Sosvilla Rivero Simón, Moral Arce Ignacio
Departamento de Fundamentos del Análisis Económico II, Universidad Complutense de Madrid, Madrid, España.
Gac Sanit. 2011 Dec;25 Suppl 2:66-77. doi: 10.1016/j.gaceta.2011.09.022. Epub 2011 Dec 9.
To provide estimates of the number of dependent individuals per grade and level for the period 2007-2045 and the cost associated with the care of these individuals for the System for Promoting the Autonomy and Care of Dependent Persons [Sistema para la Autonomía y Atención a la Dependencia (SAAD)].
Based on the Disabilities, Independence and Dependency Situations Survey (2008) and the scale for the assessment of grades and levels of dependency, we applied a two-stage estimation procedure to project the number of dependent individuals. In the first stage, we calculated the probability of a person being dependent and entitled to benefits by using a logit model. In the second stage, using an ordered logit model, we calculated the probability of distinct grades and levels of dependency in dependent persons entitled to benefits. Subsequently, we calculated expenditure projections based on average cost per point scale by grade and level of dependency.
Our results suggest a higher incidence of situations of dependency in female beneficiaries than in male beneficiaries, with higher growth rates for almost all categories of grade and level between 2007 and 2045. We estimated that in 2045 there will be 1,592,798 beneficiaries of the SAAD (596,332 men and 996,466 women). Moreover, between 2007 and 2045 the cost of care for dependent people will be multiplied by 2.64 for male beneficiaries and by 2.89 for female beneficiaries, amounting to 41,926 million euros in 2045.
The care of dependent persons is a major challenge for Spanish society both because of the number of persons that will require care and because of the greater economic cost involved. These findings should prompt a debate on how to fund services and benefits and how to ensure the sustainability of the system.
提供2007 - 2045年期间促进失能人士自主与照料系统（SAAD）中每个等级和水平的受抚养人数估计，以及照料这些人的相关成本。
基于《残疾、独立与依赖状况调查》（2008年）以及依赖等级和水平评估量表，我们应用两阶段估计程序来预测受抚养人数。在第一阶段，我们使用逻辑回归模型计算一个人处于依赖状态并有权享受福利的概率。在第二阶段，使用有序逻辑回归模型，我们计算有权享受福利的受抚养人中不同依赖等级和水平的概率。随后，我们根据每个依赖等级和水平的平均成本量表计算支出预测。
我们的结果表明，女性受益人的依赖状况发生率高于男性受益人，2007年至2045年期间几乎所有等级和水平类别的增长率都更高。我们估计，到2045年，SAAD将有1,592,798名受益人（男性596,332名，女性996,466名）。此外，2007年至2045年期间，男性受益人的失能照料成本将乘以2.64，女性受益人将乘以2.89，到2045年达到419.26亿欧元。
照料失能人士对西班牙社会来说是一项重大挑战，这既是因为需要照料的人数众多，也是因为涉及的经济成本更高。这些发现应引发关于如何为服务和福利提供资金以及如何确保该系统可持续性的讨论。
