自20世纪末期开始，我国进入快速人口老龄化发展阶段，这一趋势逐步加剧并将一直延续到本世纪末期。随着我国人口老龄化程度地不断深化，数量众多的老年人口和日益多样化的老年照顾服务需求给我国的养老和老年照顾服务体系带来了巨大的压力，这些已成为党和政府以及全社会普遍关注的重大现实课题，特别是失能或部分失能老年人的长期照顾问题，困扰着众多老年人及其家庭。如何准确地了解和掌握老年人失能状况、长期照顾服务需求类型和结构，将不同失能程度的老年人区分开来，将老年人不同的长期照顾需求了解透彻，是做好老年人长期照顾服务工作和完善长期照顾服务体系的关键。为此，必须建立一套科学的长期照顾评估工具、评估方法、一支专业的评估团队和完善规范的评估机制，根据老年人的失能状况和长期照顾需求等级进行分类和筛选，有针对性地制定资金补贴和政策支持，将有限的财政和照顾资源用到最需要的人群身上。本研究主要依托《2011年北京市老年人长期照顾需要抽样调查》数据，使用InterRAI-HC评估表（InterRAI-Home Care Assessment Form）及其ADL、IADL和COGNITION三维评估量表对北京市海淀区老年人的失能状况进行测量和评估，在此基础上综合判定老年人的失能状况。同时，结合在InterRAI-HC评估表基础上设计研发的MI筛选法、服务对照决策树、机构风险触发三种前沿方法，对不同失能程度、不同环境风险和家庭支持老年人的长期照顾需求进行评估，明确不同失能老人所对应需要的机构、社区、居家及其他服务。另外，在安德森的卫生服务利用行为模型框架下，对老年人长期照顾需求的影响因素进行分析。本研究突破了以前国内通常采用ADL或IADL二维评估量表存在的评估内容少、标准宽、结论不够具体精确以及仅局限在对老年人失能状况的评估上，而对不同失能程度老年人服务需求状况、不同家庭服务支撑情况研究关注不够等问题。研究发现：北京市海淀区老年人失能比例为6.4%，有1%老年人存在机构照顾需求，与老年实际表达的机构照顾需求相比，表达需求比评估需求要高很多，卡方检验结果显示失能老年人使用正式服务和非正式服务的比例都要高于非失能老年人，在影响服务需求的因素中，性别、年龄、居住安排、是否有非正式照顾者，社会关系状况，家居环境，自评健康状况，LTC失能状况和慢性疾病数量都可能对老人的居家与社区照顾需求产生显著影响，尤其是否有非正式照顾者，LTC失能状况和慢性疾病数量对不同方法评估的照顾需求都有显著影响。研究认为：通过与其他已有的调查研究结果比对分析，本项研究运用InterRAI-HC评估量表评估海淀区老年人失能状况结果是客观合理的，三种需求评估方法所得结果具有可靠的参考价值。InterRAI-HC评估量表及三种需求评估方法是一套科学、实用的评估工具和方法，具有很高的信度和效度，可以供政府部门和服务机构采用，在此基础上建立长期照顾服务评估监测体系，科学配置公共资源，提升长期照顾服务质量。

China has turned into an aging society since the end of the 20th century, and the rapid population-aging trend will continue to intensify and extend till the end of the 21st century. As population aging deepens, the huge aged population and their diversified care needs will bring great pressure for China’s elderly services system. Those issues are major practical subjects with common concerns in Chinese society, and also significant challenges for Chinese government in the 21st century. Particularly, the long-term care (LTC) issues of the functional incapacity elders bring much trouble for themselves and their families. As a result, how to accurately understand and grasp the LTC needs structure of Chinese elders, how to distinguish from those who have no, mild, moderate and severe LTC impairments, how to assess their actual long-term care need level or degree based on their LTC impairments, and how to develop appropriate support policies target to different levels of LTC needs are the key issues for the long-term care service system in Beijing. For this purpose, it is necessary to establish scientific and standardized assessment tools, methods and work procedurals for LTC impairments and LTC needs in China. Chinese elders could be classified and screened based on their actual functional incapacity status and their actual LTC need levels, which can ensure the limited financial and care service resources used by people who need it most.Drawing on data from "2011 Sample Survey on Elders’ Long-term Care Needs in Beijing", this study assesses elders’ LTC impairments in Beijing with using international standardized assessment tool, the InterRAI Home Care Assessment form and its ADL, IADL and COGNITION scales. Long-term care needs are measured and evaluated by using frontier approaches developed based on the InterRAI-HC Assessment Form, including the MI Choice Screening Algorithm, the Service Matching Decision Making Tree and the Institutional Risk Trigger. Also, factors affecting the long-term care needs are analyzed under the frame of Ronald M. Anderson’s health service utilization behavioral model. This study broke the previous ADL and IADL two-dimensional assessment, which comparatively has limited assessment contents, narrow standards and often leads imprecise conclusions. They also pay less attention on the different needs based on different impairment and disability status, or needs based on different family support.Study mainly found: in Haidian district of Beijing, 6.4% of the elders are assessed in the status of LTC impairment; 1% of the elders are assessed having institutional cares needs; the expressed institutional care needs are much higher than the assessed needs; older people with LTC impairments use more formal and informal care services based on chi-square test. With other conditions being equal, gender, age, living arrangement, social relations, having informal caregivers or not, home environment, self-assessed health status, LTC impairment level and number of chronic diseases can significantly affected the LTC needs among Chinese elders in Beijing. Particularly, having informal caregivers or not, LTC impairment level and number of chronic diseases all significantly influence the care needs assessed based on different assessment approaches.Study suggests: with reference to the existing studies, the results of this study are reliable and reasonable. The InterRAI-HC assessment scales and the three approaches for care needs assessment are valuable scientific and practical evaluation tools, which has high reliability and validity. They could be used for long-term care services monitoring system by Chinese government and service agencies, which can help to scientifically allocate public resources, and improve the quality of long-term care services in China.