The painful effects of the financial crisis on spanish health care

International Journal of Health Services

Volumn 44, Issue 1, 2014, Pages 25-51

  Bosch, Xavier ^a   Moreno, Pedro ^a   López Soto, Alfonso ^a  

^a UNIVERSITY OF BARCELONA   (Spain)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; BUDGET; ECONOMIC RECESSION; ECONOMICS; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH CARE SURVEY; HUMAN; METHODOLOGY; PUBLIC HEALTH; SPAIN;

BUDGETS; DELIVERY OF HEALTH CARE; ECONOMIC RECESSION; HEALTH CARE REFORM; HEALTH CARE SURVEYS; HUMANS; NATIONAL HEALTH PROGRAMS; QUALITY OF HEALTH CARE; SPAIN;

EID: 84894119193     PISSN: 00207314     EISSN: 15414469     Source Type: Journal    
DOI: 10.2190/HS.44.1.c     Document Type: Article

References (100)

1. World Bank. World Development Indicators. Washington, DC, 2011.
2. Gili, M., et al. The mental health risks of economic crisis in Spain: Evidence from primary care centres, 2006 and 2010. Eur. J. Public Health 23:103-108, 2013.
3. Eurostat Press Office. Provision of Deficit and Debt Data for 2012. April 22, 2013. http://epp.eurostat.ec.europa.eu/cache/ITY-PUBLIC/2-22042013-AP/EN/2- 22042013-AP-EN.PDF (accessed July 25, 2013).
4. Kingdom of Spain. Stability Programme Update, 2012-2015. http://www.thespanish economy.com/en-GB/Paginas/home.aspx (accessed July 25, 2013).
5. Instituto Nacional de Estadística. Encuesta de población activa. http://www.ine.es/ss/Satellite?pagename=INEHome%2FHOMELayout&L=0 (accessed July 25, 2013).
6. Centro de Investigaciones Sociologicas. Barómetro Sanitario, 2010 (Primera Oleada). Study No. 2832, March 2010. http://www.cis.es/cis/export/ sites/default/Archivos/Marginales/2820-2839/2832/Es2832.pdf (accessed July 25, 2013).
7. Martin-Moreno, J. M., et al. Spain: A decentralised health system in constant flux. BMJ 338:b1170, 2009.
8. Organisation for Economic Co-operation and Development. Health Data 2013. How Does Spain Compare? June 27, 2013. www.oecd.org/health/healthdata (accessed July 25, 2013).
9. García-Armesto, S., Campillo-Artero, C., and Bernal-Delgado, E. Disinvestment in the age of cost-cutting sound and fury: Tools for the Spanish National Health System. Health Policy 110:180-185, 2013.
10. Gené-Badia, J., et al. Spanish health care cuts: Penny wise and pound foolish? Health Policy 106:23-28, 2012.
11. García-Armesto, S., et al. Spain: Health system review. Health Syst. Transit. 12: 1-295, 2010.
12. Ministerio de Sanidad, Servicios Sociales e Igualdad. El Consejo Interterritorial. http://www.msssi.gob.es/organizacion/consejoInterterri/home. htm (accessed July 25, 2013).
13. Lopez-Casasnovas, G., Costa-Font, J., and Planas, I. Diversity and regional inequalities in the Spanish 'system of health care services.' Health Econ. 14(Suppl 1): S221-S235, 2005.
14. Organisation for Economic Co-operation and Development. StatExtracts, 2012. http://stats.oecd.org/index.aspx?DataSetCode=HEALTH-STAT (accessed July 25, 2013).
15. PricewaterhouseCoopers SL. Diez temas candentes de la Sanidad española para 2012. http://www.pwc.es/es/sala-prensa/multimedia/informe- sanidad.jhtml (accessed July 25, 2013).
16. Informe SESPAS (Sociedad Española de Salud Pública y Administración Sanitaria) 2012. La atención primaria: Evidencias, experiencias y tendencias en clínica, gestión y política sanitaria. Gaceta Sanitaria 26(Suppl 1), 2012. http://www.elsevier.es/es/ revistas/summary/gaceta-sanitaria-vol26-num-supl1 (accessed July 25, 2013).
17. Organización Médica Colegial. Profesión médica y reforma sanitaria. Propuestas para una acción inmediata. Madrid, December 2012.
18. Sahuquillo, M. R. 6.700 millones menos para sanidad. El País, February 16, 2013.
19. Castedo, A. Boi Ruiz quiere recortar hasta un 10% los sueldos en la sanidad pública. El País, April 11, 2013.
20. Güell, O. Los recortes de la Generalitat incendian la sanidad catalana. El País, April 8, 2011.
21. Metges de Catalunya. El pressupost de Salut confirma les advertències de Metges de Catalunya, January 30, 2012. http://metgesblog.com/2012/01/30/el-pressupost-de-salut-confirma-les- advertencies-de-metges-de-ca/(accessed July 25, 2013).
22. García Rada, A. Privatisation in Spain provokes protests among doctors. BMJ 345:e7655, 2012.
23. Legido-Quigley, H., et al. Will austerity cuts dismantle the Spanish healthcare system? BMJ 346:f2363, 2013.
24. McKee, M., et al. Austerity: A failed experiment on the people of Europe. Clin. Med. 12:346-350, 2012.
25. SEMFYC (La Sociedad Española de Medicina de Familia y Comunitaria). Informe sobre los recortes en los servicios sanitarios de las Comunidades Autónomas June 2012.
26. Unsigned. Decenas de municipios se quedan sin urgencias nocturnas en toda España. El País, January 16, 2013.
27. Real Decreto-ley 16/2012. BOE-A-2012-5403, pp. 31278-31312. April 20, 2012.
28. Karanikolos, M., et al. Financial crisis, austerity, and health in Europe. Lancet 381:1323-1231, 2013.
29. Ministerio de Sanidad, Servicios Sociales e Igualdad. Datos provisionales de facturación de receta médica. http://www.misssi.gob.es/ profesionales/farmacia/datos/marzo2013.htm (accessed July 25, 2013).
30. Ministerio de Sanidad, Servicios Sociales e Igualdad. Facturación de recetas médicas. http://www.mspsi.gob.es/profesionales/farmacia/datos/ home.htm (accessed July 25, 2013).
31. Farmaindustria. Encuesta anual y trimestral de deuda por suministros hospitalarios, December 2011.
32. Sahuquillo, M. R., and De Benito, E. Las listas de espera se agravan. El País, October 27, 2012.
33. Pérez-Molina, J. A., and Pulido Ortega, F. Assessment of the impact of the new health legislation on illegal immigrants in Spain: The case of human immunodeficiency virus infection. Enferm. Infecc. Microbiol. Clin. 30:472-478, 2012.
34. Reginato, E., and Grosso, R. European Federation of Salaried Doctors. European Hospital Doctors' Salaries. Document F11-071 EN, September 13, 2011.
35. Gili, M., et al. The mental health risks of economic crisis in Spain: Evidence from primary care centres, 2006 and 2010. Eur. J. Public Health 23:103-108, 2013.
36. De Lago, M. Organ donors and transplantations decrease in Spain, the leading country in both. BMJ 342:d242, 2011.
37. Martin-Moreno, J. M., et al. The effects of the financial crisis on primary prevention of cancer. Eur. J. Cancer 46:2525-2533, 2010.
38. Vila Córcoles, A., et al. Evolution of the antipneumococcal vaccination coverage among children in the region of Tarragona, Spain, 2002-2011. Rev. Esp. Salud Publica 86:637-643, 2012.
39. Elola, J., Rincón, R., and Castedo, A. El hambre se cuela en el colegio. El País, June 15, 2013.
40. Defensor del Pueblo. La Defensora del Pueblo investiga el impacto de la crisis en los hogares con niños y en la calidad de su alimentación, June 19, 2013. http://www. defensordelpueblo.es/es/Prensa/Notas/contenido- 1371636566768.html (accessed July 25, 2013).
41. Unsigned. Cortes de tráfico contra el tijeretazo en sanidad. El País April 13, 2011.
42. Menéndez, M. La presión ciudadana frena el cierre de dos hospitales en Mallorca. El País, August 11, 2012.
43. SEMFYC (La Sociedad Española de Medicina de Familia y Comunitaria). Análisis ético ante la retirada de asistencia sanitaria a inmigrantes sin permiso de residencia June 30, 2012.
44. Organización Médica Colegial y Consejo General de Enfermería. La alternativa de los médicos y enfermeros para garantizar la sostenibilidad del Sistema Nacional de Salud. Análisis e investigación, April 2013. http://www.actasanitaria.com/fileset/file- Resultados-85-Alterantivas-SNS-Medicos-y-Enfermer-6694431042059128656. pdf (accessed July 25, 2013).
45. García Vega, M. A. La salud privada aprovecha el tijeretazo público. El País, April 8, 2012.
46. Sahuquillo, M. R. Los españoles se blindan con la sanidad privada pese a la crisis. El País, December 15, 2011.
47. García-Rada, A. Conservative win in Spain's general election will boost role of private sector in healthcare. BMJ 343:d7297, 2011.
48. Prats, J. La gestión privada de la sanidad se extiende en las autonomías del PP. El País, November 3, 2012.
49. Benito, B., Montesinos, V., and Bastida, F. J. An example of creative accounting in public sector: The private financing of infrastructures in Spain. Crit. Perspec. Accounting 19:963-986, 2008.
50. Acerete, B., Stafford, A., and Stapleton, P. Spanish healthcare public private partnerships: The 'Alzira model.' Crit. Perspec. Accounting 22:533-549, 2011.
51. Prats, J. Un modelo rescatado y desigual. El País, January 6, 2013.
52. National Health Service European Office. The search for low-cost integrated healthcare. The Alzira model from the region of Valencia. Brussels, 2012. http://www. nhsconfed.org/Publications/Documents/Integrated-healthcare- 141211.pdf (accessed July 25, 2013).
53. Sevillano, E. G. El bastión de la 'marea blanca.' El País, November 10, 2012.
54. García Rada, A. Largest healthcare privatisation plan in Spain is to go ahead, despite massive opposition. BMJ 346:f236, 2013.
55. Marcos, J. Las concesionarias de los hospitales reducirán un 20% el gasto por paciente. El País, April 18, 2013.
56. Organisation for Economic Co-operation and Development. Economic Outlook, Analysis and Forecasts. November 2012. http://www.oecd.org/eco/economicout lookanalysisandforecasts/spaineconomicforecastsummary.htm (accessed July 25, 2013).
57. Unsigned. The Spanish patient. The Economist, July 28, 2012.
58. Ipsos. International Healthcare Report Card: Citizen-Patients in 15 Countries Assess Improvement to Healthcare. June 11, 2013. http://www.ipsos-na. com/news-polls/pressrelease.aspx?id=6141 (accessed July 25, 2013).
59. Organisation for Economic Co-operation and Development. Health at a Glance: Europe 2012. November 16, 2012. http://dx.doi.org/10.1787/9789264183896- en (accessed July 25, 2013).
60. Pericás, J. M., et al. Should alternatives to conventional hospitalisation be promoted in an era of financial constraint? Eur. J. Clin. Invest. 43:602-615, 2013.
61. World Health Organization Regional Office for Europe. The Tallinn Charter. 2008. http://www.euro.who.int/-data/assets/pdf-file/0008/88613/E91438. pdf (accessed July 25, 2013).
62. World Health Organization Regional Office for Europe. Health 2020. http://www. euro.who.int/en/what-we-do/health-topics/health-policy/health/ health-2020 (accessed July 25, 2013).
63. Gómez, M. V. Los sindicatos reclaman un gran pacto ante la emergencia nacional del paro. El País, May 1, 2013.
64. De Belvis, A. G., et al. The financial crisis in Italy: Implications for the healthcare sector. Health Policy 106:10-16, 2012.
65. European Commission. Europe 2020. http://ec.europa.eu/europe2020/index- en.htm (accessed July 25, 2013).
66. Eurostat Press Office. At Risk of Poverty or Social Exclusion in the EU27. December 3, 2012. http://epp.eurostat.ec.europa.eu/cache/ITY-PUBLIC/3- 03122012-AP/EN/3-03122012-AP-EN.PDF (accessed July 25, 2013).
67. Sanjurjo Martínez, A. Emergencia nacional. El País, May 5, 2013.
68. Prats, J., and Sevillano, E. G. El Gobierno volverá a subir el copago a los depen-dientes. El País, May 1, 2013.
69. Prats, J. La dependencia retrocede. El País, June 3, 2013.
70. Colegio de Registradores de la Propiedad. Panorama registral de impagos hipo-tecarios de vivienda, April 12, 2013. http://www.registradores.org/detalle- nota- prensa.jsp?DS48.PROID=21679 (accessed July 25, 2013).
71. CGPJ (Consejo General del Poder Judicial). El CGPJ informa, March 22, 2013. http://www.poderjudicial.es/cgpj/es/Poder-Judicial/En-Portada/Los- concursos-aumentaron- en-2012-un-28-por-ciento (accessed July 25, 2013).
72. Unsigned. El Senado aprueba el proyecto de ley sobre desahucios sin introducir cambios. El País May 3, 2013.
73. Rajmil, L. Destruction of a less developed welfare state and impact on the weakest, the youths. BMJ (rapid response), March 1, 2012. http://www.bmj.com/content/343/bmj.d7973?tab=responses (accessed July 25, 2013).
74. Tambor, M., et al. Diversity and dynamics of patient cost-sharing for physicians and hospital services in the 27 European Union countries. Eur. J. Public Health 21:585-590, 2011.
75. Goldman, D. P., Joyce, G F., and Zheng, Y. Prescription drug cost sharing: Associations with medication and medical utilization and spending and health. JAMA 298:61-69, 2007.
76. Nishi, A., et al. Health benefits of reduced patient cost sharing in Japan. Bull. World Health Organ. 90:426A-435A, 2012.
77. Selden, T. M., et al. Cost sharing in Medicaid and CHIP: How does it affect out-of-pocket spending? Health Aff. (Millwood) 28:W607-W619, 2009.
78. Blumenthal, D., and Dixon, J. Health care reforms in the USA and England: Areas for useful learning. Lancet 380:1352-1357, 2012.
79. Gemmill, M. C, Thomson, S., and Mossialos, E. What impact do prescription drug charges have on efficiency and equity? Evidence from high-income countries. Int. J. Equity 7:12, 2008.
80. World Health Organization. Health Policy Responses to the Financial Crisis in Europe. Copenhagen, 2012.
81. Barros, P. P. Health policy reform in tough times: The case of Portugal. Health Policy 106:17-22, 2012.
82. Miró, O. State of emergency medicine in Spain. Int. J. Emerg. Med. 3:219-226, 2010.
83. Bosch, X., et al. Quick diagnosis units versus hospitalization for the diagnosis of potentially severe diseases in Spain. J. Hosp. Med. 7:41-47, 2012.
84. Bosch, X., Jordán, A., and López-Soto, A. Quick diagnosis units: Avoiding referrals from primary care to the ED and hospitalizations. Am. J. Emerg. Med. 31:114-123, 2013.
85. Abellán Perpiñán, J. M., and Del Llano Señarís, J. Un NICE español, ¿misión imposible? Economía y Salud, Issue 73, March 2012.
86. Barlow, J., Roehrich, J., and Wright, S. Europe sees mixed results from public-private partnerships for building and managing health care facilities and services. Health Aff. (Millwood) 32:146-154, 2013.
87. Basu, S., et al. Comparative performance of private and public healthcare systems in low-and middle-income countries: A systematic review. PLoS Med. 9:e1001244, 2012.
88. Tiemann, O., Schreyögg, J., and Busse, R. Hospital ownership and efficiency: A review of studies with particular focus on Germany. Health Policy 104:163-171, 2012.
89. Sevillano, E. G. Who owns the Madrid region's hospitals? El País (English Edition), March 22, 2012.
90. Pollock, A. M., Price, D., and Liebe, M. Private finance initiatives during NHS austerity. BMJ 342:d324, 2011.
91. Pollock, A., and Godden, S. Independent sector treatment centres: Evidence so far. BMJ 336:421-424, 2008.
92. Barnaclínic. Group Hospital Clínic. http://www.barnaclinic. com/quienes-somos/en- barnaclinic.html (accessed July 25, 2013).
93. Castedo, A. Los servicios privados aumentan en los hospitales públicos catalanes. El País, April 15, 2013.
94. Camps Cervera, V., et al. Les prestacions privades en les organitzacions sani-tàries publiques. Fundació Víctor Grífols i Lucas, Issue 4, 2006. http://www. fundaciongrifols.org/portal/es/2/7353/ctnt/ dD10/-/-/cbx/04-Las-prestaciones-priva das-en-las-organizaciones-sanitarias- p%C5%93blicas.html (accessed July 25, 2013).
95. Ballart, X. A new model of primary health care in Catalonia. In Elites, Ideas and the Evolution of Public Policy, ed. M. Smyrl et al. Palgrave, London, 2008.
96. Generalitat de Catalunya. Llei 11/1995 (September 29, 1995) and Llei 15/1990 (July 9, 1990).
97. Ledesma Castelltort, A. Les entitats de base associativa (EBA) en la gestió dels serveis d'atenció primària a Catalunya. Referent 11:38-45, October 2012. http://www.uch.cat/referent/num11/documents/ referent%2011%2031oct12.pdf (accessed July 25, 2013).
98. Gallego, R. Introducing purchaser/provider separation in the Catalan health administration: A budget analysis. Public Adm. 78:423-442, 2000.
99. Bohmer, R. M. Leading clinicians and clinicians leading. N. Engl. J. Med. 368: 1468-1470, 2013.
100. Brand, H., et al. Austerity policies in Europe: Bad for health. BMJ 346:f3716, 2013.