Intermediate Care: The Investment Spain Needs to Age Better

Spain's healthcare system was designed to resolve acute episodes in a society that, half a century later, is moving toward chronic illness. That is the central argument of Alberto Martin de la Mata, director general of Fundacion Hospitalarias, who makes the case for intermediate care as the missing piece in the country's healthcare system.

Intermediate care acts as a bridge between hospital and home for patients who no longer need intensive hospital treatment but cannot safely return home either. It covers people with multiple conditions at once, frail elderly patients, neurological patients, those requiring complex rehabilitation, and those needing palliative care.

The cost of not investing in this model is high: Spain loses around 3.5 billion euros a year on hospitalizations and consultations that could be avoided, at a time when a single day of hospitalization costs between 600 and 1,000 euros depending on its complexity. Despite that, public healthcare devoted 60.1 percent of its budget to hospital care in 2024, far more than other levels of care.

International evidence backs the argument: various studies show that good coordination between health and social services can cut preventable hospital admissions by 15 to 30 percent. For Martin de la Mata, the challenge is less about expanding hospital capacity and more about strengthening that coordination between the health and social spheres.

The Fundacion Hospitalarias director also argues for a change in how the system measures success: rather than focusing solely on survival indicators, he proposes evaluating quality of life, functionality, autonomy and patient satisfaction as central criteria for assessing care for an increasingly long lived population.