Sistema sanitario público/privadoequidad, eficiencia. Propuestas de sustentabilidad

Abstract

Introduction: The aim of this study was to analyze health models of different countries according to the development and expenditure structure, to determine if there is a relationship between the equity (universality and equality in access, quality and performance) and efficiency (relationship between health outcomes and costs) with respect to financing and management (public / private). According to this results a number of proposals to ensure their sustainability are suggested. Material and methods: Health indicators are used, developed by the UNDP (United Nations Development Programme) and the OECD (Organization for Economic Cooperation and Development). The position of Spain with other countries as classified by level of development is compared, with public and private health expenditures as well as the ratio between them, health expenditures per capita adjusted for purchasing power parity, their proportion in relation to Gross Domestic Product (GDP), as well as their ability to control spending in the past 10 years. Results: Spain, in relation to others countries with more and better social development, to which we should approach a) Spends less per capita health care resources, b) has an expensive ratio of private vs public health spending and c) has a slow spending growth in the past decade. Discussion: Analyze these results, in terms of equity and efficiency of the various models of health, taking into account its position according to the human development index and its greater or lesser proportion of private speech and concludes by pointing out how health models under certain conditions, are more equitable but also more efficient than the private ones.