The Catalan Model of the Public Health System as a Framework for Carrying Out Experiences of Managed Care in Spain

Abstract

Catalonia is one of the 17 autonomous communities of Spain and it has been granted global competencies in the area of healthcare. The Catalan model establishes a separation of financing from the provision of services. The Catalan Health Service (CHS) regulates, plans, programs, evaluates, and inspects everything related to the public health sector as well as appropriating economic resources earmarked for provider and contracted services, and establishing various agreements and contracts with providers for both the hospital and primary care system. It is worth noting that the CHS allows for the development of various business management formulas as seen in the diverse management staffing and administration of the primary care health centers and hospitals. The Catalan Health Plan is the planning instrument utilized to establish priorities and to distribute resources in the most equitable and efficient manner for the Catalan Public Health System. One of the CHS's priorities has been primary healthcare reform, which includes enhancing the system's capacity as a service provider in addition to granting private entities the opportunity to be contracted as well. One of these latter models consists of the CHS ceding management and administration to a group of healthcare professionals with the support of the Professional Association of Physicians. Public health system users are identified by an individual healthcare card which in the future will contain their health record to facilitate healthcare follow-up as well as pharmaceutical tracking. At this time various plans are being carried out that allow individual primary care health centers to administer their own pharmaceutical budgets. Additionally, in collaboration with the Professional Association of Pharmacists, a computer network system is being implemented which connects pharmacies and the primary care health centers, and a project is underway with managed care companies to investigate the implementation of their principles within the Catalan Health Service.