New perspectives on the management of the Spanish national health system

  • Daniele Pompei Sacardo Universidade de São Paulo; Faculdade de Saúde Pública
  • Paulo Antonio de Carvalho Fortes Universidade de São Paulo; Faculdade de Saúde Pública
  • Oswaldo Yoshimi Tanaka Universidade de São Paulo; Faculdade de Saúde Pública
Keywords: Health Care Systems, Health Policies, Health Systems Reforms, Management Arrangements

Abstract

During the last twenty-five years, the organization of the health system in Spain has adopted diverse measures that reoriented its management and improved its efficiency and financing system as a result of deep reforms and introduction of new management instruments. This paper is a result of a documental analysis that aimed to describe the trajectory of conformation of the Spanish health system and its current organization. The paper presents some historical determinants that enabled the reforms in the sanitary sector, such as the decentralization to the Autonomous Communities level, the incorporation of coordination mechanisms, and the integration and financing of the new and distinct organizational formats that coexist in the country. Furthermore, it identifies challenges that emerge in the current scenario of the National Health System, as the immigration phenomenon, the advanced process of demographic transition, and the growing demand for improvements in the quality of care and of technological incorporation. All these factors influence the sustainability of the system, which motivated the creation of one more space for the establishment of a consensus on the fundamental role of the sanitary system for the Welfare State in Spain.

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Published
2010-03-01
How to Cite
Sacardo, D., Fortes, P., & Tanaka, O. (2010). New perspectives on the management of the Spanish national health system . Saúde E Sociedade, 19(1), 170-179. https://doi.org/10.1590/S0104-12902010000100014
Section
Part I - Articles