Regional variability in long-term care services in Spain: Needs, service use and diversification
Maria Angeles Tortosa | Valencia University
Objective: Ultimately there is international interest in the study of equity distribution of services for older people. There are different types of approaching this. Most common analysis done focus on comparisons among countries and employing information related with public expenses and on income of people. In this study we want to analyse regional equity in these services for Spain and its regions, but according to needs. The aim of our study is to explore how social services for older people respond to their individual needs, in different regional models defined by the level of service coverage and diversification.
Data and methods: We have used individual interviews from 2008 EDAD (N = 45,553) survey and the regional statistics from IMSERSO (2008, 2010), population records from 2008 and census data for 2011 (INE 2011). We classify the Spanish regions by total public service coverage and the degree of diversification of their services. Thereafter, we estimate multinomial regressions considering these micro and macro data to explain the behaviour on use of services by users depending on group of regions, and later separately by gender.
Results: It appears great services variations among regions. And we obtain 4 groups of regions according to coverage and diversification services rate. Most regions are in an intermedium and lower situation among coverage and diversification. Regressions estimations tell us Spanish regions with more diversified services seem to target needs somewhat better, that is, to have fewer older persons with unsatisfied needs and also distribute number of services more accurately to their physical frailty conditions. Furthermore, men and women profile use were scarcely different.
Policy implications: There are substantial regional variations and inequities in Spanish services for older people. Regions target services primarily to, and best, for persons with the greatest physical needs. Diversification of services ‘pays off’ but services also should address social vulnerability.