Spain: health system review
AbstractThe Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. This edition of the Spanish HiT focuses on the consequences of the totally devolved status, consolidated in 2002, and the implementation of the road map established by the 2003 SNS Cohesion and Quality Act. Many of the steps already taken underline the improvement path chosen: the SNS Inter-territorial Council (CISNS) comprising the national and regional health ministries was upgraded to the highest SNS authority, paving the way for a brand new consensus-based policy-making process grounded in knowledge management; its effects are progressively starting to be evident. It led the way to the SNS common benefits basket or the SNS human resources policy framework, laying the cornerstones for coordination and the enactment of the SNS Quality Plan. The Plan includes the work in progress to implement the national health information system, the development of a single electronic clinical record (eCR) containing relevant clinical information guaranteeing to patients continuity of care outside their Autonomous Community (AC) of residence or a single patient ID to be used across the country, thus creating the basis for the SNS functional single insurer. It has also become one of the main drivers for the design, implementation and monitoring of quality standards across the SNS, developing national health strategies to tackle both most prevalent chronic diseases (e.g. cancer, cardiovascular diseases, diabetes) and rare diseases, as well as the National Strategy on Patient Safety. The SNS still has many challenges to face, some of which are commonplace across Western developed countries and some of which result from its own idiosyncratic features. The agenda laid out by the CISNS seems to address many of these challenges; its implementation will certainly test the political maturity of the system, and that of the coordination and cohesion tools developed. The eventual results of its implementation will deserve close attention, setting the evaluative agenda for the next few years.
García-Armesto, S; Abadía-Taira, M; Durán, A; Hernández-Quevedo, C; Bernal-Delgado, E & European Observatory on Health Systems and Policies. (2010). Spain: health system review. World Health Organization. Regional Office for Europe. https://apps.who.int/iris/handle/10665/330332
Health Systems in Transition;vol. 12, n. 4
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World Health Organization. Regional Office for Europe; European Observatory on Health Care Systems (Copenhagen : WHO Regional Office for Europe, 2000)
Health systems in transition : Spain : health system review / written by Antonio Duran, Juan L. Lara and Michelle van Waveren ; edited by Vaida Bankauskaite Durán, Antonio; Lara, Juan L; Waveren, Michelle van; Bankauskaite, Vaida; World Health Organization. Regional Office for Europe; European Observatory on Health Systems and Policies (Copenhagen : WHO Regional Office for Europe, 2006)
Bernal-Delgado, E; García-Armesto, S; Oliva, J; Martínez, F; Repullo, J; Peña-Longobardo, L; Ridao-López, M and Hernández-Quevedo, C; World Health Organization. Regional Office for Europe; European Observatory on Health Systems and Policies (World Health Organization. Regional Office for Europe, 2018)This analysis of the Spanish health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Overall health status continues ...