ENQual questionnaire National Quality Policy

in Spain

Susana Lorenzo MD, MPH, PhDSusana Lorenzo MD, MPH, PhD

Quality ManagerQuality Manager

Fundación Hospital AlcorcónFundación Hospital Alcorcón

Spanish Health Care SystemSpanish 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 SystemSpanish 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 Law1986 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)

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.

Abril ReportAbril Report

2002 National health service desegregated Autonomous Communities

EFQM Excellence Model in Spain 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)