Objective/Meaning  Under the background of deep aging, the needs assessment for long-term care serves is the core component in the operation of long-term care insurance system, which directly determines the accurate identification of the security object, the efficient allocation of service resources and the safe and sustainable operation of the insurance funds. As one of the first pilot cities for long-term care insurance in China, Shanghai has formed a localized assessment system. Nonetheless, there remains room for optimization in terms of refining the assessment criteria, enhancing the professionalism of assessors, realizing the closed-loop management of procedures, and aligning the assessment outcomes with services. Taiwan region in China has entered an aging society at an earlier stage. Its Ten-Year Long-Term Care Plan 2.0 has established an integrated assessment mechanism covering the disabled persons and family caregivers, and has accumulated mature experience in the standardization of tools, the legalization of management, the institutionalization of benefits, and the informatization of supervision.

Methods/Procedures  The cross-strait comparative research method was used to systematically sort out and refine the replicable and scalable experience from the long-term care assessment system in Taiwan of China. Combined with the governance characteristics of Shanghai as a megacity and the reality of its social security system, an optimization scheme for the long-term care insurance assessment system suited to the local demands in Shanghai was constructed.

Results/Conclusions The study found that there were still some problems in the assessment system of long-term care insurance in Shanghai, such as inadequate refinement of assessment criteria, lagging construction of professional teams, imperfect supervision and dynamic reassessment mechanism, and poor linkage between assessment and service. Drawing on the mature practices of long-term care assessment in Taiwan region of China, the optimization countermeasures suitable for Shanghai were put forward from the five dimensions of assessment instruments, personnel qualifications, dynamic reassessment, information supervision, and the matching of assessment results with services, which could provide reference for developing the long-term care insurance assessment systems in megacities.