Published 30 March 2009, doi:10.1136/bmj.b1170
Cite this as: BMJ 2009;338:b1170

Analysis

Looking to Europe

Spain: a decentralised health system in constant flux

¹ Medical School and Clinical Hospital. University of Valencia, Avenue Blasco Ibañez, 15, 46010-Valencia, Spain , ² Globesalud, Proyectos y Acciones de Salud, Madrid, Spain , ³ Servizo de Calidade e Programas, Servizo Galego de Saude, Santiago de Compostela, Spain , ⁴ International Travel Vaccination Centre, Sanidad Exterior de Valencia, Valencia, Spain, ⁵ Centro Superior de Investigaciones en Salud Pública and Escuela Valenciana de Estudios de la Salud, Valencia, Spain

Analysis, doi:10.1136/bmj.a1997, doi:10.1136/bmj.39451.406123.AD

The Spanish healthcare system is one of Europe’s most efficient, but urgent reform is needed if it is to cope with changing demands and rising costs, argue Jose M Martin-Moreno and colleagues

The first 150 words of the full text of this article appear below.

The Spanish health system offers almost universal coverage, a wide variety of services, and a high quality network of hospitals and primary care centres. Although it is a national system, financed with general tax revenue, the devolution of health services to the country’s 17 autonomous communities has led to a variety of management models.

Spain, like most countries in the European Union, has seen big increases in life expectancy over recent decades thanks to improved living conditions, public health interventions, and progress in medical care.^{1 2} Spanish citizens born in 2005 can expect to live to 80.4 years old, slightly more than the average in the 15 countries that were members of the EU before 2004 (79.7 years). Maternal and infant mortality as well as other main health indicators and trends are also better than the European average (table).³ Virtually all citizens consider the social support mechanisms in place positively . . . [Full text of this article]

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