2023-09-25 08:55:32
Institutional passivity and slowness, lack of recognition or increased healthcare pressure are some of the challenges that primary care faces. The Spanish Society of Public Health and Health Administration (SESPAS) analyzes in its latest monograph the situation in which the ecosystem of the first level of care finds itself.
The Spanish health service has a great reputation on an international scale. However, in recent years the primary care system are experiencing a erosion stage full of challenges. The Spanish Society of Public Health and Health Administration (SESPAS) analyzes the situation in his new monograph entitled ‘The Primary Care Ecosystem’.
The work has been signed by sixteen authors from the academic field, public health and health administration and in it a reflection is made on the main challenges that has the first level of care ahead of it.
Furthermore, the experts who have been part of the preparation of ‘The Primary Care Ecosystem’ point out and offer some conclusions.
Eduardo Satue, vice president of SESPAS and coordinator of the monograph points out: “With this document we hope that the right questions will be raised to contribute, to the extent possible, to a
‘refoundation’ of Primary Care that allows it to serve citizens for another 40 years.”
Five challenges of the primary care system
1. Lack of staff
Professional organizations estimate that Primary Care staff lacks at least 15,500 nurses and 5,000 doctors.
Furthermore, SESPAS highlights as the main reasons, the lack of budget and decreased spending in the public health service.
Despite these shortcomings, the overexertion of professionals who work in primary care allows the lawsuits of more than 90% of patients.
2. Deficiencies not corrected and increased by the pandemic
During the pandemic, the deficiencies of primary care were clearly seen. Despite all of them, the first level of care was responsible for detecting possible complications early and prevented hospital collapse.
In fact, according to the monograph, almost the 94% of patients diagnosed with COVID-19 were treated in primary care during the first wave of the epidemic.
3. Hospitalocentrism
Society rewards resolution over containment, treating over preventing and waiting, the glamour, media presence and political reinforcement fall from the hospital.
The hospital budget has always grown more than the primary care budget. For example, during the 2008 crisis, staff cuts affected primary care the most. This means that the importance and weight of hospitals is always increasing and, on the other hand, that of primary care is more forgotten.
4. “The other” primary care
Hospitalocentrism is not only deduced by budgets or personnel. In the monograph, the experts analyze how today, Primary care work is increasingly affected. Three examples that they propose to explain it are the following:
Every day more hospitalizations occur due to hospital emergencies, without going through primary care. The number of doctors hospital emergencies has doubled in the last 16 years. The proliferation of chronic care units and anything else that fragments clinical care that loses comprehensiveness.
5. Greater effective universality of the public hospital than of primary care
The data analyzed in the monograph indicate that the public hospital is universal in theory and practice, effectively universal, accepted and used by all social classes. Something that does not happen to primary care, which has already become a kind of expanded charity avoided by almost everyone who can.
The primary care system is currently facing a long list of challenges. EFE/ Morell
Proposals to improve the primary care system
The team of SESPAS In his monograph, he suggests a series of guidelines or proposals to improve the Spanish primary care system.
As for the work of professionals and functions of the primary care team:
Greater coordination between the different primary care teams. Strengthen family and community medicine. Structuring new competencies for nurses. Include community pharmacy in the primary care team.
Refering to resource optimization:
Maneuver in the right direction financing, organization and management of primary medical care.
Furthermore, they propose a series of objectives to be achieved both at the national level and in the communities autonomous and both also enter into health relationships.
Waiting room of a health center. EFE/Andy Rain.
Conclusions of the monograph
The experts who have prepared the monograph conclude and highlight the following points as the most important to work on for the future:
The increase in both human and material resources in primary care: increase the weight of primary care in public spending as a whole, provide greater visibility and attractiveness to performance in primary care and reduce health dualization through the inclusion of mutualism.
Reorganization of powers: The development of the skills of other professionals, especially nurses and pharmacists, allows balance the workload between different team members.
Optimization of both human and material resources: The work and structural organization of the primary care network must evolve as well as care practice. To do this, they propose measures such as the flexibility of the management capacity of health centers or improving the connection of health and social information systems.
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