- Properly identifying care needs is key to an effective care system.
- With the adoption of a dependency assessment scale, Panama is moving towards the standardized criteria and transparent allocation of support.
- Team building, training, and consistent application of the scale are key to ensuring quality services and people-centered care.
One of the most important challenges for long-term care systems aimed at older persons is to objectively identify who needs support to carry out daily activities and what kind of services they require. In response, several countries have developed assessment tools known as “dependency scales.”
These scales help practitioners evaluate the physical and cognitive abilities of those who need support. This helps care systems determine how much help a person needs for daily activities such as eating, getting dressed, or maintaining personal hygiene – to establish their “degree of dependency.” Care systems use this information to determine who should receive access to benefits and care services.
Although scales are standard practice in countries around the world, their development in Latin America and the Caribbean is relatively recent. Argentina, Barbados, Chile, Costa Rica, and Uruguay have an instrument for assessing dependency. Panama has now joined this group of pioneering countries by developing a tool to assess care dependency in a systematic and transparent manner.
Panama's progress is driven by its National Care System, which was created in 2024 by Law 431. This law recognizes the right to care and establishes the state’s responsibility to identify people who require support and services. It mandates the development of a scale to determine the levels of dependency of people who require long-term care services, which guides access to the system's services.
With technical and financial assistance from the Inter-American Development Bank (IDB), the Ministry of Social Development (MIDES) designed and adopted, through Ministerial Resolution No. 298 of June 27, 2024, the Dependency Valuation Scale. This instrument establishes homogeneous criteria to identify people who require care support and classify their level of dependency into three degrees: moderate, severe, and high.
Its implementation also fundamentally redefines how the state approaches care. Rather than simply assessing specific diagnoses or conditions, the scale focuses on people's functionality and the support they need to maintain their autonomy and quality of life.
In 2026, Panama advanced the implementation of the scale by strengthening the capacities of the teams responsible for its application. As part of this strategy, technical experts conducted a process of training trainers, through which more than 25 professionals from MIDES, the National Secretariat for Disability and other institutions from different regions of the country were trained in the practical application of the scale.
This national network of trainers will progressively expand institutional capacities and ensure consistent and quality implementation in the different provinces and counties.
As Panama consolidates its National Care System, the scale will be key to defining eligibility and prioritizing those who require the most support, allowing for more equitable and efficient service provision. Its relevance increases in the face of the country's accelerated population aging: the IDB projects that the number of elderly people in Latin America and the Caribbean with functional dependence will double by 2035 and triple by 2050.
With these advances, Panama is positioned among the countries in the region that are building the technical and institutional foundations necessary to guarantee timely access to quality care services.
Learn more about the experience of Uruguay and Costa Rica in this technical note.