Renewing Primary Care: Lessons Learned From The Spanish Health Care System Articles uri icon

authors

  • BORKAN, JEFFREY
  • EATON, CHARLES B.
  • NOVILLO ORTIZ, DAVID
  • RIVERO CORTE, PABLO
  • JADAD, ALEJANDRO R.

publication date

  • August 2010

start page

  • 1432

end page

  • 1441

issue

  • 8

volume

  • 29

International Standard Serial Number (ISSN)

  • 0278-2715

Electronic International Standard Serial Number (EISSN)

  • 1544-5208

abstract

  • From 1978 on, Spain rapidly expanded and strengthened its primary health care system, offering a lesson in how to improve health outcomes in a cost-effective manner. The
    nation moved to a tax-based system of universal access for the entire
    population
    and, at the local level, instituted primary care
    teams coordinating prevention, health promotion, treatment, and
    community
    care. Gains included increases in life expectancy
    and reductions in infant mortality, with outcomes superior to those in
    the
    United States. In 2007 Spain spent $2,671 per
    person, or 8.5 percent of its gross domestic product on health care,
    versus
    16 percent in the United States. Despite concerns
    familiar to Americans—about future shortages of primary care physicians
    and relatively low status and pay for these
    physicians—the principles underlying the Spanish reforms offer lessons
    for the
    United States.