市场化改革背景下养老机构服务供给博弈研究

考虑政府补贴、市场化程度、养老机构服务成本、老年人偏好等因素,构建了完全国有化、公私并存的半市场化和完全市场化三种情形下公办和民办养老机构之间的两阶段博弈模型,比较分析了市场化程度对养老机构服务价格制定和服务水平选择的影响,实证讨论了各参数变化对养老机构收益及社会福利的影响。研究表明:完全市场化机制会降低养老机构服务质量,完全国有化机制会陷入社会福利陷阱,探索公私并存的最佳市场化水平才能更好地提高社会福利;适度推进市场化改革,提高养老机构服务水平,降低民办养老机构服务成本,适度提高对民办养老机构的补贴,将有效缓解公办和民办养老机构的不公平竞争;提高老年人支付能力,推进养老机构供给侧结构性改革,将保障机构养老服务的有效供给,促进养老服务业的健康有序发展。

A Game Analysis of Service Supply of Residential Care Facilities under the Background of Market-Oriented Reform

Considering subsidies, marketization, the cost of residential care facilities (RCFs), the preferences of the elderly and some other factors, a two-stage game model between public and private RCFs under three scenarios of full nationalization, semi-marketization and full marketization is established. Then the impact of the degree of marketization on the service price and service level setting of RCFs are analyzed, and the impact of changes of parameters on the profits of RCFs and social welfare are discussed. The result shows that full marketization mechanism will reduce service quality of RCFs, and full nationalization mechanism will make the aged care service system fall into a social welfare trap, only exploring the best marketization level can improve social welfare; appropriately promoting market-oriented reform, improving the service levels of RCFs, reducing costs of private RCFs and appropriately increasing subsidies can alleviate the unfair competition between public and private RCFs; improving the payment ability of the elderly and advancing the supply-side structural reform of RCFs will ensure the effective supply of the aged care service and promote the order development of the aged care service industry.