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

Joan Costa-Font, Sergi Jimenez-Martin, Cristina Vilaplana-Prieto and Analía Viola
Authors registered in the RePEc Author Service: Cristina Vilaplana Prieto

No 31825, NBER Working Papers from National Bureau of Economic Research, Inc

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. The passage of Act 39/2006 on the Promotion of Personal Autonomy and Care for Dependent Persons (SAAD in Spanish) on December 14th, 2006, universalized coverage for care subsidies and supports, allowing access to care conditioned only on individuals’ assessment of care needs. As a consequence, LTC spending as a percentage of GDP 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. Long-term care spending in Spain amounts to between 1.27% (conservative estimates) and 1.70% (flexible estimation) of GDP. 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.

JEL-codes: D14 G22 I18 (search for similar items in EconPapers)
Date: 2023-11
New Economics Papers: this item is included in nep-age and nep-hea
Note: AG EH PE
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Forthcoming: Universalizing the Access to Long-Term Care: Evidence from Spain , Joan Costa-i-Font, Sergi Jiménez-Martín, Cristiana Vilaplana Prieto, Analía Viola. in Long-Term Care around the World , Gruber and McGarry. 2024

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