Restructuring the welfare state: reforms in long-term care in Western European countries
Restructuring the welfare state: reforms in long-term care in Western European countries
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DOI：
10.1177/0958928708091058
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发表时间：
2008-08-01
影响因子：
3
通讯作者：
Ranci, Costanzo
中科院分区：
文献类型：
--
作者：
Pavolini, Emmanuele;Ranci, Costanzo
面对与老龄化社会有关的问题，许多欧洲国家采取了创新政策，以便在扩大社会护理的需要和限制公共开支的必要性之间取得更好的平衡。这些新政策虽然植根于独特的国家传统，但有一些共同的特点：（a）倾向于将向家庭提供的联合收割机与提供实物服务相结合;（B）建立一个基于竞争的新的社会护理市场;（c）通过提高使用者的购买力赋予他们权力;（d）采取旨在通过家庭网络促进护理的筹资措施。本文介绍了最近在六个欧洲国家（法国，德国，意大利，荷兰，瑞典和英国）推出的最重要的改革方面的长期护理。它分析了这些措施在宏观（体制和数量）、中观（服务提供结构）和微观（家庭、照顾者和需要帮助的人）层面的影响。因此，作者发现了一个总体趋势，即各国的社会护理趋于一致，并出现了一种新型的政府监管，旨在调整而不是减少福利方案。
Faced with the problems associated with an ageing society, many European countries have adopted innovative policies to achieve a better balance between the need to expand social care and the imperative to curb public spending. Although embedded within peculiar national traditions, these new policies share some characteristics: (a) a tendency to combine monetary transfers to families with the provision of in-kind services; (b) the establishment of a new social care market based on competition; (c) the empowerment of users through their increased purchasing power; and (d) the introduction of funding measures intended to foster care-giving through family networks. This article presents the most significant reforms recently introduced in six European countries (France, Germany, Italy, the Netherlands, Sweden and the UK) as regards long-term care. It analyses their impact at the macro-(institutional and quantitative), meso-(service delivery structures) and micro-level (families, caregivers and people in need). As a result the authors find a general trend towards convergence in social care among the countries, and the emergence of a new type of government regulation designed to restructure rather than to reduce welfare programmes.