The Catalan healthcare system

Departament de Salut Catalan healthcare system

Comparison among different European regional systems The Catalan healthcare system Brussels, 14-16 May, 2007

Departament de Salut Catalan healthcare system

Socio-demographic characteristics Autonomous Community Area: 31,895 km2 Population: 7,196,168 inhabitants Life expectancy: 80.10 years Birth rate (2004): 11.41 Gross Mortality rate (2004): 8,49 Infant mortality: 3.22 GDP/Capita (PPP 2003): US$ 28.740 High urban concentration Own language and culture Tourism: 22,669,000 visitors Employment by sectors : • Services 59.4 % • Industry 28.8 % • Construction 8.3 % • Agriculture 3.5% Source: IDESCAT.

Departament de Salut Catalan healthcare system

The Catalan Health Care System • • • • • • • •

Funded by taxes Decentralized Universal coverage Free access Very wide range of publicly covered services Co-payment in pharmaceutical products Services provided mainly in public facilities General practitioner as the gatekeeper of the system

Departament de Salut Catalan healthcare system

Customer-oriented organization C i t i z e n s

Emergencies

primary Health Centre

Hospitals

H1

H2

H3

Long-term Care Centre

Mental Health Centre

Departament de Salut Catalan healthcare system

General diagram of the Catalan Healthcare System Insurance

U s e r

Catalan Health Service

Services Catalan Institute of Health 20%

100%

Contracted Provides 70% Supplementary Private Insurance 20%

Private Centres 10%

Public System Network

Departament de Salut Catalan healthcare system

Scope of functions Parliament Funding Resources / Objectives

Assigns budget Draws up Health Plan

Department of Health

Transfers economic resources Planning & evaluation

Insurance (purchase of services)

Catalan Health Service

Guarantees healthcare

Provision

Network of providers

Provision & management of care

Departament de Salut Catalan healthcare system

The budget of the Catalan Government 2003

2004

2005

2006

Dept. of Health

5,596

6,616

7,229

7,949

42%

Dept. of Education

2,904

3,376

3,759

4,177

44%

Dept. of Welfare & Family

601

915

1,082

1,285

114%

Dept. of Culture

173

195

240

275

59%

9,273 11,102 12,310 13,686

48%

Budgets (million €)

TOTAL

Public expenditure in health as a percentage the GDP (2002)

Increase ’03-’06

EU average

6.4%

Spain

5.4%

Catalonia

4.7%

Departament de Salut Catalan healthcare system

Functional structure of the budget for health (2006) Socio-sanitary care 3.09%

240.52 M€

Mental health 2.90%

225.58 M€ Pharmacy 21.49%

1,671.61 M€ Primary care 16.47%

1,280.61 M€

Hospital care 50.29%

3,911.47 M€

Budget CatSalut / ICS 2006: 7.778 B€

Healtchcare transportation and others 5.76%

447.95 M€

Departament de Salut Catalan healthcare system

The social and health care model People who needs social and health care

Health Services

Department of Health

Social Services

Department of social affairs

Departament de Salut Catalan healthcare system

Main areas of work in the social and health Care system in Catalonia Geriatrics Alzheimer disease and other dementia End of live care-Palliative care Dependency caused by neurological disease

Departament de Salut Catalan healthcare system

Cartera de servicios sociosanitarios Units with admission Long-care Mid-care:

Convalescence Palliative care Polyvalent care Geriatric acute care (in general acute care hospitals)

Units without admisssion  Day care hospital  Integral ambulatory teams

Support teams

 PADES (in primary health care)  UFISS (in hospitals)

Departament de Salut Catalan healthcare system

Main challenges facing the Catalan Social and Healthcare System • Demographic and cultural changes: • Aging → Dependency • Immigration • Birth rates • Sociological and epidemiological changes • Scientific and technological advances • Economic sustainability • Implementation of Dependency act