Regionálne nerovnosti v zdravotnej a sociálnej starostlivosti o seniorov na Slovensku

Abstract

Slovakia's regional health and social care inequities in old age. This study aims to find and analyse inequity between regions in access to health and social care. Focusing on two age groups above 65 and 80, we investigate a possibility that in some regions health and social care deteriorates towards substandard level. We use a static regression test in spatial Durbin specification for the relationships between distribution of demand for health and social care in senior population, and distribution of service providers' network: general practitioners and medical specialists in the first domain, residential social care facilities in the second domain. Significant regression parameters reveal that health and social care correlate in a complex pattern, including indices of population density, settlement hierarchy and competition. Difference between public and private subjects suggests existence of cost effectiveness driving capacities into suburban area. Current intensity of population aging and related growth in cohort size in senior age encourage a novel attitude and reassessment of wellbeing, housing, security, formal and informal support. Increasing longevity creates a simultaneous participation of three or four generations in the family networks at the same time. Social and economic problems arise on basis of inter-generational responsibility. Social care for senior population is one of the most important components of state's institutional sphere. Despite long history and adaptive capacity of public social sector, on background of different socioeconomic contexts, their scope, structure, and spatial accessibility signal inequities. Regional qualities seem structurally linked with healthcare facilities, part of which evolves in a commercial regime. Supply side may avoid the burden of healthcare in old age when health and mobility decline. We pay attention to relationships between healthcare and social care capacities and suggest practical identification of regions and their parts at the municipality scale, in which inaccessibility aggregates. These regions need future spatially well-focused interventions correcting increasing commercial motive shaping distribution of service providers.