Journal of Policy Analysis and Management · 2026 · Joan Costa‐Font、Sergi Jiménez‐Martín、Cristina Vilaplana‐Prieto
中文摘要
我们估计了获得补贴性长期护理(LTC)对健康和福祉的影响。我们的分析利用西班牙2007年《失能人士自主与照护体系》(SAAD)的交错实施，该体系扩大了公共资助的普惠性LTC补贴和支持，以及其后续改革。我们使用二十年的行政数据和调查数据，并利用项目覆盖在地区和个人层面的外生变异，发现获得SAAD福利使护理接受者的抑郁症状减少约10个百分点，使其生存概率提高2.6至3个百分点，并使其生活满意度提高0.24至0.50个量表分。成本效果估计表明，所隐含的每获得一个质量调整生命年(QALY)的成本低于欧洲公共卫生支出通常可接受的效率阈值。这些发现记录了公共补贴性LTC供给所带来的可观健康回报和效率增益。
Abstract
ABSTRACT We estimate the health and well‐being effects of subsidized access to long‐term care (LTC). Our analysis exploits the staggered implementation of Spain's 2007 System of Autonomy and Care for Dependent People (SAAD), which expanded publicly funded and universal LTC subsidies and supports, as well as its subsequent reform. Using two decades of administrative and survey data and leveraging exogenous regional and individual‐level variation in program exposure, we find that access to SAAD benefits reduces the care receiver's depressive symptoms by approximately 10 percentage points, increases its survival probability by 2.6–3 percentage points, and raises its life satisfaction by 0.24–0.50 scale points. Cost‐effectiveness estimates indicate that the implied cost per quality‐adjusted life year (QALY) gained lies below commonly accepted efficiency thresholds for public health spending in Europe. These findings document sizeable health returns and efficiency gains from publicly subsidized LTC provision.