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The Catalan model of health

With the restoration of democracy and the transfer of competences in Health to the different autonomies, our government will follow a health model that is very different from that of the rest of Spain. At the same time, it is going to maintain what the previous autarchic governments have done, without changing the legal-labor regime of the workers, it is going to decide to take advantage of the physical resources and the human capital that existed in the Catalan civil society. The criteria will prevail according to which the important one is the one that the com is fa and not who is fa. In this way, prestige institutions that exist throughout the territory (municipal, religious, mutualists, fins and all, privately owned) will be incorporated into the Xarxa d’Utilització Pública (XHUP) and in this way it will be popular the political motto d’«a hospital 20 km from home».
The Ministry of Health is going to divide the seves functions in financing, planning of the necessitats of the citizens, purchase of services to the different institutions and evaluation of results.

It is fixed the objectiveius seeking the balance between the economic viability, the quality of the services, the technological innovation and the social peace. This idea was good and it faces today, but it is difficult to conclude on its own and, month after month, during these years it has been altered by political decisions reactive to the expectations of the citizens to guarantee their votes at any price. This methodology in the dam of sovint decisions is not good for the country as a whole.

Cal una revised a fons! The economic crisis of the year 2008, the 2020 pandemic caused by COVID-19 and a war of unpredictable consequences or inexorable fan. We cannot malmetre one of the pillars of our welfare society.
The continual growth of health care is a reality and it is necessary to measure the repercussions it has on the health of the population. If it does not add value, it will become a real threat to the sustainability of the health system.

It is estimated that the Estats Units between 20% and 50% of the sanitary despesa is of low value. In the Baixos Countries, the potential loss of sickness in health has been reduced by 20% due to lack of care coordination.

In 2017, the medical journal The Lancet will publish a monograph on Right Care (correct treatment/value) that he defined as the health care that provides more benefits than it does not harm and tea in all the circumstances of each patient, their seus values, the seva way of looking at things and, month by month, is based on the available scientific evidence (we know what will be) and also on the assessment of cost-effectiveness.

All health systems are making efforts to promote valuable activities both from the perspective of citizens and from scientific evidence. It is observed, however, that most of these reforms are incipient, since in addition to the technical and political difficulties involved in the implementation, there is also the strong resistance to change by health organizations and also by professional corporations. .
A group of prestige professionals, experts in health issues and leaders by Jordi Varela, Metge, and Tino Martí, economist, have put together a proposal for a new framework for the assessment and contracting of health services to the different institutions of the XHUP which is based above all on the grau de salut that it will contribute to the society.

The authors suggest that the digital transformation that we are experiencing can help to support this objective, since it facilitates access to information, can eventually modify social demand and also the commitment of public services to citizens.
The authors review the different payment models, focusing on the value of clinical actions and proposing a de nou on the allocation of resources, following the maximum of transparency, arriving at all, facilitating the sustainability of health organizations, suppressing bureaucracies unnecessary and promoted the surrender of comptes.
Amb aquests principis point out a list of measures. For example:

-Reaffirm and update the financing model for primary care, the backbone of the health system, by the name of the inhabitants and their severe characteristics.

-Promote the management autonomy of the health organizations and the surrender of comptes.

-Promote coordination between services, between organizations and between levels, promoting the introduction of incentives in the payment system.

-Increase care for people with complex social and health needs, such as mental health, within the community environment.

– Contemplate the idea of ​​making payments based on the results, of encouraging really necessary hospitalizations, of questioning forced surgical indications and complications attributable to inappropriate practices.

-Reactivate the Results Center of the Agency for Quality and Health Assessment of Catalonia (AQuAS), both with a greater focus on the quality of feina feta and with a greater impact on contracting services.

Sens dubte, to assess is to learn.

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