Montserrat Guillén Estany

Tasa de dependencia de la población española no institucionalizada y criterios de valoración de la severidad

Fundamento: El criterio de valoracion del grado de severidad de la dependencia influye en la estimacion de los costes de los servicios de cuidados de larga duracion, especialmente en la poblacion de 65 y mas anos. El objetivo de este trabajo es analizar las diferencias en la tasa de dependencia en personas con discapacidades de caracter permanente dependiendo del criterio de severidad utilizado. Metodos: Se utilizan los datos de la Encuesta sobre Discapacidades, Deficiencias y Estado de Salud recogidos por el Instituto Nacional de Estadistica en 1999. Se comparan dos criterios de valoracion de la severidad de las discapacidades padecidas por un individuo. Se ajusta el logaritmo de las tasas de prevalencia por edad, para cada sexo y se contrasta estadisticamente la existencia de diferencias significativas entre los criterios a partir de intervalos de confianza al 95%. Resultados: El criterio basado en la maxima severidad (empleado por el Instituto Nacional de Estadistica) infravalora entre 10%-25% el grado de dependencia absoluto medido por el criterio alternativo, sobrevalorando hasta un 25% los grados de dependencia moderados a partir de los 65 anos. En la poblacion masculina ese mismo criterio produce una infravaloracion del 10% en la dependencia grave a partir de los 95 anos. Conclusiones: El criterio de maxima severidad utilizado por el Instituto Nacional de Estadistica infravalora la tasa de dependencia mas grave, especialmente a partir de los 80 anos.

Escenarios del impacto de la inmigración en la longevidad y la dependencia de los mayores en la población española

INTRODUCTION The composition of the Spanish population has recently changed due to immigration. The present study aimed to estimate the magnitude of change in the calculation of healthy life expectancy and life expectancy in disability, taking the population of foreign residents into account. For this population, there is no information on mortality or the prevalence of disability. MATERIAL AND METHODS Data were extracted from the 1999 Survey on Disabilities, Handicaps and Health Status to estimate healthy life expectancy and life expectancy in disability using the Sullivan method. Data were taken from the Spanish Statistical Institute and the World Health Organization, Sullivans method was adapted to the case of two different populations, and possible scenarios were established. RESULTS The differences between the mortality table estimated for the foreign resident population and that estimated for the Spanish population were considerable and were more evident in women. At 65 years of age and in the worst scenario, which occurs when all the members of the foreign resident population are disabled, life expectancy in disability would be 2 more years for men and 3 more years for women than when the foreign population was not considered. CONCLUSIONS Our scenarios reveal that the impact of immigration on the calculation of healthy life expectancy and life expectancy in disability is moderate.

Tipologías sociodemográficas de individuos con dependencia en España y su supervivencia en estado de salud

INTRODUCTION the main objective of this study was to construct indicators that would allow individuals with dependence to be grouped, based on their socioeconomic situation, with special interest in the elderly. MATERIAL AND METHODS data were taken from the Survey of Disabilities, Deficiencies and Health Status (Spanish National Institute of Statistics). The distinct typologies of dependent individuals were analyzed by means of multivariate statistical techniques. Firstly, the factors that best established differences among individuals with dependence were determined; secondly, the sample was segmented to identify disabled individuals with dependence; and finally, healthy life expectancy and dependent life expectancy after the age of 65 years were calculated for the different groups. RESULTS the characteristics that best defined individuals with dependence were related to marital status, the care received, economic and work situation, and educational level. With these factors, seven groups for each degree of dependence were defined. The greatest differences in dependent life expectancy were found between pensioners who retired due to age and those who retired due to disability. CONCLUSIONS the profiles defined and their differences in dependent life expectancy are useful to plan long-term care resources and to quantify the costs of dependency, as well as to create systems that ensure that sufficient resources are used to decrease the differences among the groups of dependent individuals, thus inducing convergence among them.INTRODUCTION: the main objective of this study was to construct indicators that would allow individuals with dependence to be grouped, based on their socioeconomic situation, with special interest in the elderly. MATERIAL AND METHODS: data were taken from the Survey of Disabilities, Deficiencies and Health Status (Spanish National Institute of Statistics). The distinct typologies of dependent individuals were analyzed by means of multivariate statistical techniques. Firstly, the factors that best established differences among individuals with dependence were determined; secondly, the sample was segmented to identify disabled individuals with dependence; and finally, healthy life expectancy and dependent life expectancy after the age of 65 years were calculated for the different groups. RESULTS: the characteristics that best defined individuals with dependence were related to marital status, the care received, economic and work situation, and educational level. With these factors, seven groups for each degree of dependence were defined. The greatest differences in dependent life expectancy were found between pensioners who retired due to age and those who retired due to disability. CONCLUSIONS: the profiles defined and their differences in dependent life expectancy are useful to plan long-term care resources and to quantify the costs of dependency, as well as to create systems that ensure that sufficient resources are used to decrease the differences among the groups of dependent individuals, thus inducing convergence among them.Introduccion: el principal objetivo de este trabajo es la construccion de indicadores que permitan agrupar a los individuos con dependencia en funcion de su situacion sociodemografica, con especial interes por las personas mayores. Material y metodos: a partir de los datos que ofrece la Encuesta de Discapacidades, Deficiencias y Estado de Salud, del Instituto Nacional de Estadistica (INE), y mediante tecnicas de estadistica multivariante y el analisis de supervivencia, se analizan las distintas tipologias de individuos con dependencia. En primer lugar, se determinan cuales son los factores sociodemograficos que establecen diferencias entre los individuos con dependencia; en segundo lugar, se segmenta la muestra para encontrar grupos de discapacitados con dependencia. Finalmente, se realiza el calculo de las esperanzas de vida en salud y en dependencia a partir de los 65 anos para los grupos de individuos. Resultados: las caracteristicas que mejor diferencian a los individuos con dependencia estan relacionadas con el estado civil, los cuidados que reciben, la situacion economica-laboral y el nivel de estudios que poseen. Con estos factores se determinan y definen 7 grupos para cada grado de dependencia. Referente a la esperanza de vida en dependencia, las mayores diferencias las encontramos entre los jubilados por edad o por invalidez. Conclusiones: los perfiles definidos y sus diferencias en esperanza de vida en situacion de dependencia ayudan a la planificacion de recursos para los cuidados de larga duracion y la cuantificacion de los costes de la dependencia, asi como la creacion de sistemas que aseguren que los recursos disponibles se utilizan para disminuir las diferencias entre los grupos de personas con dependencia, incidiendo en la convergencia entre ellas.