医养整合下老年照护资源配置优化：基于SD-ABM混合模型的研究

我国的医养结合养老服务处于探索阶段，面临医养照护资源整合困难、配置错位、老年人照护需求满足度低等突出问题，亟需探寻优化照护资源配置的路径和方案。现有文献较少针对我国医养整合下老年照护资源配置优化的数量研究。本项目独辟蹊径地从系统科学视角出发，将照护资源配置优化问题嵌入医养整合照护服务系统优化过程，提出照护资源配置优化理论分析框架。利用空间分析工具和Shapley分解方法，分析空间结构和制度因素对照护资源配置不平等的边际贡献；构建SD-ABM混合模型，从宏观上模拟整合照护服务系统运行过程，在微观上模拟老年人个体照护服务利用行为，识别医养照护资源配置优化路径并对优化方案进行检验。基于仿真平台的模拟研究克服数据不足障碍，节约政策试验成本，是对既有研究的有效补充。研究结果可以揭示我国医养整合下照护资源配置的优化路径，为制定应对人口老龄化的医养照护资源配置优化策略提供科学依据。

Integrated care of medical and social care in China is still in its infancy, facing the issues of resource consolidation difficulties, resource mismatch and unmet care needs of the older adults. It is important to explore the optimal allocation of care resources to dissolve the resource mismatch for the elderly. There is few quantitative research on the optimization of care resources allocation for the elderly under the background of medical and social care integration in China. From the perspectives of system science, this project takes a unique approach to merge the optimization of care resource allocation in the optimization process of integrated care service system, and then put forward a theoretical framework of care resource allocation optimization. The spatial analysis instrument and Shapley decomposition method are used to analyzes the marginal contribution of spatial structure and institutional factors to the unequal allocation of medical and social care resources which provides evidence for the parameters design of resources allocation optimization. The SD-ABM model is constructed to simulate both integrated care system performance in a macro level and the decision-making behavior of older adults in a micro level to Identify the optimal path and to test the optimal plan for care resource allocation. The simulation methods used in this project overcomes the obstacle of insufficient data and saves the cost of policy experiment. The research findings are helpful to reveal the optimized path and plan of care resources allocation, to provide scientific proof for constructing Chinese optimal strategy of allocation of care resources for addressing the issue of population aging.