This study offers a descriptive spatial analysis of the potential demand and effective supply of care services for dependent older adults in Chile. By integrating sociodemographic data from administrative registries with the geographic distribution of public and private institutions providing care to older adults, across all 16 regions and 6,877 neighborhood units (unidades vecinales, UVs), the analysis identifies substantial territorial disparities in access to long term residential facilities (ELEAM) and community based programs (CEDIAM). In the Metropolitan Region, residents have access to an average of 11.6 ELEAMs within a 3 km radius. In contrast, in Aysén and Magallanes, the average distance to the nearest facility exceeds 400 km, with fewer than one center within a comparable range. Public provision, particularly through the National Service for Older Adults (SENAMA), demonstrates the lowest accessibility and further concentrates care infrastructure in urban areas. While for-profit providers exhibit greater spatial dispersion, their expansion is predominantly influenced by market forces, resulting in systematic underservice in low-income and remote areas. Spatial analysis substantiates this disparity: dependent older adults are highly concentrated in specific neighborhoods (Moran’s I = 0.92), whereas care facilities are primarily located in urban centers, proving territorial misalignment between demand and supply. These results highlight the importance of integrating spatial equity criteria into the development of Chile’s National Care System. Enhancing the nonprofit sector through regulatory frameworks and targeted subsidies could address territorial disparities caused by limited public coverage and market-driven provision, thereby fostering a more equitable and territorially balanced care model.
Authors: Bárbara Flores Arenas, M. Beatriz Fernández-Lorca & Valentina Jorquera-Samter
