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Spain: Long-Term Services & Supports

Spain: Long-Term Care

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Population, Mid-Year 2019: 46,737,000
Projected Population Mid-Year 2030: 46,230,000
Percentage of Population Under Age 25 Years, Mid-Year 2019: 24%
Percentage of Population 65 Years Or Over, Mid-Year 2019: 20%

Source: United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Prospects 2019: Data Booklet (ST/ESA/SER.A/424).


Percent of Adults Aged 65 and Over Receiving Long-Term Care (2017): 9.8%
Percent of Adults Aged 65 Years and Over Reporting To Be In Fair, Bad, or Very Bad Health (2017): 56.8%
People With Dementia Per 1,000 Population (2019): 20.2%
Projected Number of People With Dementia Per 1,000 Population in 2050: 41.8%
Long-Term Care Workers Per 100 People Aged 65 And Over (2016): 4.5
Long-Term Care Beds In Institutions and Hospitals Per 1,000 Population Aged 65 And Over (2017): 46.8
Long-Term Care Expenditure (Health and Social Components) By Government and Compulsory Insurance Schemes, as a Share of GDP (%) (2017): 0.7%

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.


Formal Long-Term Care Workers At Home (FTE) (2018): NA
Formal Long-Term Care Workers In Institutions (FTE) (2018): NA
Long-Term Care Recipients In Institutions Other Than Hospitals (2018): 240,131
Long-Term Care Recipients At Home (2018): 1,080,528

Source: Organization for Economic Cooperation and Development. OECD.Stat. Last accessed Oct. 7, 2020.


“Older people make up a growing proportion of the Spanish population. Nearly one in five people (19 %) was aged 65 and over in 2018, up from one in nine (11 %) in 1980, and this share is projected to rise to more than one in three (36 %) by 2050.

“Spanish people nowadays can expect to live an additional 21.5 years when they reach the age of 65, 1.5 years more than the EU average. However, many of these years are lived with some health issues and disabilities (Figure 4).

“Nearly 60 % of people aged 65 and over reported having one or more chronic conditions in 2017, although this may not impede them from living a normal life and carrying on their usual activities if it is properly managed. More than one in five reported at least one limitation in activities of daily living, such as eating or dressing, which may require some long-term care assistance. Nearly 40 % also reported some symptoms of depression, a greater proportion than in other EU countries.”

Source: OECD/European Observatory on Health Systems and Policies (2019), Spain: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“Long-term care can take the form of inpatient care in dedicated longterm hospital beds or “single-specialty” geriatric hospitals, or as part of the services provided in the context of Law 39/2006 for the Promotion of Personal Autonomy and Assistance for Persons in a Situation of Dependency, namely SAAD [National System for the Assistance of Dependent People].

“When it comes to dedicated long-term hospital beds, the SNS [National Health System] has 10,899 long-term care beds that represent 9% of public beds, and 77% of long-term care beds in the country, according to 2015 data (MSSSI, 2017m). Additionally, private hospitals (usually, not-for-profit) hold 3,102 beds that might be used to complement public supply (MSSSI, 2017m). Typically, hospital long-term beds cover palliative care needs, either in chronic patients or patients with cancer.

“When it comes to SAAD, services are provided through a network of social centres and services available in the ACs [Autonomous Communities], including regional public institutions, services provided by the municipalities, national reference centres for support of specific causes of disability, as well as accredited partner private centres. ACs have total freedom to set up this network of providers where nongovernmental organizations and not-for-profit institutions are considered as priority partners (compared with for-profit providers). Priority in access to services is determined by the assessment of the applicants’ degree of dependency and financial assets. Services are co-paid according to the type of service required and the ability to pay.”

Source: Bernal-Delgado E, García-Armesto S, Oliva J, Sánchez Martínez FI, Repullo JR, PeñaLongobardo LM, Ridao-López M, Hernández-Quevedo C. Spain: Health system review. Health Systems in Transition, 2018;20(2):1–179.


Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and several other nations.


Page last updated Nov. 21, 2021 by Doug McVay, Editor.

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