Universalizing the Access to Long-term Care: Evidence from Spain

Joan Costa-Font, Sergi Jimenez-Martin, Cristina Vilaplana Prieto and Analía Viola

No eee2023-19, Studies on the Spanish Economy from FEDEA

Abstract: Spain together with Scotland are two countries that exhibit the largest expansions in long term care (LTC) in the last two decades, universalizing subsidies and supports. This paper is part of a global effort to provide a snapshot of the trends in LTC use and access, as well as the financing, and organization of the LTC system compared to other higher-income countries. After the passage of Act 39/2006 on the Promotion of Personal Autonomy and Care for Dependent Persons (SAAD in Spanish) on December 14, 2006, which universalized coverage for care subsidies and supports, access to care solely depends on individuals’ assessment of care needs, which has expanded the use of care, and spending as a percentage of GDP (which has risen from 0.5% in 2003 to nearly 0.9% in 2019), despite private LTC insurance playing a minor role. Still today, LTC remains heavily reliant on informal care, which is now partially subsidized by a caregiving subsidy as part of SAAD, which has expanded the weekly hours of publicly funded support for personal home help have increased significantly. Finally, the system reveals significant gender imbalances in the provision of care, with women accounting for most caregivers in both formal (87%) and informal (58%) care.

Date: 2023-06
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Working Paper: Universalizing the Access to Long-term Care: Evidence from Spain (2023)
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