Due to the different models and concepts of long-term care insurance systems in different countries, scholars at home and abroad hold different views on the concept of long-term care. However, the views of American scholars 由于不同国家长期护理保险制度模式不同，理念不同，国内外学者对长期护理概念持有不同看法。然而，美国学者Rosalie A. Kane and 和Robert L. Kane are generally recognized by scholars around the world, i.e., long-term care refers to the long-term provision of personal care, basic medical services and social services for people who have lost or do not have the functions of daily living [1]. Long-term care services include low-level care services to support daily living, such as eating, dressing, bathing, toileting, and transportation, as well as some basic medical services, such as wound dressing, pain management, monitoring, prevention, rehabilitation, and palliative care and nursing [2]. Long-term care insurance (LTCI) is a form of social insurance that spreads the economic risk of people who need long-term care services. Specifically, long-term care insurance refers to a social insurance system in which insurers entrust organizations or individuals to provide, in accordance with the law, daily living care, basic medical services and social services to insured individuals who have lost or are unable to carry out activities of daily living and who are enrolled in long-term care, basic medical services and social services.的观点得到了世界各国学者的普遍认可，即长期护理是指为失去或不具备日常生活功能的人长期提供个人护理、基本医疗服务和社会服务^[1]。长期护理服务包括支持日常生活的低水平护理服务，如吃饭、穿衣、洗澡、如厕、交通等，以及一些基本的医疗服务，如伤口包扎、疼痛管理、监测、预防、康复和姑息治疗和护理^[2]。长期护理保险是以社会保险的形式对需要长期护理服务的人的经济风险进行分散。具体而言，长期护理保险是指保险人委托组织或者个人依法为已丧失或者无法进行日常生活活动能力的已参保长期护理、基本医疗服务和社会服务的个人提供日常生活护理、基本医疗服务和社会服务的社会保险制度。

According to the logical dimension of "the social security system consists of the basic constituent elements of identification按照“社会保障制度由被保险人身份识别、公共服务、资金筹措、资金管理监督、福利支付支付、结算支付等基本构成要素”的逻辑维度，长期护理保险制度的主要内容分析如下： of the insured, public service, financing, fund management and supervision, benefit payment and settlement payment", the main contents of the long-term care insurance system are analyzed as follows: 1. Participants Participants are individuals who are obliged by law to pay long-term care insurance premiums and enjoy the right to apply for insurance benefits when the need for long-term care services arises, also known as those included in the long-term care insurance coverage. Participants are individuals who are obligated by law to pay long-term care insurance premiums and are entitled to apply for insurance benefits when the need for long-term care services arises, and are also referred to as persons covered by long-term care insurance. Long-term care insurance organization The long-term care insurance organization is the insurer of long-term care insurance, and its main responsibilities include: firstly, it is responsible for the registration of participants, financial management of the fund, declaration and acceptance, approval of treatment, approval of expenses, settlement and payment, and construction and maintenance of the information system; secondly, it is responsible for guiding the development of long-term care service organizations through bidding or entrusting the purchase of long-term care services. The financing system for mobilizing funds for long-term care insurance includes financing sources, financing levels and financing methods. The financing of social insurance comes from the mutual assistance and sharing of the whole society by multiple subjects. From the perspective of long-term care insurance financing in China's current pilot program, the main sources of multiple financing are: transfer of the balance of the comprehensive medical insurance fund, transfer of funds from individual accounts of medical insurance, individual or unit contributions, financial subsidies, welfare lottery public welfare funds, etc. Basically, according to the pilot program in each region, two or more sources of financing are chosen. Financing methods include quota financing, proportional financing and mixed financing. Flat-rate financing refers to the payment of an exact amount of participation fee for a specific period of time. Proportionate financing refers to the proportional contribution of the insured, including the basis and rate of contribution. Hybrid financing is the use of both fixed and proportional financing. The level of financing depends on the level of economic development, the degree of aging, and the scope and level of protection.4. Benefit PaymentThe design of a long-term care insurance treatment payment system consists of two components: identification of care needs and payment for insured treatment. (1) Determination of Need for CareThe identification of need for care is the legal act by which an insurer determines, based on an application for care by an insured person or another person, whether an insured person has a need for care and what level and degree of care he or she should receive, in accordance with the provisions of the Long-Term Care Act. The states generally provide for an independent, specialized third party to make a valid determination based on statutory criteria. Determining the need for care is a statutory prerequisite to whether an insured person can receive care and to what extent and standard of care d. (2) Benefit Treatment Payment for long-term care insurance is the process of determining the scope and content of treatment payments by paying the insured person according to certain standards, forms, and methods of payment for treatment. The forms of treatment payment generally include service payment, cash payment and hybrid payment. Payment for services are services commissioned by the insurance agency to be provided by the service provider in accordance with the needs of the cared-for person, including housework, assistive devices, home delivery of meals, accessibility modifications, emergency calls, and so on. Cash payments are made by the insurance agency directly to the cared-for person and are paid in cash. Cash benefits are cash compensation provided by the insurance agency directly to the person being cared for. The person being cared for can choose the care services according to his/her needs, or the services can be provided by his/her relatives, and the cash benefits will be used as compensation to the relatives. These include both fixed-amount benefits and benefits that actually occur. Hybrid payments are a combination of payments for services and cash payments. Payment options include fixed and limited payments. Fixed rate payments are paid at a fixed rate. Limited payments are paid from the Long-Term Care Insurance Fund up to a maximum. Costs include bed charges, nursing service charges, nursing equipment use charges, nursing supplies, appraisal and assessment charges, treatment charges and medicine charges. The payment standard is the criterion for the proportion of nursing costs to be paid by the Fund. Different classification criteria are used in different pilot regions, including determining the proportion of contributions for institutional care and home care based on the form of care; determining the proportion of contributions for employees and urban and rural residents based on the scope of coverage; determining the proportion of payment based on the degree of incapacity; and determining the proportion of payment based on the level of the care facility. These payment rates determine different coverage.5. Care service providersCare service providers are divided into home care service providers, community care service providers, and institutional care service providers. Home-based care is a care model that combines informal care provided by family members and specialized care provided by individual service providers or professional organizations for persons with disabilities who live at home, as opposed to traditional family care. Community care is between family care and institutional care, and groups of persons with disabilities do not need to leave the community in which they live; the community is the main provider of care services, taking on responsibility for living care, medical rehabilitation and nursing care. The community is the main body of care services, taking care of life care, medical rehabilitation and nursing care. Institutional care is a model of care in which older persons receive specialized, integrated services in socialized institutions. Institutional care services are necessary only when home care services and community care services are unable to meet the needs of the person in need of care. Institutional care service providers need to be qualified and capable of providing care services, and all types of medical institutions, elderly care institutions and nursing institutions can be care service providers. Institutional care service providers implement an agreement management system, and the agreement includes the scope of service, service content, settlement method, management assessment, liability for breach of contract, etc.6. Management and SupervisionThe supervision and management of long-term care insurance includes fund supervision and management, service supervision and management, and management and management and information system. Fund supervision and management includes the operation and supervision of the long-term care insurance fund, generally in accordance with the current social insurance fund system. Supervision and administration of services includes agreement management and supervision and auditing of service organizations and practitioners, which should be legally qualified and in accordance with the management regulations of the relevant departments, and practitioners should have appropriate qualifications and service capabilities. The supervision and management of management includes management procedures, service standards, agreement management and supervision and inspection of management organizations. Supervision and management of information systems relies on the application of "Internet plus" and other innovative technologies to build and supervise the long-term care insurance system platform.1.参与者参与者是依法有义务缴纳长期护理保险费，并在出现长期护理服务需求时享有申请保险福利的个人，也称为长期护理保险覆盖范围所包括的人员。长期护理保险机构长期护理保险机构是长期护理保险的保险人，其主要职责包括：一是负责参保人登记、基金财务管理、申报受理、治疗审批、费用审批、结算支付、信息系统的建设维护;二是负责通过招标或委托购买长期护理服务来指导长期护理服务机构的发展。资金调动长期护理保险的融资体系包括融资来源、融资水平和融资方式。社会保险的融资来源于多主体全社会的互助共享。从我国当前试点中长期护理保险融资来看，多重融资的主要来源有：综合医疗保险基金余额转入、医保个人账户资金转入、个人或单位缴费、财政补贴、福利彩票公益基金等，基本按照各地区试点情况， 选择两个或两个以上的融资来源。融资方式包括配额融资、比例融资和混合融资。统一利率融资是指在特定时间段内支付确切金额的参与费。按比例出资是指被保险人的按比例出资，包括出资基础和出资率。混合融资是指同时使用固定融资和比例融资。融资水平取决于经济发展水平、老龄化程度以及保护的范围和水平.4.福利支付长期护理保险治疗支付制度的设计包括两个环节：护理需求的识别和保险治疗的支付。（1）照料需要的确定照料需要是指保险人根据被保险人或者其他人的照料申请，根据《长期照料法》的规定，确定被保险人是否有照料需要，以及他或她应接受何种程度和程度的照料的法律行为。各州一般规定独立、 专门的第三方根据法定标准做出有效决定。确定护理需求是被保险人是否可以接受护理以及在多大程度上和标准接受护理的法定先决条件d.（2）福利待遇长期护理保险的治疗费支付，是指按照一定的标准、形式和方法向被保险人支付治疗费，确定治疗费支付范围和内容的过程。。治疗支付的形式一般包括服务支付、现金支付和混合支付。服务费是保险代理机构委托服务提供者根据被照顾者的需要提供的服务，包括家务、辅助器具、送餐上门、无障碍改造、紧急呼叫等。现金付款由保险机构直接支付给被照顾者，并以现金形式支付。现金福利是保险机构直接向受照料对象提供的现金补偿，受照者可以根据自己的需要选择照料服务，也可以由其亲属提供服务，并将现金福利作为对亲属的补偿。这些包括固定金额的福利和实际发生的福利。混合支付是服务支付和现金支付的组合。付款方式包括固定付款和有限付款。固定费率付款按固定费率支付。限额付款由长期护理保险基金支付，最高限额为上限。费用包括床位费、护理服务费、护理设备使用费、护理耗材、鉴定评估费、治疗费和药品费。支付标准是基金支付护理费用比例的标准。不同试点地区采用不同的分类标准，包括根据照料形式确定机构照料和家庭照料的缴费比例;根据覆盖范围确定职工和城乡居民的缴费比例;根据丧失行为能力的程度确定付款比例;并根据护理机构的级别确定支付比例。这些支付标准决定了不同的承保范围.5.护理服务提供者护理服务提供者分为家庭护理服务提供者、社区护理服务提供者和机构护理服务提供者。居家养老是指残疾人居家养老，由家庭成员提供非正式照料，由个人服务提供者或专业组织提供专门照料相结合的照料模式，有别于传统的家庭照料。社区照料介于家庭照料和机构照料之间，残疾人群体不需要离开他们所居住的社区，社区是照料服务的主体，承担生活照料、医疗康复和护理服务。社区是护理服务的主体，照顾生命护理、医疗康复和护理。机构照料是老年人在社会化机构接受专业化、综合服务的一种照料模式。。机构护理服务是必需的只有当家庭护理服务和社区护理服务无法满足需要护理的人的需要时，才需要。机构护理服务提供者需要具备提供护理服务的资格和能力，各类医疗机构、养老机构、护理机构等都可以成为护理服务提供者。机构照料服务提供者实行协议管理制度，协议内容包括服务范围、服务内容、结算方式、管理评估、违约责任等6.管理与监督长期护理保险的监督与管理包括资金监督管理、服务监督管理、管理与管理与信息系统。基金监督管理包括长期护理保险基金的运营和监督，一般按照现行社会保险基金制度进行。服务监督管理包括对服务机构和从业人员的协议管理和监督审计，应当具有合法资格并符合有关部门的管理规定，从业人员应当具有相应的资质和服务能力。对管理的监督管理包括管理程序、服务标准、协议管理和对管理组织的监督检查。信息系统监督管理依托应用“互联网加”等创新技术，对长期护理保险系统平台进行建设和监管。