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ENQual questionnaire National Quality Policy in Spain. Susana Lorenzo MD, MPH, PhD Quality Manager Fundación Hospital Alcorcón. Spanish Health Care System. 1855 Health Law 1942 Illness' mandatory coverage Management through Instituto Nacional de Previsión
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ENQual questionnaire National Quality Policy in Spain Susana Lorenzo MD, MPH, PhD Quality Manager Fundación Hospital Alcorcón
Spanish Health Care System • 1855 Health Law • 1942 Illness' mandatory coverage • Management through Instituto Nacional de Previsión • general medicine, drug prescription and several ambulatory surgery • 1967 Health Care Services Ordination (S. S.). • Primary , secondary and tertiary levels • Clusters’ planning • 1977 Social Security White Book
Spanish Health Care System • 1978 National Health Service • 1981 Ministry of health and consumer affairs • 1986 Health Law • 2002 National health service desegregated Autonomous Communities • 2002 Patient rights law
1986 Health Law • Universal coverage (100%) • Financing through taxes, salary and special taxes • NHS model • Based on Health care areas for management purposes • Primary health Reform based in Alma-Ata • Health care level Reorganization • Private and public management (concerts are possible) • Patients’ rights • Community participation regulated (Consejos de Salud)
Abril Report Objectives: 1. Improve managers’ responsibilities and system’s efficiency. 2. Patient satisfaction and choice capacity. 3. Promote costs consciousness. 4. Flexibility and autonomy to manage budgets. 5. Improve people participation and implication. Recommendations: • ORGANIZATION: decentralization, Consejo Interterritorial payment derived form objectives. • MANAGEMENT: to measure health product, to develop economic analysis, clinicians deployment, improve quality in health care • FINANCIATION: from National General Budget besides SS.
2002 National health service desegregated Autonomous Communities
EFQM Excellence Model in Spain • Asturias: Hospital Monte Naranco (2) • Aragón todos los hospitales y áreas de salud 2002 (1) • Baleares: Fundación Hospital Manacor (1) • Cantabria: Area Torrelavega • Cataluña: Hospital Creu Roja (1), ICO (1), Sagessa (1), Hospital del Piu 1, AP, otros en curso • Galicia: Hospital Arquitecto Marcide (2); Hospital Juan Canalejo (1) (unidad del corazón) • Madrid: todos los hospitales y areas de atención primaria 2003 • Murcia: en curso en varios hospitales • Osakidetza (1996-2003): 3 autoevaluaciones (hospitales y áreas). 4 reconocimientos • Valencia: Hospital La Fé (1); Instituto de Oftalmología (1)