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      Impacto económico de una implantación plena del Plan de Choque en Dependencia 2021-2023 en España Translated title: The impact of a full implementation of the Action Plan on Dependency 2021-2023 on the Spanish economy

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          Abstract

          Resumen Objetivo Valorar el impacto económico de la implantación del Plan de Choque en Dependencia (PCD), que representa la primera respuesta del gobierno de España ante las significativas carencias que la pandemia de COVID-19 puso de manifiesto en los Servicios de Dependencia. El PCD establece como prioridades la eliminación de las listas de espera, la mejora de los servicios priorizando la atención en domicilio, y la profesionalización y la estabilización del empleo en el sector. Método Para cumplir este objetivo se ha realizado una estimación del incremento de demanda de prestaciones y servicios en 2023, suponiendo que se cumplen las actuaciones que el PCD establece como inmediatas en el momento de su firma en 2021, para después, mediante una modelización multisectorial, cuantificar el impacto de las inversiones públicas requeridas, analizando no solo el impacto económico directo en los sectores económicos implicados en la dependencia, sino también los impactos indirectos e inducidos sobre la economía en su conjunto. Resultados Los requerimientos de inversión pública para el año 2023 serán de 13.962 millones de euros, cifra cercana al 1% del producto interior bruto, con un impacto en la economía en términos de producción de 41.570 millones, un valor añadido bruto de 21.046 millones y la creación de unos 440.000 empleos. Conclusiones Se pone de manifiesto que cumplir el PCD requiere un aumento del compromiso de financiación pública, más allá de las inyecciones puntuales del Plan de Recuperación, Transformación y Resiliencia. Estas inversiones tienen un impacto económico positivo en el conjunto de la economía del país, y no solo en el sector de servicios sociales.

          Translated abstract

          Abstract Objective To assess the impact on the economy of the implementation of the Action Plan on Dependency (APD), devised by the Spanish government as a first measure to tackle the major shortages in Dependency Services brought to light pursuant to COVID-19 pandemic. The APD establishes as priority areas the suppression of waiting lists, the improvement of dependency services, with a focus on home-care, and the professionalization and stabilization of employment. Method To achieve this goal, first, an estimate of the increased demand for benefits and services in 2023 has been carried out, supposing that all the priority measures established in the PCD in 2021 are fully implemented. Then, the impact of investment on the economy has been measured using multisector modeling. This analysis considers not only the direct economic impact on the sectors providing services to dependent population, but also the indirect and induced impact on the economy as a whole. Results The total public investment required for the plan in 2023 will reach 13,962 million Euro, which represents around 1% of the GDP. The impact on the economy in terms of production is expected to reach 41,570 million, while the impact on gross value added will be 21,046 million, together with the creation of nearly 440,000 jobs. Conclusions The results reveal that, for the APD to be fully implemented, public funding needs to be increased way beyond the occasional allocation of funds established in the Recovery, Transformation and Resilience Plan. These investments have a positive impact not only on the social and welfare sector, but also on the country's economy.

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          Input-Output Analysis: Foundations and Extensions

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            Input-Output Analysis: Frontiers and Extensions

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              Out-of-Pocket Healthcare Expenditures in Dependent Older Adults: Results From an Economic Evaluation Study in Mexico

              Background: Dependence is a significant health-related condition for older adults (OA) and implies that self-care is transferred to other people, the community or institutions. Recent studies have analyzed the relationship between out-of-pocket (OOP) healthcare expenditures and dependence. Nonetheless, these studies were not specifically designed to estimate the economic impact of dependence. Our aim was to estimate the total adjusted annual OOP healthcare expenditures in dependent older adults compared to independent ones. Additionally, we explore the potential combined effect of basic activities of daily living (ADL) and instrumental activities of daily living (IADL) dependence on OOP healthcare expenditures. Methods: Data comes from the cross-sectional study “Economic impact of physical dependence in older adults and the burden of informal care” conducted in 2018 with a sample of 735 community-dwelling older Mexican adults ages 60 and older. We used direct (medical and non-medical) and indirect costs to estimate the OOP healthcare expenditures associated with dependence. We applied the Katz scale to assess dependence in ADL and the Lawton scale to assess dependence in IADL. Two-Part regression models were used to analyze the relationship between dependence and OOP health expenditures. Results: Presence of ADL dependence represented a higher level of expenditure, 107% compared to non-dependent OA (β = 1.07, CI95%: 0.43–1.71), and 97% for IADL dependence (β = 0.97, CI95%: 0.49–1.45). The combined effect of ADL and IADL dependence (132%) was greater (β = 1.32, CI95%: 0.74–1.90) than the effect of ADL or IADL dependence alone. In monetary terms, OA with ADL dependence had a total annualized mean OOP healthcare expenditure of $31,865 (Mexican pesos), OA with IADL $26,912, and combined ADL and IADL $39,520. Conclusions: ADL and IADL dependence are associated with the total annualized OOP healthcare expenditures. This association is even higher when both conditions are present together. These findings highlight the economic implications of the dependence for individuals, their families, and the health system. Given that current evidence on effective interventions to prevent dependence in OA is insufficient, future studies should be conducted to estimate their costs and determine what interventions work, as well as their effectiveness and cost-effectiveness in different sub-groups of the population, and how these might be appropriately implemented.
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                Author and article information

                Journal
                gs
                Gaceta Sanitaria
                Gac Sanit
                Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS) (Barcelona, Barcelona, Spain )
                0213-9111
                2023
                : 37
                : 102289
                Affiliations
                [1] Madrid Madrid orgnameUniversidad Rey Juan Carlos orgdiv1Facultad de Ciencias de la Economía y de la Empresa orgdiv2Departamento de Economía Financiera y Contabilidad Spain
                Article
                S0213-91112023000100208 S0213-9111(23)03700000208
                10.1016/j.gaceta.2023.102289
                67a950a4-4c35-44a7-8906-f6319c10cbb9

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 27 July 2022
                : 29 November 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 0
                Product

                SciELO Spain

                Categories
                Originales

                Long-term care,Bienestar social,Cuidados de larga duración,Social welfare

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