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.
Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Population Dynamics , EmploymentABSTRACT
It seems necessary to assess the mortality of older people living in long-term care homes to examine its determinants, including the structural and organizational characteristics of these centers and their relationship with the use of health and social services. Attempting to investigate the mortality of the population over 65 years of age living in long-term care homes during COVID-19, we were not able to identify those who died at their long-term care home and, consequently, to know their number of deaths and their causes. In this field note, we describe this anomalous situation and propose a solution: compliance with the law that obliges all citizens to register at their usual address, which should be required in the process of admission to a residence. This would ensure the availability of the necessary data to know the mortality of the population residing in a residence.
ABSTRACT
Older people and their care workers have been disproportionately affected by the COVIDâ€19 pandemic. Many OECD Member countries have taken measures to contain the spread of the infection and improve the care workforce. Yet the health crisis is highlighting and exacerbating preâ€existing structural problems in the longâ€term care (LTC) sector. In many OECD Member countries, recruiting enough workers in LTC remains a challenge and care workers experience difficult working conditions. Skills mismatch and poor integration with the rest of health care lie at the root of preventable hospital admissions even in normal times. Such challenges are likely to become ever more acute if no further action is taken given the speed of population ageing. Policies to improve recruitment and which also address retention through training, improvements in coordination and productivity, leveraging the effect of digital technologies, are needed.Alternate :Les personnes âgées et leurs soignants ont été touchés de manière disproportionnée par la pandémie de COVID‑19. De nombreux pays de l’OCDE ont pris des mesures pour empêcher la propagation de l’infection et augmenter le nombre de soignants. Néanmoins la crise sanitaire met en lumière et exacerbe les problèmes structuraux existants dans le secteur des soins de longue durée. Dans de nombreux pays membres de l’OCDE, le recrutement d’un nombre de travailleurs suffisants dans le domaine des soins de longue durée demeure un défi et les soignants ont des conditions de travail difficiles. L’inadéquation des compétences et une mauvaise intégration avec le reste des soins de santé donnent lieu à des hospitalisations évitables, même en temps normal. Compte tenu de la vitesse à laquelle la population vieillit, ces défis sont susceptibles de s’accentuer encore plus si aucune autre action n’est entreprise. Il est nécessaire de mettre en Å“uvre des politiques visant à améliorer le recrutement et permettant de maintenir les effectifs via la formation, des améliorations dans la coordination et la productivité, tout en tirant parti de l’effet des technologies numériques.Alternate :La pandemia de COVIDâ€19 ha afectado de forma desproporcionada a las personas de la tercera edad y sus proveedores de cuidados. Muchos paÃses miembros de la Organización de Cooperación y Desarrollo Económicos (OCDE) han adoptado medidas encaminadas a evitar que la infección se propague y aumentar el número de proveedores de cuidados. A pesar de ello, la crisis sanitaria está poniendo de relieve y agravando los problemas estructurales existentes en el sector de los cuidados de larga duración. En muchos paÃses miembros de la OCDE, la contratación de un número suficiente de proveedores de cuidados de larga duración sigue constituyendo un desafÃo y las condiciones de trabajo de dichos proveedores son complejas. Incluso en circunstancias normales, se registran hospitalizaciones evitables debido a competencias inadecuadas y a la escasa integración con el resto del sistema de atención de salud. Habida cuenta de la velocidad a la que envejece la población, es probable que estos problemas se agraven si no se adoptan medidas al respecto. Se precisan polÃticas que tengan por objetivo mejorar la contratación y abordar la retención mediante programas de formación, mejoras en materia de coordinación y de productividad, e iniciativas de aprovechamiento de las tecnologÃas digitales.Alternate :Ältere Menschen und ihre Pflegekräfte sind von der COVIDâ€19â€Pandemie unverhältnismäßig stark betroffen worden. Viele OECDâ€Mitgliedstaaten haben Maßnahmen ergriffen, um die Ausbreitung der Infektion einzudämmen und das Pflegepersonal zu fördern. Die Gesundheitskrise verdeutlicht und verschärft jedoch bereits bestehende strukturelle Probleme im Langzeitpflegebereich. In vielen OECDâ€Mitgliedstaaten ist es nach wie vor eine Herausforderung, genügend Arbeitskräfte für die Langzeitpflege zu finden, und die Arbeitsbedingungen für Pflegekräfte si d schwierig. Ein Qualifikationsdefizit und eine unzureichende Einbindung in die übrige Gesundheitsversorgung sind die Ursache für vermeidbare Krankenhauseinweisungen selbst in normalen Zeiten. Diese Herausforderungen werden wahrscheinlich immer akuter werden, wenn angesichts der raschen Alterung der Bevölkerung keine weiteren Maßnahmen ergriffen werden. Es bedarf Strategien zur Verbesserung der Personalrekrutierung und der Personalbindung durch Fortbildung, Verbesserung der Koordinierung und der Produktivität unter Nutzung der Wirkung digitaler Technologien.Alternate :ÐŸÐ°Ð½Ð´ÐµÐ¼Ð¸Ñ COVID‑19 оказала неравнозначное влиÑние на пожилых людей и перÑонал по уходу за ними. Многие Ñтраныâ€Ñ‡Ð»ÐµÐ½Ñ‹ ОÐСРпринимают меры, чтобы контролировать раÑпроÑтранение инфекции и улучшать качеÑтво рабочей Ñилы в Ñфере ухода. Однако ÐºÑ€Ð¸Ð·Ð¸Ñ Ð² облаÑти Ð·Ð´Ñ€Ð°Ð²Ð¾Ð¾Ñ…Ñ€Ð°Ð½ÐµÐ½Ð¸Ñ Ð²Ñ‹Ð´Ð²Ð¸Ð³Ð°ÐµÑ‚ на первый план и уÑугублÑет ранее ÑущеÑтвовавшие Ñтруктурные проблемы в облаÑти долгоÑрочного ухода (ДУ). Во многих Ñтранахâ€Ñ‡Ð»ÐµÐ½Ð°Ñ… ОÐСРнайм доÑтаточного количеÑтва работников Ð´Ð»Ñ Ð”Ð£ оÑтаётÑÑ Ð¿Ñ€Ð¾Ð±Ð»ÐµÐ¼Ð¾Ð¹, а Ñами работники в Ñфере ухода имеют Ñ‚Ñжёлые уÑÐ»Ð¾Ð²Ð¸Ñ Ñ‚Ñ€ÑƒÐ´Ð°. Даже и в обычные времена неÑоответÑтвие навыков и плохое взаимодейÑтвие Ñ Ð¾Ñтальными Ñлужбами Ð·Ð´Ñ€Ð°Ð²Ð¾Ð¾Ñ…Ñ€Ð°Ð½ÐµÐ½Ð¸Ñ Ð»ÐµÐ¶Ð°Ñ‚ в оÑнове предотвратимых гоÑпитализаций. Ð£Ñ‡Ð¸Ñ‚Ñ‹Ð²Ð°Ñ ÑкороÑÑ‚ÑŒ ÑÑ‚Ð°Ñ€ÐµÐ½Ð¸Ñ Ð½Ð°ÑелениÑ, такие проблемы, вероÑтно, ещё Ñильнее обоÑÑ‚Ñ€ÑÑ‚ÑÑ, еÑли в дальнейшем не будут приниматьÑÑ ÑоответÑтвующие меры. Ðеобходимы меры по улучшению Ñитуации Ñ Ð½Ð°Ð±Ð¾Ñ€Ð¾Ð¼ перÑонала, а также по удержанию работников поÑредÑтвом тренингов, ÑƒÐ»ÑƒÑ‡ÑˆÐµÐ½Ð¸Ñ ÐºÐ¾Ð¾Ñ€Ð´Ð¸Ð½Ð°Ñ†Ð¸Ð¸ работы и продуктивноÑти, Ñффективного иÑÐ¿Ð¾Ð»ÑŒÐ·Ð¾Ð²Ð°Ð½Ð¸Ñ Ñ†Ð¸Ñ„Ñ€Ð¾Ð²Ñ‹Ñ… технологий.Alternate :è€å¹´äººåŠå…¶ç…§æŠ¤å·¥ä½œäººå‘˜éå—äº†æ–°å† è‚ºç‚Žå¤§æµè¡Œç—…ä¸æˆæ¯”例的影å“。许多ç»åˆç»„织æˆå‘˜å›½å·²é‡‡å–æŽªæ–½æŽ§åˆ¶æ„ŸæŸ“ä¼ æ’并改善照护人员队ä¼ã€‚然而, 这场å¥åº·å±æœºæ£å‡¸æ˜¾å¹¶åŠ 剧长期照护部门业已å˜åœ¨çš„结构性问题。在许多ç»åˆç»„织æˆå‘˜å›½, æ‹›è˜è¶³å¤Ÿçš„长期照护工作人员ä»ç„¶æ˜¯ä¸€é¡¹æŒ‘战, 照护人员也é¢ä¸´ç€è‰°éš¾çš„工作æ¡ä»¶ã€‚å³ä½¿åœ¨æ£å¸¸æƒ…况下,å¯é¿å…å…¥é™¢é—®é¢˜çš„æ ¹æºåœ¨äºŽæŠ€èƒ½ä¸åŒ¹é…以åŠä¸Žå…¶ä»–å«ç”Ÿå¥åº·éƒ¨é—¨çš„æ•´åˆä¸åŠ›ã€‚鉴于人å£è€é¾„化速度, 如ä¸é‡‡å–进一æ¥è¡ŒåŠ¨, 这些挑战å¯èƒ½ä¼šå˜å¾—æ›´åŠ ä¸¥å³»ã€‚éœ€è¦åˆ¶å®šæ”¿ç–æ¥æ”¹å–„æ‹›è˜, 并通过培è®ã€æ”¹å–„å调和生产力以åŠåˆ©ç”¨æ•°å—技术æˆæžœæ¥ç•™ä½äººæ‰ã€‚Alternate :تأثر كبار السن والعاملين ÙÙŠ مجال رعايتهم بشكل غير متناسب بجائØØ© كوÙيدâ€19. واتخذت العديد من البلدان الأعضاء ÙÙŠ منظمة التعاون والتنمية ÙÙŠ الميدان الاقتصادي ØŒ لا يزال توظي٠عدد كاÙ٠من العاملين ÙÙŠ مجال الرعاية طويلة الأمد يمثل تØديًا ويواجه العاملون ÙÙŠ المجال ذاته ظرو٠عمل صعبة. ويكمن عدم تطابق المهارات وضع٠التكامل مع بقية جوانب الرعاية الصØية ÙÙŠ أساسمنظمة التعاون والتنمية ÙÙŠ الميدان الاقتصاديتدابير لاØت٠اء انتشار العدوى وتØسين القوى العاملة ÙÙŠ مجال الرعاية. ومع ذلك، Ùإن الأزمة الصØية تسلط الضوء على المشاكل الهيكلية الموجودة مسبقًا وتؤدي إلى تÙاقمها ÙÙŠ قطاع الرعاية طويلة الأمد. ÙˆÙÙŠ العديد من البلدان الأعضاء ÙÙŠ الإستشÙاءات التي يمكن الوقاية منها، Øتى ÙÙŠ الأوقات العادية. ومن Ø§Ù„Ù…Ø±Ø¬Ø Ø£Ù† ØªØµØ¨Ø Ù…Ø«Ù„ هذه التØديات أكثر Øدة إذا لم يتم اتخاذ مزيد من الإجراءات بالنظر إلى سرعة شيخوخة السكان. وهناك Øاجة إلى سياسات لتØسين التوظي٠والتي تتناول الاستبقاء من خلال التدريب، وتØسين التنسيق والإنتاجية، والاستÙادة من تأثير التكنولوجيات الرقمية.Alternate :Os idosos e seus profissionais de saúde foram desproporcionalmente afetados pela pandemia de Covidâ€19. Muitos paÃses membros da OCDE tomaram medidas para conter a propagação da infecção e melhorar a mão de obra assistencial. No entanto, a crise da saúde está destacando e agravando os problemas estruturais preexistentes no setor de cuidados de longa duração (LTC). Em muitos paÃses membros da OCDE, o recrutamento de trabalhadores suficientes para LTC continua sendo um desafio e os profissionais de saúde vivenciam condições de trabalho difÃceis. A incompatibilidade de competências e a integração deficiente com o restante dos cuidados de saúde estão na raiz das internações hospitalares evitáveis, até mesmo em tempos normais. Esses desafios provavelmente se tornarão cada vez mais intensos se nenhuma ação adicional for tomada, considerandoâ€se a velocidade do envelhecimento da população. Há necessidade de polÃticas para melhorar o recrutamento e que também abordem a retenção por meio de treinamento, melhorias na coordenação e na produtividade, aproveitando o efeito das tecnologias digitais.
ABSTRACT
Facilities have been the focus of the greatest impact of COVID-19 in terms of mortality and extreme situations, along with health centers. The main objective of this article is to describe how the arrival of SARS-CoV-2 affected facilities, focusing on Spain during the first pandemic months, and to point out lessons learned. Despite the measures and regulations approved in the first weeks of March 2020, these centers were not prepared for the arrival of an epidemic such as the one experienced. The clearest indicator of this is a strong impact on mortality in residential facilities. The excess of deaths in residences has been estimated at 26,448 people between March 2020 and May 2021 (10.6% of the total number of dependents cared for in residences, with an excess mortality of 43.5%), with deaths concentrated in the first months of the pandemic. However, there are other effects to be considered such as those that affect the mental health and quality of life of residents, family members, and residential facilities staff. Assuming that no two pandemics are possibly alike, it is essential to draw lessons from lived experience that may be useful to prepare for similar future situations and strengthen a long-term care system that was already frail before the arrival of SARS-CoV-2.