Gaceta sanitaria
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To determine the perceived quality variables related to satisfaction and to identify the influence of sociodemographic factors on user satisfaction with hospital emergencies. ⋯ The variables influencing emergency patients' satisfaction were determined, allowing areas where corrective action could be introduced to be identified. In addition, possible confounding factors that should be controlled for when comparing results among distinct hospitals were identified. The emergency satisfaction questionnaire is a useful instrument to evaluate and improve quality of care.
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In November 2008, at the request of the Directorate General of Public Health of the Ministry of Health and Social Policy, the Commission to Reduce Social Inequalities in Health in Spain was established with a mandate to develop a proposal for interventions to reduce health inequalities. This article aims to present the work carried out and the documents prepared by the Commission. ⋯ The document listed a total of 166 recommendations, divided into 14 areas and ordered by priority. These recommendations highlight that health inequalities cannot be reduced without a commitment to promote health and equity in all policies and to move toward a fairer society.
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We address the contribution of financial incentives linked to pay for performance (P4P) to improving the quality of care. The situation of P4P is analyzed internationally and in the distinct health services in Spain. The participation of P4P in wage compensation and the effects of the current economic crisis on these incentives is discussed. We review the results of recent studies to clarify the role of these incentive models and assess possible orientations and new proposals.
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In 2010, the Spanish National Health Service (NHS) paid for 958 million prescriptions. Given the massive population exposure to medication, the risks associated with drug consumption are highly significant from the perspective of public health. Areas requiring improvement in primary care prescription include overtreatment of patients in low risk situations, undertreatment of those in whom medication is indicated, poor patient information, polymedication, self-medication and the appreciable percentage of preventable adverse effects. ⋯ Some key elements to improve this situation include more integrated healthcare, the development of electronic medical records systems, overall strategies to improve safety, and reducing the role of the pharmaceutical industry. Macro strategies include creating an agency able to objectively assess the additional value provided by a new drug and its additional cost, price fixing in line with cost-effectiveness, and exclusion of drugs with little or no added value from coverage, etc. Managing prescription involves the development of longitudinal patient care programs that incorporate clinical actions from different professionals, including whom to treat, how much to treat and how to treat.