基于二维量化分析框架的上海市失能老年人长期照护政策文本研究OA

Objective:To analyze the characteristics of policy instrument usage and the key focuses of system construction in long-term care policies for disabled older adults in Shanghai city,so as to provide a basis for policy optimization.Methods:Based on Rothwell and Zegveld's policy instrument theory and the continuity of long-term care services,a two-dimensional framework(policy instrument types×service delivery processes)was developed.Content analysis was applied to policy documents issued in Shanghai city from January 2014 to December 2024,resulting in coded policy units.The coded data were quantified by using descriptive statistics,with frequencies and percentages calculated for each dimension.Cross-tabulations were constructed to examine the distribution between policy instrument types and service delivery processes.Results:A total of 55 policy texts were included,and 134 policy analysis units were extracted.Two-dimensional cross-analysis revealed an uneven distribution of policy instruments across different elements.Among the types of policy instruments,environmental(38.81%)and supply-type(34.33%)instruments dominated,while demand-type instruments were weak(26.87%).In the service delivery process,"service provision and execution"(35.82%)and"service planning and content"(21.64%)accounted for the higher proportions,while the links of"demand assessment and access"(9.70%)and"quality supervision and evaluation"(15.67%)were relatively underdeveloped.Conclusions:The long-term care policy system in Shanghai city has taken initial shape,but problems such as imbalanced instrument structure and poor process coordination persist.The policy instrument mix should be optimized,and demand assessment and quality supervision should be strengthened to promote the development of the system toward precision and continuity.