Abstract
Spain has universal public health care coverage. Emergency care provisions are offered to patients in different modalities and levels according to the characteristics of the medical complaint: at primary care centers (PCC), in an extrahospital setting by emergency medical services (EMS) and at hospital emergency departments (ED). We have more than 3,000 PCCs, which are run by family doctors (general practitioners) and pediatricians. On average, there is 1 PCC for every 15,000 to 20,000 inhabitants, and every family doctor is in charge of 1,500 to 2,000 citizens, although less populated zones tend to have lower ratios. Doctors spend part of their duty time in providing emergency care to their own patients. While not fully devoted to emergency medicine (EM) practice, they do manage minor emergencies. However, Spanish EMSs contribute hugely to guarantee population coverage in all situations. These EMS are run by EM technicians (EMT), nurses and doctors, who usually work exclusively in the emergency arena. EDs dealt with more than 25 million consultations in 2008, which implies, on average, that one out of two Spaniards visited an ED during this time. They are usually equipped with a wide range of diagnostic tools, most including ultrasonography and computerized tomography scans. The academic and training background of doctors working in the ED varies: nearly half lack any structured specialty residence training, but many have done specific master or postgraduate studies within the EM field. The demand for emergency care has grown at an annual rate of over 4% during the last decade. This percentage, which was greater than the 2% population increase during the same period, has outpaced the growth in ED capacity. Therefore, Spanish EDs become overcrowded when the system exerts minimal stress. Despite the high EM caseload and the potential severity of the conditions, training in EM is still unregulated in Spain. However, in April 2009 the Spanish Minister of Health announced the imminent approval of an EM specialty, allowing the first EM resident to officially start in 2011. Spanish emergency physicians look forward to the final approval, which will complete the modernization of emergency health care provision in Spain.
Highlights
The views expressed in this paper are those of the author(s) and not those of the editors, editorial board or publisher.Spain, 1 of the 27 countries constituting the European Union, is located in the southwest of Europe
Int J Emerg Med (2010) 3:219–226 on the Iberian Peninsula, and 2 are archipelagos
emergency departments (ED) should be reserved for more complex patients to avoid overcrowding; it is well accepted that internal factors play a more important role than external factors in explaining the generalized delays in receiving urgent care
Summary
The views expressed in this paper are those of the author(s) and not those of the editors, editorial board or publisher. 1 of the 27 countries constituting the European Union, is located in the southwest of Europe. It had an area of 505,988 km with a population of 46,157,822 inhabitants as of 2008. Int J Emerg Med (2010) 3:219–226 on the Iberian Peninsula, and 2 are archipelagos (the Canary Islands located in the Atlantic Ocean, off the northwest coast of Africa, and the Balearic Islands located in the Mediterranean Sea) These autonomous communities are heterogeneous in terms of extension and population, ranging from more than 8 million people in Andalusia to 0.3 million in La Rioja (Fig. 1). Spain receives nearly 60 million tourists every year, with some areas increasing their population several fold during the summer [3]
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