本文關(guān)鍵詞： 醫(yī)養(yǎng)結(jié)合 養(yǎng)老機構(gòu)項目 BOT模式 壽命周期風(fēng)險 風(fēng)險配置　出處：《天津理工大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：我國老齡人的養(yǎng)老問題已成為一個較為嚴(yán)重的社會問題。失能老人數(shù)量持續(xù)增加,對于我國常見的“4+2+1”家庭而言,傳統(tǒng)的家庭養(yǎng)老已經(jīng)不堪重負,社會化專業(yè)養(yǎng)老機構(gòu)成為緩解養(yǎng)老負擔(dān)問題的重要的途徑,并在政策層面成為國家大力推行的養(yǎng)老手段。目前我國養(yǎng)老機構(gòu)大多處于“有養(yǎng)無醫(yī)”狀態(tài),在條件較好的養(yǎng)老機構(gòu)中,醫(yī)療設(shè)施的配置也較為簡陋,無法真正滿足老人的養(yǎng)老醫(yī)護需求。急需全面開展“醫(yī)養(yǎng)結(jié)合”型養(yǎng)老機構(gòu)(MPCPA)項目的建設(shè)。但我國財政投資項目往往運行效率低下,且僅依靠政府財政的力量無法承受MPCPA項目的巨額投資壓力,這為社會資本參與到MPCPA項目的建設(shè)提供了良好的契機。BOT模式作為政府和社會資本合作(PPP)模式的一種,在我國MPCPA項目的建設(shè)中受到普遍關(guān)注。但是一些BOT項目現(xiàn)狀表明,由于政府與社會資本在合約設(shè)計時風(fēng)險配置不合理,導(dǎo)致了我國一些正在建設(shè)或運營的項目存在諸多問題。鑒于此,合理的風(fēng)險配置成為MPCPA-BOT項目成功的關(guān)鍵。由于未發(fā)現(xiàn)相關(guān)研究,因此本文以MPCPA-BOT項目為分析單元,以政府和社會資本之間的風(fēng)險配置為主題,開展我國MPCPA項目在BOT模式下的全壽命周期風(fēng)險配置問題研究。首先,綜合采用文獻研究、相關(guān)案例研究和咨詢訪談等多種方法,識別出我國MPCPA-BOT項目的壽命周期風(fēng)險因素(LCRF)清單。通過對LCRF與MPCPA-BOT項目結(jié)果之間的關(guān)系的分析,構(gòu)建了LCRF與MPCPA-BOT項目結(jié)果之間的關(guān)系模型,即:LCR模型。其次,采用問卷調(diào)查的方式進行LCR風(fēng)險因素的檢驗,并結(jié)合二維綜合評價法對LCRF清單中的風(fēng)險因素從發(fā)生概率和影響程度兩個維度進行重要度測定,以識別MPCPA-BOT項目的關(guān)鍵風(fēng)險。最后,通過對風(fēng)險分擔(dān)相關(guān)理論的分析,構(gòu)建了風(fēng)險配置的影響因素模型(RAI),作為本研究風(fēng)險配置方案的設(shè)計依據(jù),由此設(shè)計并提出了MPCPA-BOT項目LCR風(fēng)險配置方案,即:風(fēng)險分配矩陣,并采用問卷調(diào)查法檢驗了關(guān)于風(fēng)險分配矩陣的假設(shè)。研究發(fā)現(xiàn),MPCPA-BOT項目全壽命周期中存在30余個風(fēng)險因素,其中以醫(yī)療機構(gòu)選取不當(dāng)風(fēng)險、工程質(zhì)量風(fēng)險等為關(guān)鍵風(fēng)險因素。在風(fēng)險分配矩陣中,政府信用風(fēng)險、適老化設(shè)計風(fēng)險等風(fēng)險的配置設(shè)計獲得了以專業(yè)人士為主體的調(diào)查人群高度認(rèn)同。
[Abstract]:The problem of the aged has become a serious social problem in our country. The number of disabled old people has been increasing continuously. For the "421" families, the traditional family pension has been overwhelmed. The socialized professional pension institutions have become an important way to alleviate the burden of the aged, and have become the means of the government to promote the pension at the policy level. At present, most of the pension institutions in our country are in the state of "having no medical care". In better conditions for the aged, the allocation of medical facilities is also relatively simple. It is urgent to carry out the construction of MPCPA project. However, the financial investment projects in China are often inefficient. And it can not bear the huge investment pressure of the MPCPA project only relying on the government financial strength, which provides a good opportunity for the social capital to participate in the construction of the MPCPA project. Bot model is one kind of the cooperation between the government and the social capital. In China, the construction of MPCPA projects has received widespread attention. However, the current situation of some BOT projects shows that the allocation of risks between government and social capital in contract design is unreasonable. In view of this, reasonable risk allocation is the key to the success of MPCPA-BOT project. Since no related research has been found, this paper takes the MPCPA-BOT project as an analysis unit. Taking the risk allocation between government and social capital as the theme, this paper studies the whole life cycle risk allocation of MPCPA projects in China under the BOT model. Firstly, it synthesizes the methods of literature research, relevant case studies and consultation interviews, etc. The life cycle risk factors of MPCPA-BOT projects in China are identified. Through the analysis of the relationship between LCRF and the results of MPCPA-BOT projects, the relationship model between LCRF and the results of MPCPA-BOT projects is constructed, that is, the MPCPA-BOT model. The LCR risk factors are tested by questionnaire, and the importance of the risk factors in the LCRF list is measured from two dimensions of occurrence probability and influence degree combined with the two-dimensional comprehensive evaluation method to identify the key risks of the MPCPA-BOT project. Based on the analysis of the related theory of risk sharing, this paper constructs the risk allocation influencing factor model, which is the basis for the design of the risk allocation scheme of this study, and then designs and puts forward the LCR risk allocation scheme of the MPCPA-BOT project, that is, the risk allocation matrix. The hypothesis of risk distribution matrix was tested by questionnaire survey. It was found that there were more than 30 risk factors in the whole life cycle of MPCPA-BOT project, among which improper risk was selected by medical institutions. Project quality risk is the key risk factor. In the risk allocation matrix, the risk allocation design of government credit risk and suitable aging design risk has been highly recognized by the survey crowd with the professional as the main body.
【學(xué)位授予單位】：天津理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：D669.6;R197.1

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1 王玉靜;BOT模式下“醫(yī)養(yǎng)結(jié)合”養(yǎng)老機構(gòu)項目壽命周期風(fēng)險配置研究[D];天津理工大學(xué);2017年

2 楊曉明;出租型房地產(chǎn)項目壽命周期成本預(yù)測[D];中南大學(xué);2009年

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