors=Wenyan WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322929591035241253, articleId=1322929589684675363, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=新加坡3Ms体系对我国多场景协同长期护理模式的启示, columnId=1220689488938980091, journalTitle=护理研究, columnName=综合研究, runingTitle=null, highlight=null, articleAbstract=

系统梳理新加坡长期护理模式中3Ms体系的发展背景,剖析其多场景协同的实践路径与技术赋能机制,并针对我国长期护理服务现存问题提出针对性启示,以期为构建符合我国国情的高质量长期护理服务体系提供参考。

, authors=惠瑞康, 杨帆, 王文燕*, *, 邢晓冬, 刘恩惠, authorsList=惠瑞康, 杨帆, 王文燕, 邢晓冬, 刘恩惠, authorCompany=null, correspAuthors=王文燕, authorNote=

惠瑞康,硕士研究生在读

, correspAuthorsNote=
王文燕,E-mail:
WANG Wenyan, E-mail:
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新加坡3Ms体系对我国多场景协同长期护理模式的启示
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惠瑞康 , 杨帆 , 王文燕 *, * , 邢晓冬 , 刘恩惠
护理研究 | 综合研究 2026,40(15): 2675-2680
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护理研究 |综合研究 2026 , 40 (15) : 2675 -2680
新加坡3Ms体系对我国多场景协同长期护理模式的启示
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惠瑞康, 杨帆, 王文燕*, * , 邢晓冬, 刘恩惠
作者信息
  • 1内蒙古民族大学护理学院,内蒙古 028000
通讯作者:
王文燕,E-mail:
WANG Wenyan, E-mail:
作者简介:

惠瑞康,硕士研究生在读

Enlightenment of Singapore's 3Ms system to China's multi-scenario collaborative long-term care model
Ruikang HUI, Fan YANG, Wenyan WANG , Xiaodong XING, Enhui LIU
Affiliations
  • 1School of Nursing, Inner Mongolia Minzu University, Inner Mongolia 028000 China
出版时间: 2026-08-10 doi: 10.12102/j.issn.1009-6493.2026.15.013
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系统梳理新加坡长期护理模式中3Ms体系的发展背景,剖析其多场景协同的实践路径与技术赋能机制,并针对我国长期护理服务现存问题提出针对性启示,以期为构建符合我国国情的高质量长期护理服务体系提供参考。

长期护理服务  /  人口老龄化  /  新加坡  /  3Ms体系  /  技术赋能

This study systematically sorted out the development background of the 3Ms system in Singapore's long-term care model,analyzed its multi-scenario collaborative practice paths and technology empowerment mechanisms,and proposed targeted inspirations for the existing problems in long-term care services in China,in order to provide reference for building a high-quality long-term care service system that is in line with China's national conditions.

long-term care services  /  population aging  /  Singapore  /  3Ms system  /  technology empowerment
惠瑞康, 杨帆, 王文燕, 邢晓冬, 刘恩惠. 新加坡3Ms体系对我国多场景协同长期护理模式的启示. 护理研究, 2026 , 40 (15) : 2675 -2680 . DOI: 10.12102/j.issn.1009-6493.2026.15.013
Ruikang HUI, Fan YANG, Wenyan WANG, Xiaodong XING, Enhui LIU. Enlightenment of Singapore's 3Ms system to China's multi-scenario collaborative long-term care model[J]. Chinese Nursing Research, 2026 , 40 (15) : 2675 -2680 . DOI: 10.12102/j.issn.1009-6493.2026.15.013
长期护理是指因年老、疾病或伤残等因素导致丧失生活自理能力,需提供长期的生活照料、医疗护理和辅助性支持的综合性服务[1]。随着全球人口老龄化持续加剧,长期护理需求日益凸显。第七次全国人口普查显示,我国60岁及以上老年人口数约为26 402万人,占全国总人口数的18.7%,相较于2010年上升5.44个百分点,标志着我国进入人口老龄化快速发展阶段[2]。老龄化加速使老年群体,尤其是失能、半失能老年人的长期护理需求激增[3],同时也暴露出我国服务体系存在保障断层、场景割裂、技术应用不足等问题[4-6]。
新加坡与我国文化背景、家庭观念及老龄化挑战契合,其3Ms[保健储蓄(medisave)、健保双全(medishield)、保健基金(medifund)]医疗保障体系为长期护理模式,具有重要借鉴价值。据2024年新加坡人口简报,65岁以上公民占比达19.9%,2030年将达22.2%[7],老龄化压力下的3Ms实践对我国具有现实参考意义。相较于美国、德国等国家,新加坡强调个人、家庭、政府共同责任的社保理念,更贴合我国基本国情。本研究旨在梳理新加坡3Ms体系的发展脉络及核心逻辑,深入剖析其技术赋能与质量保障机制,对于探索我国长期护理服务体系的一体化、高质量发展路径,具有重要的参考价值。
新加坡3Ms体系的建立与推进与经济发展、人口结构变化及社会护理需求密切相关。20世纪50年代,新加坡国内生产总值(GDP)全球排名第6位[8]。20世纪60年代末,新加坡人口老龄化问题逐渐凸显。研究显示,新加坡生育率由2000年的1.6%降至2020年的1.1%[9]。与此同时,人口老龄化进程急剧加速,65岁以上人口占比从2000年的7.2%上升至2023年的18.7%,预计于2030年将突破22.2%[7]。其人口结构的改变引发一系列护理需求问题,具体如下:1)家庭规模小型化与核心化趋势显著,传统的家庭养老模式难以应对。据统计,2020年新加坡独居老年人占比已达15%[10]。失能老年人的照护责任被迫向社会转移。2)失能、失智群体规模进一步扩大。预计2030年将增至6.9万人,其中30%的失能人群至少需要10年的长期照护[11]。3)医疗费用上涨,单一的家庭储蓄与政府福利难以覆盖和维持长期护理的高额开支,亟须建立多层次、可持续的保障机制。在此背景下,新加坡政府摒弃“全福利”或“全市场”两极路径,以“个人责任为主、政府托底为辅”的原则确立3Ms体系,通过“个人储蓄-风险共担-贫困兜底”层级协同,为多场景护理服务提供全流程资金与标准支撑,既能缓解政府压力,又能保障长期护理可及性与可持续性。
保健储蓄是新加坡中央公积金制度的医疗保障核心,要求雇主与雇员按工资比例共同缴费至个人专属账户,用于支付个人及家庭医疗费用,缓解大病医疗负担[12]。账户内费用可以覆盖公立医院B2/C类病房(6~8人间)、部分私立医院诊疗及高血压、糖尿病等慢性病的相关费用[13]。未使用的资金余额可累积生息,可供退休后支付长期护理及其他老年医疗开支。此外,该体系允许直系亲属间共用保健储蓄,通过家庭内部的风险共担与福利共享,增强整体的抗风险能力。既保障了基本医疗服务的可及性,同时还可有效避免医疗资源的过度使用和浪费。然而,研究表明,当前新加坡多数老年人的保健储蓄金额仍不足以覆盖晚年医疗支出,长期护理缺口极为显著[14]。为此,新加坡政府进一步提出“终身护保计划”(care shield life)。该计划是一项强制性长期护理保险,要求所有30岁及以上居民参与,旨在为重度失能者提供每个月至少600新元补助,缓解其长期照护产生的经济压力,从而全面提升老年人的生活质量和医疗保障的水平[15]。其在筹资模式上,遵循“个人缴费、国家补贴”的原则,明确保险属性而非普惠福利。强调个人责任的意识形态连续性,显著扩大了风险共担范围,也强化社会共济功能[16]。综上所述,保健储蓄与终身护理保险计划形成储蓄+保险双重支撑,但仍存在低收入人群账户易透支、缴费负担不均等问题。
健保双全计划是保健储蓄的重要延伸与扩展,该计划最初于1990年实施,以自愿参保形式推出,通过“社会共济、风险分担”的社会保险机制,防范灾难性的医疗支出导致因病致贫,故又称大病保险计划[17]。2015年,新加坡政府将健保双全计划升级为强制性的、全民受保、终身享保的健保双全计划,真正意义上确保了长期护理的延续性[18]。为促进公平,新加坡政府基于“收入+住房”双层维度进行评估,为中低收入人群提供25%~60%的基础保费补贴,对建国、立国一代有突出贡献的人群额外叠加40%~60%的专项补贴[19]。在保障范围上,其覆盖公立医院B2/C类病房及部分私立医院的治疗费用,同时将重大疾病纳入报销范围,特定的慢性病和高额的药物也可报销。由此可见,健保双全弥补了保健储蓄的不足,确保投保人有能力支付重大疾病或长期疾病开销,为参保人筑起关键经济安全网[20]。
总而言之,健保双全计划的保障范围侧重于公立医院基础病房及重大疾病,对轻中度长期护理服务及高端护理要求覆盖不足,难以满足老年人护理服务需求多样化的要求;保费动态调整虽能应对医疗费用的上涨,但缺乏对老年群体专项减免设计,可能增加部分参保群体的缴费压力;同时,也限制了老年人对私立医院的选择,降低了就医体验。
保健基金是政府针对低收入人群专项设置的捐赠基金,其本金完全来自财政拨款,旨在为低收入人群提供最终的医疗保障。申请者需为新加坡公民,在保健基金批准医疗机构治疗,动用保健储蓄和健保双全计划后仍无力支付医疗费用,经家庭经济状况审查即可申请资助[18]。为确保资金审批的公平与高效,各级公立医院均设有保健基金委员会。该委员会负责审核申请人的具体申请条目,并依据申请人的经济状况和所需的医疗需求,确定具体的资助金额[21]。此计划将中央与地方紧密连接起来,既能精准识别需要帮助的群体,又能灵活解决复杂多变的现实问题。但此计划覆盖范围仅限新加坡公民,将长期居住的非公民群体排除在外,不利于社会保障公平性的体现;同时,审查流程严格,导致困难群体错失政府保障;资金链条全部来自政府拨款,缺乏其他渠道来源,可能会受到政府财政情况波动的影响。
新加坡3Ms体系通过将强制性储蓄、政府帮扶、社会救济有机结合,构建了长期护理的资金保障核心,为护理服务的开展奠定了经济基础。但资金保障的落地离不开具体服务场景的承接,需要结合护理场景转化为老年人可感知的服务效能。新加坡实践核心亮点之一便是将其融入多场景的护理实践中,形成连续、高效的长期护理服务网络。
为确保护理人员的服务质量,新加坡以法规规范与资金激励推动护理人员专业化建设。依据“Healthcare services(nursing home service)regulations 2023”要求,新加坡对护理人员进行专项培训。2024年起,技能创前程计划进一步与保健储蓄形成协同,大幅提高护理人员年度培训津贴标准,扩大培训名额规模,通过政策激励提高养老护理员队伍的专业素养[18]。林杰等[22]研究表明,专业护理人才是体系建设的核心,新加坡通过严格的护理教育体系保障人才供给。在技术适配方面,通过医疗保健生产力基金-技术采纳计划(HPF-TA),养老机构可通过健保双全计划报销大额护理设备采购费用。海军部村庄养老综合体的电动护理床等设备均通过该机制获得资金支持[23]。Ong等[24]研究证实,养老院医院(HaNH)模式可让养老院居民获得住院级治疗,缓解病床短缺,与居家医院(HaH)模式中位住院时长相当,具备机构急性照护的可行性。最后,在保护弱势群体方面,保健基金作为最终安全网,为符合条件的低收入老年人提供养老院床位费及护理服务的全额补贴[25]。
总之,3Ms体系通过资金激励与标准规范,实现养老护理专业化及技术化双重提升,既能保障养老护理员服务质量,又能以智能设备赋能服务效能,为机构护理高质量发展提供坚实基础。但由于护理机器人的引入,其操作界面复杂、语音交互适配性低,导致老年群体自我使用难度增大,需要护理员协助,反而增加人力负担;且养老院医院虽然能够提供基础医疗照护,但是面对复杂急症的处理欠佳,其急救设备配置远不及医院完善,难以应对高风险的急症场景。未来需要在适老化技术改造及跨机构急救救助方面不断完善,以满足老年护理照护需求。
新加坡是以公立医院为主体、私立医院为补充的医疗服务体系。通过3Ms体系的费用补贴,实现了医院资源的高效利用以及费用的调控。在老年人出院时,病人用保健储蓄结清综合评估费用,并由专业康复师进行系统评估日常生活能力、认知状态,为制定个性化延续护理计划提供依据[26]。针对脑卒中、骨科术后等需要长期康复护理的病人,健保双全计划报销相应比例的康复机器人费用,覆盖每个月2次的专家会诊费用,减少病人往返负担,保障治疗连续性与医疗效果[26]。此外,新加坡医院通过电子健康记录共享平台,实现了医院、社区、居家康复服务的有机衔接。病人出院时,护理员将健康评估结果与后续护理方案有机结合,并协助预约社区护理,形成出院评估—方案制定—转介衔接—持续跟进的链条化护理模式。在医院资源分配方面,形成了差异化费用分担机制[27]。这一制度模式通过费用分担引导非急症病人选择恰当的病房等级,有效提高了公共医疗资源的配置效率。
总之,医院场景的3Ms体系实现了急性期质量与长期护理的有序衔接,提高了医疗资源利用效率。但也存在一些问题,如转介流程烦琐,部分病人可能因评估周期长、资料提交延迟导致护理衔接断层;同时,因A级病房无补贴的设定,病人所接受的医疗资源受限。这些问题还需通过进一步完善制度及精准配置资源来解决。
活跃乐龄中心是社区养老服务体系中的重要设施之一,充分体现了新加坡政府倡导“原地养老”的理念,该模式不仅让老年人保持家庭归属感,还可与家庭成员保持联系、互动,对保持健康、减少抑郁症等老年性精神疾病的发生大有益处[28]。在硬件支持方面,新加坡政府投入大量资金用于老龄硬件环境设施的建设,提升家庭与公共空间的无障碍联通,政府相关部门通过引进专业社会组织,为老年人提供多元化课程、文娱活动和日常照料的服务[29]。典型的活跃乐龄中心通常为12~14层的综合建筑,且每个场所配备专业的医护人员进行指导[14]。在资金供应层面,3Ms体系为活跃乐龄中心的持续运营提供了核心支撑,政府计划为活跃乐龄中心提供专项资金支持,其中保健储蓄承担社区护理员培训费用的60%,重点提升居家照护、慢性病管理等专业技能。同时,日间照护服务通过健保双全计划报销相应比例费用,充分体现社区护理的普惠性与持续性[17]。
综上所述,活跃乐龄中心通过3Ms体系资金与资源支持,构建了普惠性强、贴合老年人需求的社区护理平台,是家庭与机构护理的关键枢纽。但也存在着诸多问题,如地域差异,核心城区与偏远地区存在硬件配置、服务种类上的显著差异;活跃乐龄中心服务内容虽多元化,但其侧重基础生活照料以及文化娱乐方面,针对失能、失智人群的照料缺乏专业化;同时,活跃乐龄中心运作需要政府资金的支持,长期护理持续性容易受财政影响。因此,资源配置及服务能力的提升也是后续应关注的热点。
新加坡长期护理数字化转型始终将技术创新与3Ms体系相融合,在医院场景中,电子健康记录共享平台已为数字化奠定了基础,而医院到家庭(H2H)计划进一步通过人工智能模型升级这一协同模式[30]。同时,联动保健储蓄基金优先覆盖其社区随访费用,为入院风险高的病人提供从急性住院到家庭和社区环境的安全、及时过渡,这种设计让3Ms体系的资金投放更贴合实际需求,进一步提升基金使用效率。同时,建议扩大人工智能模型在慢性病管理中的应用场景。Zhang等[31]研究显示,新加坡糖尿病视网膜病变筛查项目(SiDRP)利用远程眼科对19所社区医院进行全国筛查,缓解了医院压力,改善了病人就医体验,极大节省了政府开支。新加坡卫生系统推出的NUHS@Home试点项目,亦在居家医院模式中融合远程监测与团队协作,进一步拓展急性期护理的数字化边界[32-33]。
综上所述,数字化技术打通医院、社区及居家的服务壁垒,保障了资金的落地与可持续性。但数字鸿沟问题也逐渐凸显,老年群体的智能设备操作能力不足、网络覆盖不均,无法享受到远程诊疗及人工智能监测,存在数字服务享用差异;同时,现有法律对数据使用的边界界定不清,个人信息安全可能存在泄漏风险。因此,未来需推进老龄化适配,完善隐私保护相关法律法规,以进一步优化老年护理人工智能技术服务。
在技术赋能的整体框架下,护理机器人作为智能化照护的核心载体,已从概念探索逐步走向系统化应用。新加坡将护理机器人技术定位为人机协同照护体系中的重要一环,旨在弥补人力短缺、提升服务精度,并延伸情感支持的可能边界。在这一理念引导下,新加坡理工大学等机构研发的居家陪伴型机器人,已实现从基础功能辅助到部分情感交互的能力跃升,展现出其在真实场景中的综合价值。其外接智能设备实时检测生理指标,通过语音、灯光提示服药以提升依从性,借助红外传感与声音识别检测跌倒等紧急情况并预警,还可协助老年人使用智能设备、搭建社交桥梁;情感支撑上,人工智能系统可识别4类基础情绪,通过播放音乐、安慰语气、记忆分享功能回应老年人的负面情绪[33]。Zhao等[34]研究显示,居家机器人在居家场景中,日均使用23.4次,独居老年人通过其获取健康监测、社交连接等服务,孤独感量表评分降低37%,有效缓解独居老年人孤独感,助力其心理健康维护。
与此同时,护理机器人存在的问题逐渐显露,对重度失能、失智老年人的翻身、转移操作存在安全隐患,无法替代专业护理人员;人工智能识别情绪后回应机械,难以产生情感共鸣;护理机器人的研发、维护费用较贵,正常家庭难以承担其高额费用。因此,未来仍需在这些方面进一步改进,从而提升护理质量与服务体验。
结合新加坡3Ms体系“个人储蓄+社会共济+政府托底”的层级协同逻辑。针对我国试点中保障范围有限、筹资形式单一、制度衔接不畅等现实问题,可以从短期目标与长期目标进行融合建设。短期需明确职工长期护理保险单位与个人缴费比例,城乡居民按经济水平适配缴费并获政府补贴;推行家庭共济机制,允许职工个人账户资金共享给直系亲属,对低保、特困及重度失能失智病人实行个人缴费全额代缴。长期目标是加快构建我国统一的长期护理保险制度框架,筹资标准与当地经济发展水平动态吻合挂钩,拓展商业补充保险并给予相应税收优惠,设立由政府拨款、福彩公益金、社会捐赠等构成长期护理救助基金。明确政府、企业、个人的缴纳责任与比例,探索更适合我国经济与国情的筹资机制。我国长期服务体系未来的改革关键在于破解长期护理保险、基本医疗保险与养老服务补贴这3项制度间的壁垒。通过加强制度协同与信息共享,使其形成政策合力,确保所有老年群体能公平地获得基本护理服务。
新加坡3Ms体系融合不同场景,核心在于将统一的资金支付标准应用于多场景,形成了资源高效流动的连续服务链,合理利用医疗资源分配,避免医疗资源的过度浪费。相比之下,我国长期护理服务在“场景割裂”困境中存在巨大挑战,在老年照护方面存在体系散碎低效、照护需求复杂多样等[35]问题。医疗机构、养老机构、社区居家服务中心之间缺乏有效的转介机制与服务标准衔接,造成医疗资源分散,导致出院后的老年人在不同服务场景转换时常面临服务中断或重复评估的困境。针对以上困境,结合新加坡活跃乐龄中心模式,在城乡街道推进社区护理中心建设,配备完善的照料设施;农村地区以乡镇卫生院为枢纽增设长期照护服务站,提升农村医疗服务的可及性。同时,推进养老机构与医疗机构之间的合作,完成现有养老机构标准化建设,因地制宜地推动构建整合照护模式。同时,制订长期护理服务转介管理规范,建立统一的失能等级评估标准,实现评估结果跨场景、跨区域互认,减少医疗资源过度消耗。搭建全国统一的长期护理服务信息平台,整合服务资源,实现服务预约、转介及监管全程数字化,形成“医院急性治疗—社区康复护理—居家持续照护”的闭环。通过政策引导、资金激励,构建社区整合照护模式。
新加坡在长期护理领域发展进程中,着力推进该领域的技术应用与标准化建设,在技术层面,政府通过医疗保健生产力基金等政策,激励养老机构购入护理机器人与远程监测设备,并利用人工智能数据模型进行健康风险预测、优化资源配置。在制度层面,通过Healthcare Services系列法规,对护理人员资质、培训时长和设施设备标准进行严格规范,建立了完善的质量把控体系。我国在此方面尚存不足,智慧养老技术多停留在试点层面,老年智慧护理、数字化养老信息技术和系统使用、智能养老器材运用等方面的人才和技能培养不足[35]。针对以上问题,国家应出台相对应的长期护理服务标准,明确机构、社区、居家护理的服务内容、操作流程及质量指标;明确规定护理人员的资质审查标准,做到持证上岗全覆盖。同时,建立以服务满意度、护理事故发生率、失能改善率为指标的质量评价体系,将其纳入考核标准,强化质量监管。对养老机构、社区护理中心采购智能护理设备给予相应补贴,鼓励引入康复机器人、居家检测设备,为居家失能老年人配备智能监测工具,为其提供便利及安全。除此之外,应支持医学院校开设长期护理照护相关专业,扩大专业人才培养规模,设立海外护理人才专项引进计划,重点吸纳在老年护理、失智护理等领域具备丰富经验的专业人才,加强与新加坡等护理体系相对成熟国家的交流合作,开展护理人才联合培养规划,鼓励海外华人护理人才回国发展,多维度缓解护理人才缺口压力。
新加坡长期护理保险制度的核心优势之一,在于深度契合当地重视家庭责任的传统文化价值,其中最值得借鉴的是家庭共济的缴费与保障机制,这种机制更加强化家庭在共同养老中的作用,通过亲属间的风险共担,拓宽了资金来源渠道,让护理保障更具温度与可持续性。我国同样是一个遵循孝道的传统文化国家,应借鉴新加坡长期护理经验,完善我国的相应政策,从家庭支持、社区联动、社会参与3个方面共同改进我国的护理照护体系。在家庭支持方面,对全职照料重度失能老人的照护者给予相对应的补贴,为失能家庭提供免费的居家护理及机构短期托养的“喘息服务”,进一步帮助缓解照护倦怠问题。社区联动方面,建立社区照护联动网络,缓解独居老年人孤独、焦虑及抑郁情绪。定期面向家庭照护者开展技能培训,提升家庭照护专业性。社会参与层面,鼓励社会开展关爱失能老年人项目,对符合条件的项目给予政府购买服务资金支持,鼓励家政服务公司等市场主体拓展长期照护业务,给予相对应的税收减免政策。总之,通过多渠道、多方面及多平台共同宣传普及长期护理支持政策及科学照护知识,提升公众认知度及参与意愿,形成家庭、社区、社会的良性循环。
在全球人口老龄化加剧背景下,长期护理服务的供需平衡与体系优化已成为各国共同面临的养老难题,本研究系统梳理了新加坡3Ms体系的实践路径,深入分析其运行机制,并结合我国城乡差异、经济水平、文化特质等因素,针对我国长期护理发展现状的不足提出启示和建议,旨在为我国构建高质量、可持续的长期护理服务体系提供参考。新加坡3Ms体系仍存有局限性:1)服务体系。标准化照护难以满足个性化需求,失智、共病群体服务断层,转介流程复杂,资源分布不均。2)技术应用。智能设备适老化不足,老年群体面临数字鸿沟,数据安全不完善,设备与维护成本高昂。3)制度设计。3Ms体系对非公民覆盖有限,保费减免缺失,护理机器人情感交互与急症处理能力不足。
展望未来,我国在借鉴过程中,应始终坚持因地制宜、循序渐进原则,避免照搬照抄,结合我国的区域发展不平衡、农村保障薄弱等国情逐步推进落实。未来,我国应从以下几个方面持续推进长期护理服务体系的优化与创新:1)构建符合国情的长期护理保险多层次资金保障体系,结合城乡差异设定差异化缴费机制,引入商业保险与社会捐赠,重点解决农村失能、失智老人的照护难题;2)推动跨场景协同的服务整合,依托信息化平台打通医疗机构、养老机构与社区居家服务之间的转介壁垒,建立统一评估与质量监管机制;3)加强技术适配与标准化建设,研发适老化智能设备,开展社区数字素养培训,完善数据安全与隐私保护法规;4)重视家庭与社会力量在照护体系中的作用,完善家庭共济与照护者支持政策,扩大专业护理人才规模,提升服务的文化适配性与制度可持续性。总而言之,我国应立足本土实际,在借鉴国际经验的基础上,逐步构建兼具公平性、可及性与文化适配性的我国特色长期护理服务模式,真正实现老有所护、护有所质的发展目标。

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doi: 10.12102/j.issn.1009-6493.2026.15.013
  • 接收时间:2025-11-20
  • 首发时间:2026-10-30
  • 出版时间:2026-08-10
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  • 收稿日期:2025-11-20
  • 修回日期:2026-05-08
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    1内蒙古民族大学护理学院,内蒙古 028000

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王文燕,E-mail:
WANG Wenyan, E-mail:
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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