The nursing home market - Spain (2023)

1.2 The European market

Europe's population is aging: in ****, the over-**s will account for more than a fifth of the European population. By ****, this proportion is expected to rise to almost a third. The European population aged ** and over is expected to rise from *% in **** to over **% in ****.

Proportion of the population aged ** and over Europe **, ****-****, in % Source: ****

The three European countries with the highest proportion of people aged ** and over are Italy (***).

Housing demand for seniors Europe, ****, in millions of people Source: ****

Europe's population is aging at an accelerating pace (***) rising from around **% in **** to an estimated **% in ****, and even **% in ****. As a result, the care needs of the elderly population are set to increase exponentially over the coming years, raising the question of how to finance them against a backdrop of public finance crises in all European countries[***]

Investment volume in retirement homes Europe, ****, in billions of euros Source: ****

The UK was the leading "European" country in terms of investment in retirement homes, with **.** billion euros in ****. Germany was in *nd place, investing **.** billion euros in ****. However, the gap between *nd and *rd place was quite wide, with the Netherlands investing just *.** billion euros in senior residences.

This can be explained ...

1.3 The domestic market

Sales of medicalized senior residences in Spain fluctuated between **** and ****. It rose from *.** billion euros in **** to *.** billion euros in ****, an increase of *.**%. In ****, it fell slightly to *.** billion euros, down *.**%. In ****, it rose slightly to *.** billion euros, an increase of *.*%. Finally, in ****, it reached *.** billion euros, an increase of *.**% on the previous year

Sales trends in the Spanish nursing home sector Spain, **XX-****, billions of euros Source: ****

In ****, it was estimated that **% of sales would come from the public sector, **% from the mixed sector and **% from the private sector.

Segmentation of sector sales in **** Spain, ****, % of sales Source: ****

2.1 Demographics

Between **** and ****, the number of Spaniards aged over ** rose steadily, from *.** million in **** to *.** million in ****. This represents an increase of **.*% over this **-year period. The smallest increase was between **** and ****, with growth of *.**%, while the largest increase was between **** and ****, with growth of *.**%. On average, Spain's over-** population grew by *.**% per year over this period.

Evolution of the population over ** Spain, ****-****, in millions Source: ****

The map below shows the proportion of people aged ** and over by Autonomous Community in ****.

Spanish life expectancy is currently the highest on the European continent, with an average of **.* years in ****. [***]. The graph below shows life expectancy at over ** for Spanish men and women.

Life expectancy over ** Spain, ****, years Source: ****

The proportion of Spain's population aged over ** is set to increase significantly over the coming decades. In ****, it will represent **.*% of the total population, rising to **.*% in ****, an increase of *.* percentage points. This upward trend will continue, reaching **.*% in ****, **.*% in **** and **.*% in ****. The proportion of the population over ** will peak in **** at **.*%, before declining slightly to **.*% in ****. Overall, by ****, the proportion of people aged over ** will increase by *.* percentage points compared to ****.

Projection of population aged over ** Spain, ****-****, % of total population Source: ****

This ...

2.2 Typical resident profile

In Spain, the percentage of men living alone varies with age. Between the ages of ** and **, **.*% of men live alone. This figure rises slightly for men aged ** to **, with a rate of **.*%. However, this percentage rises significantly for men aged ** or over, reaching **.*%. As for women, the percentage living alone is higher at all ages. Between the ages of ** and **, **.*% of women live alone. This figure rises considerably for women aged ** to **, with a rate of **.*%. The highest rate is observed among women aged ** or over, where **.*% live alone. These data can be used to assess the potential demand for nursing homes. Indeed, the factor of loneliness may determine whether or not people will be placed in a nursing home.

Percentage of Spaniards living alone by age and gender Spain, ****, % (***) Source: ****

Added to this is the dependency ratio of the Spanish population aged over **. Indeed, dependency and its effects are a factor in people being placed in nursing homes. In ****, nationwide, **.**% of the Spanish population over ** was dependent.

Dependency rate of people aged ** and over in Spain Spain, ****, % of population Source: ****

The map below shows the dependency ratio of the population aged ** and over by Autonomous Community. Castilla y León, ...

2.3 Perception of nursing homes

within Spanish society, only *.**% of respondents would like to live in a retirement home, while **.**% would not. With regard to aging at home, **.*% of respondents would prefer to remain at home with medical assistance, **.**% without medical assistance, and **.*% would opt for day care in a nursing home.

Spaniards and nursing homes Spain, ****, % of population Source: ****

When it comes to companionship, **.*% of older people would be interested in sharing a flat with other older people, and **% would like to do so with like-minded people.

Companionship and old age Spain, ****, % Source: ****

3.1 Market breakdown

In ****, there were a total of *,*** nursing homes in Spain. The map below shows the geographical distribution of these centers. It shows that Catalonia, with **.**% of centers, Castilla y León with **.**% and Andalusia with **.**% are the * Autonomous Communities with the most nursing homes.

The number of places is shown on the map below. The communities with the highest number of nursing home places are Catalonia (***).

Breakdown of the population over **: MAP

3.2 Private versus public establishments

by ****, the Spanish market for nursing homes will be **% private and **% public.

Breakdown of Spanish retirement homes by private or public type Spain, ****, % of total Source: ****

The map below shows the regional disparities between the number of private and public facilities. Extremadura and the Canary Islands are the only Autonomous Communities with more public than private establishments. Conversely, the Basque Country, Catalonia and Murcia have the highest rates of private establishments in the Kingdom, with **.*%, **.*% and **.*% private establishments respectively.

Private sector :

Of the *,*** private establishments in Spain in ****, there is a relatively even distribution between the different types of center according to size. Centers with between ** and *** places dominate the market, with **.*% of total facilities, followed by centers with between ** and ** places, which account for **.*% of the market. Centers with *** or more places represent **.*% of the market, while centers with fewer than ** places account for **.*%.

Breakdown of Spanish private nursing homes by size. Spain, ****, % Source: ****

In terms of number of places, this distribution results in a situation where **.*% of places are in centers with *** or more care places. Centers with between ** and *** places account for **.*% of available places, those with between ** and ** places for **.*% of market places, and centers with fewer ...

3.3 Market structure

Current structure :

--> INE CNAE ****

Magnitudes of the nursing home sector Spain, ****, number, thousands, billions Source: ****

Matching supply and demand

In Spain, despite a *% increase in the number of places in retirement homes by ****, social services are still not meeting the needs of this population. According to a report by the Association of Directors and Managers of Social Services, there remains a shortfall of **,*** places to reach the recommended rate of * places per *** people aged ** and over, as defined by the World Health Organization. In addition, there is an unmet demand for **,*** places for very dependent people. There is therefore a current mismatch between supply and demand. The table below shows the different ratios in the various Autonomous Communities.

Source: ****

Autonomous Community Number of places per *** inhabitants % of people over ** in the Autonomous Community Andalusia * **,* % Aragón *,* **,* % Principado de Asturias *,* **,* % Balears (***) *,* **,* % Canarias *,* **,* % Cantabria *,* **,* % Castilla Y Leon *,* **,* % Castilla la Mancha *,* **,* % Cataluña *,* **,* % Comunitat Valenciana *,* **,* % Extremadura *,* ** % Galicia *,* **,* % Comunidad de Madrid *,* **,* % Murcia *,* **,* % Navarra *,* **,* % País Vasco *,* **,* % La Rioja *,* **,* % Ceuta *,* **,* % Melilla *,* **,* % TOTAL ESPAÑA *,* **,* %

Source: ****

This difficulty in matching demand is a challenge for the market, all the more so as the number of retirees will increase in the future.

The arrival of new seniors ...

4.1 The different nursing homes in Spain

Depending on status:

--> PRIVATE PUBLIC = SERVICES + PRICE.

Note that the main criteria for differentiating between the private and public sectors are internal services and the speed of finding a place.

Source: ****

Acceptance criteria in the public sector:

The following are the main criteria for admission to a public nursing home. The "Ley de Dependencia para personas mayores" law explains these criteria in detail, and in part * of this study, a more detailed overview is available:

The person concerned must be over **, or ** in the case of moderate or severe dependence. The applicant must not require medical care requiring hospitalization, nor suffer from severe behavioral disorders. The applicant must have been registered for at least two years in the municipality where the residence is located. They must not have been sanctioned in any other institution run by the autonomous community or municipality. He/she must be a beneficiary of the public pension system, the spouse of a pensioner, or be entitled to social benefits as provided for by law or IMSERSO international agreements.

Depending on degree of dependence :

Source: ****

TYPOLOGY OF SERVICES OFFERED IN THIS TYPE OF PRIVATE RESIDENCE?

4.2 Prices

In public or mixed establishments, the price of a nursing home corresponds to between **% and **% of the retiree's annual income.

Price of a public nursing home in Spain Spain, ****, % of residents' annual income Source: ****

The following table shows private nursing home prices by Autonomous Community:

Source: ****

--> PRICES FOR DIFFERENT PATHOLOGIES?

4.3 Supply trends: luxury nursing homes in Spain

Luxury residences:

Luxury nursing homes offer an ideal environment for the elderly, thanks to their personalized attention, wide range of services and high level of comfort. In Spain, these high-end residences are numerous, and although expensive, they guarantee their residents and their families a full range of amenities, benefits and services. These residences are impeccably maintained to ensure maximum comfort for residents, and every space is adapted to their physical limitations. In terms of food, these residences offer varied menus tailored to each resident's individual dietary preferences, helping to maintain their optimal health. Another strong point of these residences is the quality of the rooms, which are carefully decorated to provide a warm atmosphere. Each room is personalized to create a unique space, and equipped with all the safety measures necessary to ensure the well-being of each resident, according to his or her needs and abilities. Consider the following nursing homes: Centro Residencial Valmonte, Centro Residencial Sanitas Txindoki, or El Pardo de Aravaca.

Among the services that stand out in luxury residences are the following:

Psychogeriatric care Occupational therapy Physiotherapy Medical psychology Speech therapy Exclusive medical service available ** hours a day Pedicure Hair salon Transfers and personal transport Hydrotherapy

Care ...

5.1 Regulations

The Dependency Act: Ley **/****, de ** de diciembre, de Promoción de la Autonomía Personal y Atención a las personas en situación de dependencia, defines the criteria for dependency that can affect the elderly. This law also sets out the proportion of economic aid available to these people, according to their degree of dependence.

Spain defines * degrees of dependence:

Degree *: Moderate dependence, requiring assistance with certain activities of daily living. Degree *: Severe dependence, requiring assistance with several activities of daily living. Degree *: Severe dependence, requiring assistance with all activities of daily living.

To qualify for financial assistance, Spanish citizens must also meet the following conditions:

be in a situation of dependence according to the degrees established by law (***). Spanish nationality. Have been legally resident in Spain for at least five years, including the two years preceding the application. be recognized as a dependent person by the assessment body of the autonomous community concerned. be registered in the Autonomous Community where the application is made.

The following economic benefits are available:

Service-related economic benefits (***) or Service Vouchers: This benefit enables access to these services in the private sector when the dependent person prefers this option to a public place. Payments ...

6.1 Segmentation

• Aralia Servicios Sociosanitarios Sa
• GERIATROS SA
• LA SALETA CARE SLU
• SANITAS MAYORES SL.
• INTERCENTROS BALLESOL SA
• Quavitae Servicios Asistenciales Sau