La sostenibilidad del Sistema Nacional de Salud en España

Martín, José Jesús Martín; González, María del Puerto López del Amo

doi:10.1590/s1413-81232011000600016

Cited by 14 publications

(5 citation statements)

References 6 publications

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“…The current Spanish public health system has its roots in the middle of the last century and is inspired by European continental models of social security, however, unlike these models, it employs an extensive network of internally governed centers and organizations of an ambulatory and hospital nature [1]. Spanish Law regarding general health services (1986) established a national health system made up of 17 regional health services.…”

Section: Introductionmentioning

confidence: 99%

Nursing as a Sustainability Factor of the Health System during the COVID-19 Pandemic: A Qualitative Study

et al. 2020

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Earlier this year, Spain took center stage in the emerging health crisis due to the SARS-CoV-2 pandemic. On 14 March 2020, a state of alarm was declared to manage this health crisis. The contribution of nursing professionals to sustainability of the system during this health crisis has been vital, not only in specialized care but, in a more understated way, in primary care. The objective of the present study was to describe the perceptions and lived experiences of primary care nurses during the COVID-19 health emergency. A qualitative study taking a phenomenological approach was carried out, triangulating data collected through non-participant observations, eight in-depth interviews, and two discussion groups with community nurses and case managers. A total sample of 20 key informants was obtained during the month of May, 2020. The key informants expressed strong positive perceptions of the recognition received from service users and satisfaction when acknowledging that they have been an important source of emotional support. Informants identify the importance of their work in sustaining the system, particularly outlining team cohesion and communication, whilst also evaluating the empowering position in which service users and society itself has put them.

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Section: Introductionmentioning

confidence: 99%

Nursing as a Sustainability Factor of the Health System during the COVID-19 Pandemic: A Qualitative Study

et al. 2020

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“…However, there is a strong territorial decentralization of health jurisdictions in the Autonomous Communities. Therefore, the final drug financing is an Autonomous Regions' responsibility covering almost 100% of population [19]. That means that caring of schizophrenia patients is covered by the public system.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of antipsychotics in reducing schizophrenia relapses

García-Ruiz

Pérez-Costillas²,

Montesinos³

et al. 2012

Health Econ Rev

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BackgroundSchizophrenia is a severe form of mental illness which is associated with significant and long-lasting health, social and financial burdens.The aim of this project is to assess the efficiency of the antipsychotics used in Spain in reducing schizophrenia relapses under the Spanish Health System perspective.Material and methodsA decision-analytic model was developed to explore the relative cost-effectiveness of five antipsychotic medications, amisulpride, aripiprazole, olanzapine, paliperidone Extended-Release (ER) and risperidone, compared to haloperidol, over a 1-year treatment period among people living in Spain with schizophrenia. The transition probabilities for assessed therapies were obtained from the systemic review and meta-analysis performed by National Institute for Health and Clinical Excellence (NICE).ResultsPaliperidone ER was the option that yielded more quality-adjusted life years (QALYs) gained per patient (0.7573). In addition, paliperidone ER was the least costly strategy (€3,062), followed by risperidone (€3,194), haloperidol (€3,322), olanzapine (€3,893), amisulpride (€4,247) and aripiprazole (€4,712).In the incremental cost-effectiveness (ICE) analysis of the assessed antipsychotics compared to haloperidol, paliperidone ER and risperidone were dominant options. ICE ratios for other medications were €23,621/QALY gained, €91,584/QALY gained and €94,558/QALY gained for olanzapine, amisulpride and aripiprazole, respectively. Deterministic sensitivity analysis showed that risperidone is always dominant when compared to haloperidol. Paliperidone ER is also dominant apart from the exception of the scenario with a 20% decrease in the probability of relapses.ConclusionsOur findings may be of interest to clinicians and others interested in outcomes and cost of mental health services among patients with schizophrenia.Paliperidone ER and risperidone were shown to be dominant therapies compared to haloperidol in Spain. It is worthwhile to highlight that schizophrenia is a highly incapacitating disease and choosing the most appropriate drug and formulation for a particular patient is crucial.The availability of more accurate local epidemiological data on schizophrenia would allow a better adaptation of the model avoiding some of the assumptions taken in our work. Future research could be focused on this.

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“…Se establece, entonces, un sistema sanitario altamente descentralizado. Diversos autores han apuntado posibles problemas que pueden asociarse a dicho modelo (Martín y López del Amo, 2011;Cabasés, 2010;Martín, 2006;Ruiz-Huerta y Granado, 2003), que se sintetizarían en el riesgo de no alcanzar una verdadera equidad en los servicios ofrecidos a todos los ciudadanos, con independencia del lugar en el que vivan. En este sentido, la Ley 16/2003 de cohesión y calidad del Sistema Nacional de Salud se promulgó con la intención de garantizar dicho principio de equidad.…”

Section: El Sistema Nacional De Saludunclassified

Fronteras en el contexto español: ¿barreras o puentes para la cooperación sanitaria?

González

Santamaría

2014

dag

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Recepción: noviembre de 2012Aceptación: enero de 2013 ResumenLas fronteras delimitan sistemas político-administrativos con normas y prácticas propias en diversas materias. En relación con la asistencia sanitaria transfronteriza, en el presente artículo, se muestra que, en algunos contextos, como el de un estado semifederal como el español, los problemas y las soluciones en las fronteras externas (entre estados) y las internas (entre comunidades autónomas) se asemejan. En primer lugar, se analiza la cooperación en las exteriores y, para ello, se repasa el marco normativo comunitario y español, para después abordar un estudio de caso, el de la Cerdaña (frontera entre España y Francia). A continuación, se vuelve la mirada a la cooperación horizontal de las comunidades autó-nomas, el Sistema Nacional de Salud y los fondos destinados a equilibrar el gasto entre las administraciones regionales. Dos estudios de caso (las relaciones, desde el punto de vista sanitario, entre Cataluña y Aragón, así como entre la Rioja y el País Vasco) ilustrarán las tensiones y las negociaciones entre gobiernos regionales, que llevaron a proponer una solución en el marco general del Estado. Palabras clave: fronteras externas; fronteras internas; sanidad; cooperación transfronteriza; península Ibérica. Resum. Fronteres dins el context espanyol. Barreres o ponts per a la cooperació sanitària?Les fronteres delimiten sistemes politicoadministratius amb normes i pràctiques pròpies en diverses matèries. En relació amb l'assistència sanitària transfronterera, en el present article, s'hi mostra que, en certs contextos, com ara el d'un estat semifederal com l'espanyol, els problemes i les solucions a les fronteres externes (entre estats) i les internes (entre comunitats autònomes) són semblants. En primer lloc, s'hi analitza la cooperació a les exteriors; després de repassar el marc normatiu comunitari i espanyol, s'hi aborda un estudi de cas, el de la Cerdanya (frontera entre Espanya i França). A continuació, s'hi analitza la cooperació horitzontal de les comunitats autònomes, el Sistema Nacional de Salut i els fons destinats a equilibrar la despesa entre les administracions regionals. Dos estudis de cas (les relacions, des del punt de vista sanitari, entre Catalunya i Aragó, així com entre la Rioja i el País Abstract. Borders in the Spanish context. Barriers or bridges for healthcare cooperation?Borders delimitate political-administrative systems that adopt different sets of rules and procedures dealing with different matters. Regarding cross-border health care, our analysis shows that in some contexts, as is the case in a semi-federal state as Spain, problems and solutions can be applied to external borders (between states) and also to internal borders (between autonomous regions). First, we treat cooperation at the external ones. Once described European and Spanish legal frameworks, a case study is analysed, that of Cerdanya (Spain-France border). Then, we turn our attention to horizontal cooperation between Spanish regions, the National Heal...

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La sostenibilidad del Sistema Nacional de Salud en España

Abstract: The sustainability of the Spanish National Health System

Cited by 14 publications

References 6 publications

Nursing as a Sustainability Factor of the Health System during the COVID-19 Pandemic: A Qualitative Study

Nursing as a Sustainability Factor of the Health System during the COVID-19 Pandemic: A Qualitative Study

Cost-effectiveness analysis of antipsychotics in reducing schizophrenia relapses

Fronteras en el contexto español: ¿barreras o puentes para la cooperación sanitaria?

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