Evaluation of Spanish Health System during the COVID-19 Pandemic: Accountability and Wellbeing Results

Abstract

The COVID-19 pandemic poses a challenge for health systems. For this reason, it is essential to evaluate the management of health systems in the face of the pandemic, identifying the factors that may contribute to its failure or success. This management is more difficult in decentralized countries, since in them, health competencies are distributed among different levels of government. This is the case in Spain, one of the countries most affected by the pandemic. Therefore, the aim of this article is to evaluate how the Spanish health system has managed the COVID-19 pandemic. Four factors related to health management are analyzed: transparency, communication, reputation and well-being generated. For this purpose, a quantitative analysis is used with the contrast of secondary sources, such as the Merco rankings or survey data from the Centro de Investigaciones Sociológicas (Sociological Research Center). The results show that although the flow of communication about the health system increases considerably, such information comes mainly from the media, with a deficit in the transparency of health management. Likewise, although the reputation of the health system increases at the beginning of the pandemic, as it progresses, there is a deterioration in citizen satisfaction with the healthcare management and the services provided, as well as in the well-being generated by them. This study may have implications for decision making by public authorities regarding the different factors of health management.

Spanish Healthcare Sector Management in the COVID-19 Crisis Under the Perspective of Austrian Economics and New-Institutional Economics

“…Previous studies on healthcare management and its different elements during crisis (64), with special attention to accountability and wellbeing evaluation (16), have not paid attention to the theorems of Mises and Buchanan-Tullock applied to crisis management. However, the outbreak of a pandemic such as the one that occurred with COVID-19 poses a main challenge for research in this area.…”

“…The methodology used in this research is mixed: (a) the theoretical framework of the Austrian Economics (56)(57)(58)(59)(60)(61), and the New Institutional Economics (5,6,35); (b) the applied economics in COVID-19 crisis (62)(63)(64), related to the Spanish healthcare system (16); based on a quantitative approach using both descriptive analysis and bi-variable analysis, which allow observing the territorial differences among the variables for this study. The configuration of the Spanish healthcare system requires the research to be carried out from a regional perspective, that is, to examine the different elements of health management in each of the autonomous health systems, including those of national government management when necessary.…”

“…Also, the increased demand for information in times of health and economic crisis (12) requires bigger coordination and more accountability amongst state powers in the crisis management. This paper studies the Spanish case, with special attention to the healthcare sector, because there was mismanagement (of exceptionality abuse) in terms of health, economy, law, and accountability (13)(14)(15), with a decrease of wellbeing among the citizens (16), under the Austrian Economics approach (i.e., Mises' theorem, dynamic efficiency), and New-Institutional Economics (i.e., unfinished agenda theorem). How and why did it happen?…”

“…FIGURE 2 | Reputation of Spanish regional healthcare systems before and during COVID-19 according to the perception of health professionals and experts (%). Source: Peña-Ramos et al(16).…”

Measuring the Impact of Future Outbreaks? A Secondary Analysis of Routinely Available Data in Spain

“…When addressing COVID-19 transparency of health management matters. As the pandemic progressed in Spain there is a deterioration in citizen satisfaction with the healthcare management and the services provided, as well as in the well-being generated by them [ 13 ].…”