Políticas de austeridad y cambios en las pautas de uso de los servicios sanitarios. Informe SESPAS 2014

Abstract

This article analyzes the main changes in healthcare use patterns in Spain related to the economic recession and to the measures taken to address it. The impact of the reform of drug copayment is examined; the number of prescriptions has decreased, although the effects of this reform on adherence, access to necessary and effective treatments, and health, are still unknown. This article also describes how waiting times and waiting lists for surgery have increased in recent years, as has the population's dissatisfaction with the national health system. Analysis of microdata from the Spanish national health surveys for 2006 and 2011/12 show that the economic recession is deterring the use of uncovered dental visits among the lowest social class. We recommend clearer definition of the role played by copayments within the national health system, and focussing on those who most need healthcare in order to prevent the more socioeconomically advantaged collectives from consuming a larger share of available services after the cuts.

Changes in Access to Health Services of the Immigrant and Native-Born Population in Spain in the Context of Economic Crisis

“…The decrease in unmet healthcare need, both in the autochthonous and immigrant population, could be associated with the increase in perception of good health during the same time period. These results agree with other studies [ 19 , 22 ], but do not agree with Eurostat data that points to an increase in unmet health need in Spain, particularly for the lowest income quintiles (2008–2012 period) [ 38 ]; this could be related to a different formulation of the question. The analysis of the reasons for unmet healthcare need show the presence of access barriers to care and changes during the time period, although these results should be interpreted with caution due to the difficulties in comparing the two surveys.…”

“…They were explored through a close-ended question with contain different response options and because the category “ other reasons ” cannot be further analyzed, because there was no possibility to specify a different answer from the given list. On one hand, the increase in the lack of access to care due to wait times agrees with evidence regarding the increase in waiting times within the current healthcare context [ 22 ]. On the other hand, the marked decrease in the reason “ lack of time to attend health services due to work ” in the immigrant population could be related to the increase in unemployment.…”

“…Until recently, studies carried out in Spain on the effects of the economic crisis have focused on its impact on population health [ 20 , 21 ]. Only one study analyzes the effects of the crisis on the general population’s access to health services, showing a decrease in health service use compared to 2006, especially among unskilled workers [ 22 ].…”

Place of Birth Inequalities in Dental Care Use Before and After the Economic Crisis in Spain

“…In fact, previous studies show that when in the presence of loss of income, people tend to restrict the use of health services that are considered less essential, such as preventive services [40], among which dental services may be included [9,21,38]. services after three years of economic growth and employment growth [18,41]. In fact, after the labor reform, income and social inequalities have increased and, as a consequence, the access to goods and services [35].…”

“…Thus, adults must pay the total cost of dental care and is the largest private expense in health for Spanish households. This cost represents an important barrier for access contributing to inequalities in access to dental care services among socioeconomic disadvantaged groups since 1997 [14,15,[17][18][19][20] and even increasing inequalities during the economic crisis [21]. The economic crisis began in 2008 and was characterized by a decline in macroeconomic indicators such as the Gross Domestic Product (GDP), employment and/or national income.…”