Catalan long-term care system reaches the majority of age: what have we learned?

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  • dc.contributor.author Hernández-Pizarro, Helena M.
  • dc.contributor.author Prades-Colomé, Albert
  • dc.date.accessioned 2025-04-28T09:30:40Z
  • dc.date.available 2025-04-28T09:30:40Z
  • dc.date.issued 2025-04
  • dc.description.abstract Catalonia is one of the regions with the highest life expectancy among OECD countries, and it is expected to remain so in the coming decades. Currently, only half of this total life expectancy at age 65 is spent in good health. Far from healthy aging, in 2021, around 66% of the population over 65 did not rate their health status as good or very good, and 49% reported experiencing limitations in carrying out daily living activities (ADL) (OECD, 2024). In this context, the Spanish Long-Term Care System (LTCS), which represents the fourth pillar of the welfare state, is coming of age. The main objective of this text is to present the key lessons learned during this period based on a wide range of analyses of the system. To contextualize this evidence, the evolution of the Spanish LTCS is first reviewed, presenting its main characteristics and comparing them with those of its European counterparts. Secondly, the main insights gained from research conducted on the Spanish LTCS are presented. This research has focused on different aspects. One area of study has examined the –precarious- financial sustainability of the Spanish LTCS, identifying chronic underfunding and a flawed design that have limited the positive effects of benefits and increased the burden on families. On the other hand, the design and implementation of the Spanish LTCS ensure equitable access to and navigation within the system. However, inequities have been documented in the type of benefits received, as there is a higher demand for service-based benefits among beneficiaries with lower economic status. The economic impact of the Spanish LTCS has also been explored, revealing significant returns, particularly through job creation. Another aspect analysed is the effects of long-term care benefits on beneficiaries and their families. In this regard, research has shown that the introduction of the system has reduced hospitalizations, especially those resulting from conditions that could be avoided with adequate long-term care. Additionally, Spanish LTCS benefits have led to lower savings levels and an increase in the supply of informal caregivers, improving their well-being and increasing the likelihood of early retirement. Finally, the COVID-19 pandemic exposed critical weaknesses in residential care, including insufficient funding and staffing shortages, which contributed to high mortality rates during this period.
  • dc.identifier.uri http://hdl.handle.net/10230/70225
  • dc.language.iso eng
  • dc.relation.ispartofseries Health Policy Papers (CRES); 7 (2025)
  • dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License Creative Commons Attribution 4.0 International, which permits unrestricted use, distribution and reproduction in any medium provided that the original work is properly attributed.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri https://creativecommons.org/licenses/by/4.0/
  • dc.title Catalan long-term care system reaches the majority of age: what have we learned?
  • dc.type info:eu-repo/semantics/workingPaper

Col·leccions

Health Policy Papers (CRES)