Transcript Spanish Health Care System

ENQual questionnaire
National Quality Policy
in Spain
Susana Lorenzo MD, MPH, PhD
Quality Manager
Fundación Hospital Alcorcón
Spanish Health Care System
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1855 Health Law
1942 Illness' mandatory coverage
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1967 Health Care Services Ordination (S. S.).
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Management through Instituto Nacional de Previsión
general medicine, drug prescription and several
ambulatory surgery
Primary , secondary and tertiary levels
Clusters’ planning
1977 Social Security White Book
Spanish Health Care System
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1978 National Health Service
1981 Ministry of health and consumer affairs
1986 Health Law
2002 National health service desegregated
Autonomous Communities
2002 Patient rights law
1986 Health Law
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Universal coverage (100%)
Financing through taxes, salary and special taxes
NHS model
Based on Health care areas for management purposes
Primary health Reform based in Alma-Ata
Health care level Reorganization
Private and public management (concerts are possible)
Patients’ rights
Community participation regulated (Consejos de Salud)
Abril Report
Objectives:
1. Improve managers’ responsibilities and
efficiency.
2. Patient satisfaction and choice capacity.
3. Promote costs consciousness.
4. Flexibility and autonomy to manage budgets.
5. Improve people participation and implication.
system’s
Recommendations:
• ORGANIZATION: decentralization, Consejo Interterritorial
payment derived form objectives.
• MANAGEMENT: to measure health product, to develop
economic analysis, clinicians deployment, improve quality in
health care
• FINANCIATION: from National General Budget besides SS.
2002 National health service desegregated
Autonomous Communities
EFQM Excellence Model in Spain
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Asturias: Hospital Monte Naranco (2)
Aragón todos los hospitales y áreas de salud 2002 (1)
Baleares: Fundación Hospital Manacor (1)
Cantabria: Area Torrelavega
Cataluña: Hospital Creu Roja (1), ICO (1), Sagessa (1), Hospital
del Piu 1, AP, otros en curso
Galicia: Hospital Arquitecto Marcide (2); Hospital Juan Canalejo
(1) (unidad del corazón)
Madrid: todos los hospitales y areas de atención primaria 2003
Murcia: en curso en varios hospitales
Osakidetza (1996-2003): 3 autoevaluaciones (hospitales y áreas).
4 reconocimientos
Valencia: Hospital La Fé (1); Instituto de Oftalmología (1)