El modelo español de cuidados de larga duración ante el desafío de la desigualdad

In Spain, as in most of the neighboring countries, socioeconomic and demographic changes have implied significant challenges for the care system.   Providing sufficient support to the population with fewer economic resources has been one of these challenges, although this issue has occupied a secondary place in the analysis of long-term care models. This article analyzes the inequalities experienced by elderly people in a situation of dependency when they try to access formal and informal at home care based on their income level. This same perspective is applied to nearby countries to compare the capacity of the Spanish care model to support population with fewer resources in the international scenario. The analysis will be supported by the latest Survey of Health, Aging and Retirement in Europe (SHARE) with data from the year 2017. The results show that the Spanish model has a low capacity to provide support to older people with care needs, regardless of their income level. However, it is the population with medium-low resources that experiences the greatest accessibility issues to formal care. This is fundamentally the result of the institutional design of the care model, highly focused on the population with fewer resources, and highly commercialized for the rest. Everything indicates that to overcome these limitations it is not only necessary to advance in the defamiliarization of care services and at home-care, but also to incorporate a greater number of community stakeholders in the attention of dependent population.