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ICS: CATALONIAN ICS: CATALONIAN HEALTH INSTITUTEHEALTH INSTITUTE
INTRODUCTIONINTRODUCTION
Spanish Health System: National Health Spanish Health System: National Health SystemSystem
Reformed in 1984 to become the current Reformed in 1984 to become the current Primary Health SystemPrimary Health System
Federal type government where each region Federal type government where each region manages its own budget. Catalonia since manages its own budget. Catalonia since 19811981
CATALONIAN HEALTH CATALONIAN HEALTH CARECARE
CATSALUT: acts like a public insurance CATSALUT: acts like a public insurance company. It is directly dependent on the company. It is directly dependent on the Catalan Government.Catalan Government.
Integrates all resources (public or private) Integrates all resources (public or private) into the Public Health Offer.into the Public Health Offer.
Primary Health Care in CataloniaPrimary Health Care in Catalonia
CatSalut
PHC services’ suppliers
EBAsTown HallICS
Contrac.
ICS: CATALONIAN HEALTH ICS: CATALONIAN HEALTH INSTITUTEINSTITUTE
• It’s the It’s the “biggest” primary health care supplier “biggest” primary health care supplier
(with approximately 85% of the services)(with approximately 85% of the services)
ICS: ORGANIZATIONICS: ORGANIZATION
Management
PHC division
7 PHC Subdivision
4 PHC Services
10 PHC Centres
Barcelona City
Dreta
Congrés
Barcelona: Barcelona: organizationorganization
3D
4C
3E
3C
SAP ESQUERRA BCN
SAP LITORAL
SAP DRETA BCN
LA MINA
9G
9F
9E
8H
8I
SAP MUNTANYA
3G
3A
2A
2C
4A
2D
2E
4B
5C
10I10H10G
10C
1D
2I 10E
5D
1A
3B
1C
2B
1E 2H
2G
5A
5B
5E
10J
10B
10D1B 10A
2J
9C6E6C
9A
8D7D6D
7G7B
9D8B
7C
6B2K 10F
7A
7E
8A
7F
8C
8F8E
8G
6A
MONTCADA IREIXACH
Hospitals de Referència
HOSPITAL DEL MAR
HOSPITAL CLÍNIC
HOSPITAL SANT PAU
HOSPITAL VALL D’HEBRON
SAP EXPLORACIONS I TRACTAMENTS
SAP ATENCIÓ URGENT
AC a càrrec de l’EAP
CAPSE (ICS-HOSPITAL CLÍNIC)
1. Who 1. Who are we?are we?
SAP DRETA PRIMARY SAP DRETA PRIMARY CARE SERVICESCARE SERVICES
•10 PHC Centres
• Support Units:
•Radiology
•Laboratory
• Special units:
• Mental Health
• Paliative Home Care
• Phisiotherapy
CONGRÉS 9CCONGRÉS 9C
CONGRÉS PRIMARY CONGRÉS PRIMARY CARE CENTRECARE CENTRE
Created in 1997Created in 1997 Population: 32.648 inhabitantsPopulation: 32.648 inhabitants 27% older than 6527% older than 65 > 15 years old> 15 years old The PHC with the oldest population in The PHC with the oldest population in
BarcelonaBarcelona
CONGRÉS: STAFFCONGRÉS: STAFF DirectorDirector 11 Head of nursingHead of nursing 1 1 Medical staffMedical staff 2020 PediatriciansPediatricians 22 Nursing staffNursing staff 1717 Social workerSocial worker 1 1 DentistDentist 11 Head of admin. Head of admin. 1 1 Admin. staffAdmin. staff 1717 Women´s health 3 gynae, 3midw.Women´s health 3 gynae, 3midw. Mental Health 2 psych.Mental Health 2 psych.
PERSONNEL FEATURESPERSONNEL FEATURES Personnel size decided by the institutionPersonnel size decided by the institution
Jobs entry by public competition (there is no free Jobs entry by public competition (there is no free
personnel selection)personnel selection)
(1800 –3000 Euros / month) x 14 doctor(1800 –3000 Euros / month) x 14 doctor
(1200-1800 Euros/ month ) x 14 nurse (1200-1800 Euros/ month ) x 14 nurse
Salary payment, with incentives related to Salary payment, with incentives related to
quantity/quality work and also years workedquantity/quality work and also years worked
Work hours: 7 hours x 5 days (plus saturdays on rota)Work hours: 7 hours x 5 days (plus saturdays on rota)
2. Who do we care for?2. Who do we care for?
POPULATION POPULATION FEATURESFEATURES
Aged populationAged population
High morbimortalityHigh morbimortality
3. How do we organize?3. How do we organize?
GENERAL GENERAL ORGANIZATIONORGANIZATION
Each Basic Unit of Care (doctor and nurse) Each Basic Unit of Care (doctor and nurse)
does 4 surgery based sessions and 1 home does 4 surgery based sessions and 1 home
visit session per weekvisit session per week
Each doctor and nurse have a population of Each doctor and nurse have a population of
2000 clients under their care2000 clients under their care
3.1. Access3.1. Access
CONTACT OUR SERVICESCONTACT OUR SERVICES
Appointments: directly requested by the patient Appointments: directly requested by the patient
or requested by the health team or requested by the health team
Number of visits per day: limited to 35 ( 7 -10 Number of visits per day: limited to 35 ( 7 -10
minutes/visit)minutes/visit)
Urgent visits handled by 1 member of the team Urgent visits handled by 1 member of the team
every dayevery day
On call hours carried out by a different teamOn call hours carried out by a different team
3.2. Surgery Sessions3.2. Surgery Sessions
9 - 14 h. Office/ Home visits
14 - 15 h. Team sessions
TEAM ACTIVITY
15-20 h. Office/ Home visits
3.3. Home Care3.3. Home Care
HOME CAREHOME CARE
Scheduled Acute and Chronic home visits: Scheduled Acute and Chronic home visits:
ATDOM ProgrammeATDOM Programme
Support teams (PADES): Paliative Home CareSupport teams (PADES): Paliative Home Care
3.4. Specialized Care3.4. Specialized Care
The specialist in the centreThe specialist in the centre
The hospital specialistThe hospital specialist comes to the centre to: comes to the centre to: VisitVisit Provide consultancy servicesProvide consultancy services To teachTo teach
Hours of work adjusted to Primary Care Team Hours of work adjusted to Primary Care Team needsneeds
3.5.3.5. CommunityCommunity
Talks on HealthTalks on Health
One per monthOne per month
Based on topics that the clients find Based on topics that the clients find
interestinginteresting
TALKS TO THE COMMUNITY
4. Teaching
TEACHINGTEACHING
Teaching scheme started in 1978Teaching scheme started in 1978 Specialists in Family MedicineSpecialists in Family Medicine Four years of formationFour years of formation Every Registrar has its own tutor in Primary Every Registrar has its own tutor in Primary
Care Care Acreditation needed for tutors and teaching Acreditation needed for tutors and teaching
centrescentres
5. Research
RESEARCHRESEARCH
Important role in the professional Important role in the professional curriculumcurriculum
Foundation that supports research in Foundation that supports research in primary care: Goll i Gurina. primary care: Goll i Gurina.
Different research lines depending on Different research lines depending on preferencespreferences
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