Long-term care policies in Spain: welfare state and resilience in the European context

Abstract

This paper analyses the long-term care system in the context of Spain’s aging population from a comparative and multilevel perspective. Starting with the European regulatory framework, it examines the main characteristics of long-term care systems in Europe and the challenges of establishing a welfare system in Spain amidst two consecutive crises: the economic and financial crisis of 2008–2014 and the pandemic crisis of 2020–2022. To achieve this, in addition to a thorough review of international literature, the study utilises legislation and reports from the European Commission, the Council of Europe, the World Health Organization, databases from the National Institute of Statistics and the Ministry of Social Rights, and Spain’s Ministry of Health. The article concludes that Spain’s long-term care model has evolved over time and has established a universal system characterised by territorial inequality. This inequality stems from regional preferences for service provision versus monetary compensation and their varying degrees of reliance on direct management or involvement of private organisations.