中国居家社区养老与机构养老耦合协调格局及影响因素研究

doi:10.12118/j.issn.1000-6060.2025.310

摘要/Abstract

摘要：

推动不同养老模式耦合协调发展是优化我国养老服务资源配置的有效路径。基于2018—2022年面板数据，运用耦合协调度模型和地理探测器等方法，实证分析中国居家社区养老与机构养老的时空耦合协调性及其影响因素。结果表明：（1）居家社区养老与机构养老耦合协调度和相对发展度总体上呈上升趋势。耦合协调度随时间发展表现出持续向好趋势，相对发展度居家社区养老“同步发展>超前发展>滞后发展”的态势逐渐清晰。（2）迈入协调阶段的省域规模持续扩大，并逐步展示出从中东部地区拓展至西部及东北地区的演化态势；两者相对发展度的阶段跃升现象显著，尤其是西部地区，跃升省域数量相较于中部和东部地区更为突出。（3）两者耦合协调度具有正向空间相关性，且呈现波动上升演进方向，相关性强度表现出“西部>东部>中部>东北”的空间分布，主要为高-高聚集和低-低聚集2种模式。（4）组织力量、养老需求和科技水平是二者耦合协调度的主要影响因素。研究结果可为破解我国养老服务供给结构性矛盾，创新发展养老服务政策体系提供理论依据与决策参考。

关键词: 居家社区养老, 机构养老, 养老服务, 耦合协调, 影响因素

Abstract:

Promoting the coordinated development of different elderly care models is an effective way to optimize the allocation of elderly care service resources in our country. Based on panel data from 2018 to 2022, this study empirically analyzes spatiotemporal coupling coordination and influencing factors of home community elderly care and institutional elderly care in China using a coupling coordination model, a geographic detector, and other methods. The results indicate that (1) The coupling coordination degree and relative development degree between home community elderly care and institutional elderly care are generally on the rise. The coupling coordination degree has shown a continuous improvement trend over time. The relative development degree of home community elderly care is gradually becoming clear with the trend of “synchronous development>advanced development>lagging development”. (2) The number of provinces entering the coordination stage (III and IV) continues to increase and shows an evolutionary pattern of gradually spreading from the central and eastern regions to the western and northeastern regions in space. The phenomenon of stage transition in relative development is more pronounced, and the western region has significantly more provinces in transition than the central and eastern regions. (3) The coupling coordination degree has a positive spatial correlation and a fluctuating upward trend. The correlation strength shows a spatial pattern of “western>eastern>central>northeast”, with mostly HH-type and LL-type clustering. (4) Organizational strength, elderly care demand, and technological level are the main influencing factors of the coupling coordination degree. This study’s findings can provide a theoretical basis and policy recommendations for addressing structural contradictions in China’s elderly care service supply and for innovating the development of the elderly care policy system.

Key words: home community elderly care, institutional elderly care, elderly care services, coupling coordination, influencing factors

刘昊, 李福莲, 汪圣. 中国居家社区养老与机构养老耦合协调格局及影响因素研究[J]. 干旱区地理, 2026, 49(2): 381-392.

LIU Hao, LI Fulian, WANG Sheng. Coupling and coordination pattern and influencing factors of home community elderly care and institutional elderly care in China[J]. Arid Land Geography, 2026, 49(2): 381-392.

图/表 10

图1

表1

居家社区养老与机构养老的指标体系"

目标层	一级指标	二级指标	指标说明	单位	属性
居家社区养老	人员情况	年末职工数	各类社区养老服务机构实有职工人数	人	+
		社会工作师人数	通过全国社工职业水平考试的人员总数	人	+
	硬件设施	每千老人社区养老服务机构数	社区服务机构和设施总数/60岁以上老年人口数	个·(10³人)^-1	+
		每千老人居家社区养老床位数	（特困人员救助供养机构床位、全托服务社区养老服务机构和设施床位、日间照料社区养老服务机构床位和社区互助型养老设施床位数总和）/60岁以上老年人口数	张·(10³人)^-1	+
		老年人人均居家社区养老建筑面积	各类社区养老服务机构和设施建筑面积总和/60岁以上老年人口数	m²·人^-1	+
	服务水平	每千老人全托照料服务人数	为老年人提供全日集中住宿和照料护理服务的人数总和/60岁以上老年人口数	人·(10³人)^-1	+
		社区养老服务人次数	各类社区养老服务机构和设施提供的养老服务人次数	人次	+
机构养老	人员情况	每千老人养老机构职工数	各类养老机构实有职工人数/60岁以上老年人口数	人·(10³人)^-1	+
		每千老人专业技术技能人员数	各类养老机构中直接为老年人提供服务的人员总数/60岁以上老年人口数	人·(10³人)^-1	+
	硬件设施	每千老人养老机构数	（社会福利院、农村特困人员救助供养机构和其他各类养老机构总数）/60岁以上老年人口数	个·(10³人)^-1	+
		每千老人机构养老床位数	（社会福利院床位、特困人员救助供养机构床位以及其他各类养老机构床位数总和）/60岁以上老年人口数	张·(10³人)^-1	+
		老年人人均机构养老建筑面积	各类养老机构建筑面积总和/60岁以上老年人口数	m²·人^-1	+
	服务水平	年末在院人数	各类养老机构在实际收留抚养的人员总数	人	+
		康复和医疗门诊人次数	设有医疗服务窗口（部门）的养老机构提供的康复和医疗门诊服务人次数	人次	+

表1

图2

图3

图4

图5

表2

表3

表4

表5

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指标	2018年	2019年	2020年	2021年	2022年
Global Moran’s I	0.195	0.285	0.422	0.340	0.332
Z	2.298	3.058	4.569	3.836	3.762
P	0.016	0.002	0.000	0.001	0.002

因子	指标释义	单位	q	P
养老需求（X₁）	老年人抚养比	％	0.138	0.008
经济发展（X₂）	人均地区生产总值	元	0.058	0.287
人才队伍（X₃）	老年相关社会工作志愿者数量	10⁴人	0.085	0.018
组织力量（X₄）	社会工作类机构数	个	0.196	0.001
政策支持（X₅）	养老政策文件数目	条	0.080	0.042
科技水平（X₆）	宽带互联网用户占比	％	0.100	0.009

因子	X₁	X₂	X₃	X₄	X₅	X₆
X₁	0.138
X₂	0.250↖	0.058
X₃	0.267↗	0.239↖	0.085
X₄	0.360↗	0.299↖	0.271↗	0.196
X₅	0.242↖	0.145↖	0.239↖	0.326↖	0.080
X₆	0.332↖	0.298↖	0.355↖	0.347↖	0.204↖	0.100