[EQ] Renewing Primary Care: Lessons Learned From The Spanish Health Care System

Renewing Primary Care:
Lessons Learned From The Spanish Health Care System

Jeffrey Borkan^1,*, Charles B. Eaton², David Novillo-Ortiz³, Pablo Rivero Corte⁴ and Alejandro R. Jadad⁵

¹ Jeffrey Borkan, chair of the Department of Family Medicine at the Alpert Medical School, Brown University, in Providence, Rhode Island.
² Charles B. Eaton, director of the Center for Primary Care and Prevention at the Alpert Medical School and director of the Heart Disease
  Prevention Center at Memorial Hospital of Rhode Island, Brown University.
³ David Novillo-Ortiz, adviser for e-health at the Pan-American Health Organization PAHO/WHO, in Washington, D.C.,
  and a lecturer in the Department of Library Science and Documentation, Carlos III University, in Madrid, Spain.
⁴ Pablo Rivero Corte, Director General of Quality, Ministry of Health and Social Policy (Spain), in Madrid.
⁵ Alejandro R. Jadad, chief innovator and founder of the Centre for Global eHealth Innovation and holds the Canada Research Chair in
  eHealth Innovation and the Rose Family Chair in Supportive Care. Professor in the Departments of Health Policy, Management, and Evaluation
  and of Anesthesia, and in the Dalla Lana School of Public Health, University Health Network and University of Toronto, in Ontario, Canada.

August 2010 29:8 Health Affairs - doi: 10.1377/hlthaff.2010.0023 HEALTH AFFAIRS 29, NO. 8 (2010): 1432–1441
©2010 Project HOPE— The People-to-People Health Foundation, Inc

Abstract: http://bit.ly/9kILlO  [Subscription required]

"….From 1978 on, Spain rapidly expanded and strengthened its primary health care system, offering a lesson in how to improve health outcomes in a cost-effective manner.
The nation moved to a tax-based system of universal access for the entire population and, at the local level, instituted primary care teams coordinating prevention, health promotion, treatment, and community care. Gains included increases in life expectancy and reductions in infant mortality, with outcomes superior to those in the United States. In 2007 Spain spent $2,671 per person, or 8.5 percent of its gross domestic product on health care, versus 16 percent in the United States.

Despite concerns familiar to Americans—about future shortages of primary care physicians and relatively low status and pay for these physicians—the principles underlying the Spanish reforms offer lessons for the United States. ^……"

"….The Spanish experience has shown that it is possible to transform primary care, as part of an overall health care transformation conducted in a short time frame with modest investments, and still achieve impressive improvement in the health of the population….". ▪

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