Círculo de la Sanidad and the Gaspar Casal Foundation are presenting ‘La Sanidad española en cifras 2018’ (‘Spanish Healthcare in Figures 2018’) at the Ministry of Health. This biannual report sets out the main indicators describing the healthcare system’s performance and outcomes. Dr Alicia Coduras, a researcher at Institut Opinòmetre, contributed to the study as the book’s coordinator.
One of the study’s conclusions is that Spain’s public healthcare system ‘retained its recognised standing globally and within Europe, withstanding the adverse economic climate and beginning a path of improvement in several areas’.
The book includes information on investment, waiting lists, demographic trends, mortality, the population’s sociodemographic profile and well-being, lifestyles, and biological and social determinants, among other topics. It also provides specific information for each autonomous community, which is particularly relevant given that substantial responsibility for healthcare has been devolved to the regions.
Demand for healthcare in Spain increased gradually and moderately between 2012 and 2016, in line with the population’s growing needs, particularly among people aged over 65. Average life expectancy reached 82.5 years, one of the highest in the world. Ageing is therefore one of the major challenges facing the healthcare system in every autonomous community. High youth unemployment also increases young people’s economic dependence in many regions, making this another area requiring attention alongside older people’s dependency needs.
Spain’s overall age-standardised mortality rate fell by 3.5% between 2012 and 2015, placing the country tenth among 32 European countries in the latter year. The most prevalent causes are associated with respiratory diseases, malignant tumours of the colon and rectum, drug use and perinatal mortality.
In terms of morbidity, 5 rates, covering hospitalisation for diabetes, tuberculosis, cerebrovascular diseases, hypertensive diseases and COPD, fell in more than 50% of the autonomous communities between 2012 and 2016. Accident rates, both at work and on the roads, showed the least variation. Asthma, diabetes and mental disorders, particularly Alzheimer’s disease, increased slightly but significantly.
Regarding lifestyles, the report highlights 5 positive decreases: risky alcohol consumption, smoking, premature births, poverty and the percentage of people aged 25–64 with less than primary education. It also identifies 4 increases with a negative impact: sedentary lifestyles, cannabis use among older people and adolescents, overweight and obesity, and low-birthweight babies.
Finally, public healthcare coverage reaches around 99% of the population in every autonomous community. Public expenditure has increased moderately, although not uniformly across the regions. Greater investment in human and material resources would be desirable to improve management and bring demand into line with service capacity, reducing the impact of waiting lists and waiting times, the weakest aspect of the system’s structure.