ICS: CATALONIAN HEALTH INSTITUTE. INTRODUCTION Spanish Health System: National Health System Spanish Health System: National Health System Reformed in.

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