Spain: Health System Review.

Q1 Medicine
Health systems in transition Pub Date : 2024-09-01
Enrique Bernal-Delgado, Ester Angulo-Pueyo, Manuel Ridao-López, Rosa M Urbanos-Garrido, Juan Oliva-Moreno, Daniel García-Abiétar, Cristina Hernández-Quevedo
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引用次数: 0

Abstract

This review of the Spanish health system analyses recent developments in health organization and governance, financing, health care provision, recent reforms and health system performance. Overall health status continues to improve in Spain, which presents the highest life expectancy in the European Union - although some socioeconomic inequalities in health persist and risk factors such as overweight, tobacco and alcohol consumption and illegal drug use remain a concern. The Spanish national health system (SNS) provides universal coverage, and it is mainly funded by taxes. Health competences are transferred to the regions, while the Ministry of Health is responsible for the overall coordination of the SNS. Health spending has seen a large increase as a percentage of GDP, following the COVID-19 pandemic in 2020, remaining high in 2021 (10.8% of GDP). While the benefits package is comprehensive, cost-sharing is required for pharmaceuticals and some prostheses; nonetheless, out-of-pocket (OOP) payments do not result in catastrophic spending for households. Co-payments have been largely reformed with further exemptions in place since 2020. Primary care remains at the centre of the SNS, with the Family Doctor 1 acting as the gatekeeper to specialized and hospital care. The 2019 Strategic Framework for Primary and Community Care aims for primary care to adapt to and address new epidemiological, societal and technological challenges that have emerged over the last decade. Regarding provision of care, there is a shortage of physicians in some specialties and problems in covering vacancies in some rural areas of the country, particularly for primary care physicians. Health system reforms since 2018 have focused on widening the population covered by the health system, reducing co-payments, improving the scope of coverage in terms of increasing provided services, and the reinforcement of primary care. Future challenges for the health system include addressing access gaps, such as the limited coverage of some services (such as dental and optical care), and large waiting lists for some services. Some gaps in efficiency remain, such as the low numbers of qualified personnel in some medical specialties, the shortage of mental health resources, the underuse of effective treatments, and the overuse of non-appropriate or ineffective procedures.

西班牙:卫生系统审查。
这篇对西班牙卫生系统的回顾分析了卫生组织和治理、融资、卫生保健提供、最近的改革和卫生系统绩效方面的最新发展。西班牙的总体健康状况继续改善,是欧洲联盟中预期寿命最高的国家————尽管健康方面的一些社会经济不平等仍然存在,超重、烟酒消费和非法吸毒等风险因素仍然令人关切。西班牙国家卫生系统(SNS)提供全民覆盖,主要由税收提供资金。卫生职能移交给各地区,卫生部负责全国卫生服务体系的全面协调。在2020年COVID-19大流行之后,卫生支出占国内生产总值的百分比大幅增加,到2021年仍保持在高位(占国内生产总值的10.8%)。虽然一揽子福利是全面的,但药品和一些假肢需要分担费用;尽管如此,自费支付并不会给家庭带来灾难性的支出。自2020年以来,共同支付已在很大程度上进行了改革,并有进一步的豁免。初级保健仍然是社会服务体系的中心,家庭医生1充当专科和医院保健的看门人。2019年初级和社区保健战略框架旨在使初级保健适应和应对过去十年出现的新的流行病学、社会和技术挑战。在提供保健方面,一些专业的医生短缺,在该国一些农村地区填补空缺方面存在问题,特别是初级保健医生。自2018年以来,卫生系统改革的重点是扩大卫生系统覆盖的人口,减少共同支付,在增加提供的服务方面扩大覆盖范围,并加强初级保健。卫生系统未来面临的挑战包括解决获取方面的差距,例如某些服务(如牙科和眼科护理)的覆盖范围有限,以及某些服务的等候名单很大。在效率方面仍然存在一些差距,例如某些医疗专业合格人员数量少、精神卫生资源短缺、有效治疗方法使用不足以及过度使用不适当或无效的程序。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health systems in transition
Health systems in transition Medicine-Medicine (all)
CiteScore
16.00
自引率
0.00%
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