A health card tarjeta sanitaria for the Andalusian Health Service. Member feedback about Electronic health record: Lunch, consumed ad libitum, also included carrots, applesauce, and milk. The design tool is based on the combination of the rigidity of the host structure and the operating capacity of the SMA. The aim of our work was to extract mechanical properties of a new plasma polymer called L-PPE: In large Spanish cities, there are numerous clinics. This study concentrates particularly on a period of a few days where the concentration of sea conveniio aerosols was higher. This page was last edited on 11 Novemberat The device made during this project consists of a silicon wafer on which were deposited shup nm silicon nitride layer, then a nm silicon dioxide layer and convnio another nm silicon nitride layer.
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Public intervention in collective health problems has always been of interest to governments and societies, especially in the control of epidemics through the establishment of naval quarantines , the closing of city walls and prohibitions on travel in times of plague , but also in terms of hygienic and palliative measures.
Al-Andalus — Muslim -ruled medieval Spain—was distinguished by its level of medical knowledge relative to the rest of Europe, particularly among the physicians of the Golden age of Jewish culture in Spain.
In the years after the Reconquista , the Real Tribunal del Protomedicato regulated the practice of medicine in Spain and in its colonies. However, the system of medical faculties at the various universities was very decentralized. Medicine was one of the principal fields of activity for the novatores of the late 17th century, but their initiatives were individualized and localized. At the beginning of the 19th century, the Balmis Expedition to administer the smallpox vaccine throughout the Spanish colonies was a public health undertaking of unprecedented geographical scope.
The system was based on a percentage tax linked to employment. First, it carries out a mandate of the Spanish Constitution, whose articles 43 and 49 establish the right of all citizens to protection of their health.
The law recognizes a right to health services for all citizens and for foreigners resident in Spain. Second, Title VIII of the Constitution confers upon the autonomous communities broad purview in matters of health and health care. The autonomous communities have first-order importance in this area, and the law permits devolution of these functions from the central government to the autonomous communities, in order to provide a health care system sufficient for the needs of their respective jurisdictions.
Article The administrative device set up by the law is the National Health System. The presumption underlying the adopted model is that in each autonomous community, authorities are adequately equipped with necessary territorial perspective, so that the benefits of autonomy do not conflict with the needs of management efficiency.
The National Health System is thus conceived as the set of health services of the Autonomous Communities properly coordinated. Thus, the various health services fall under the responsibility of the respective autonomous communities, but also under basic direction and coordination by the central state.
The respective health services of the autonomous communities would gradually realize a transfer of health resources from the central government to the autonomous communities.
By , all of the autonomous communities had gradually assumed purview in matters of health and had established stable models to finance the assumed purview. Meanwhile, in the 17 years since the original law, Spanish society had undergone many cultural, technological and socioeconomic changes that affected people's ways of life and affected the country's patterns of disease and illness.
These posed new challenges to the National Health System. Therefore, the law establishes coordination and cooperation of public health authorities as a means to ensure citizens the right to health protection, with the common goal of ensuring equity, quality and social participation National Health System.
The law defines a core set of functions common to all of the autonomous health services. Without interfering with the diversity of forms of organization, management and services inherent in a decentralized system, it attempts to establish certain basic, common safeguards throughout the country.
This law attempts to establish collaboration of public health authorities with respect to benefits provided, pharmacy, health professionals, research, health information systems, and the overall quality of the health system. Toward these ends, the law created or empowered several specialized organs and agencies, all of which are open to the participation of the autonomous communities. It puts into law severe cuts in the Spanish National Health System, including the following:.
The Ministry of Health and Social Policy develops the policies of the Government of Spain in matters of health, in planning and delivery of services, as well as exercising the purview of the General Administration of the State to assure citizens the right to protection of their health.
The ministry has its headquarters on the Paseo del Prado in Madrid , across the street from the Museo del Prado. The General Health Law of created the Interterritorial Council of the Spanish National Health Service Consejo Interterritorial del Servicio Nacional de Salud , CISNS as the organ of general coordination in matters related to health between the central State and the autonomous communities who were given authority in health matters under that law.
It is jointly composed, and coordinates the basic lines of health policy in matters affecting contracts; acquisition of health and pharmaceutical products, as well as other related goods and services; as well as basic health personnel policies. Under this law, the CISNS functions variously as a plenary body, by delegated committees, through technical commissions, and through work groups.
It meets as a plenary body at the initiative of its president or at the initiative of one-third of its members; plenary meetings occur at least four times a year.
To some extent, this is a formality: resolutions from CISNS commissions are typically adopted by consensus. Under the Law of Cohesion, CISNS functions mainly through the adoption of and compliance with joint accords, through the political use of the plenary sessions, with each member making an uncompromising defense of the interests of its region. Presentations, committees, and working groups have been very important, some more than others.
Important committees include: . The principal aspects of the Interterritorial Council are:. The Interterritorial Council is constituted by the Minister of Health and Consumer Affairs [now of Health and Social Policy], who holds its presidency, and by the Councilors with purview over matters of health of the autonomous communities. The vicepresidency of the body will be fulfilled by one of the Councilors with purview over matters of health of the autonomous communities, elected by all of the Councilors who make up the body.
The CISNS will come to know, debate among other things, and, as appropriate, make recommendations on the following matters:. The prior functions shall be exercised without prejudice to the legislative purview of the Cortes Generales and, as appropriate, the norms of the General Administration of the State; likewise the normal developmental, executive and organizational purview of the autonomous communities. The State finances, through general taxes, all health benefits and a percentage of pharmaceutical benefits.
This tax is shared among the several autonomous communities according to various sharing criteria now that the communities are responsible for health in their respective territories. Each autonomous community then establishes its respective portfolio of services, which includes at least the service portfolio of the National Health System. Article 42 of the General Health Law sets out that ayuntamientos — municipal governments —have the following responsibilities with respect to health, without prejudice to the purview of other public administrative bodies:.
As a consequence of the decentralization contemplated by the Spanish Constitution, each autonomous community has received adequate transfers to create a health service, the administrative structure that manages all of the centers, services and establishments of the community itself, as well as its deputations, municipal governments, and whatever other territorial administrations fall within that community.
Concretely, it establishes that:. Its effect on the healthcare provision can be seen in the following articles:. Article 10 of the Law of Cohesion establishes that the financing of the Spanish health system is the responsibility of the autonomous communities in conformity with the accords of transfer and the current system of autonomic financing, notwithstanding the existence of a third party liable to pay.
Sufficient financing of services is determined by the resources assigned to the autonomous communities in conformity to what is established in the laws of autonomic financing.
Inclusion of a new service in the catalog of services of the National Health System is accompanied by an economic memo that contains the positive or negative financial impact it is expected to imply. This memo is brought up to the Council of Fiscal Policy and Finance for analysis and approval as to whether to proceed.
Prior to , public financing of health care occurred mostly through highly regressive payroll taxes. In , the law that established the Spanish National Health System also shifted financing toward progressive general taxes and away from payroll taxes. In , reform to income tax deductions allowed high income earners to deduct more for private insurance. Although this reform was intended to decrease overconsumption of health care services, it had the side effect of more regressive financing of public health services.
Nevertheless, that same year payroll taxes were completely phased out while higher indirect taxes on excise goods such as alcohol and tobacco were earmarked for health care. Article 57 of the Law of Cohesion establishes that citizens' access to health services will be facilitated by use of an individual health card tarjeta sanitaria individual , as the administrative document that accredits its holder and provides certain basic data.
In order to best facilitate collaboration, quality, and continuity of services, the each card includes a standardized form of basic identification data for the holder, and indicates in which autonomic health service the person is enrolled.
In particular, the cards incorporate a digital form of this information; health facilities throughout Spain have appropriate equipment to read the digital information from the cards. A cardholder should thereby be able to access all the services of all relevant health professionals throughout the country. A patient's clinical history is a medical-legal document that arises from the interactions between health professionals and their clients.
From a medical and legal point of view, the clinical history is the only document valid to track this history of interactions. In primary care, where methods of health promotion are important, the clinical history document is sometimes known as a "health history" historia de salud or "life history" historia de vida. This history should be available at all authorized locations, but nowhere else: except as needed for treatment, the information is considered confidential and access is restricted.
A Health Area may be exclusively focused on primary care or may include specialists as well. In Andalusia, for example, each existing Basic Health Zone takes care of a population between 5, and 20, inhabitants. The Basic Health Zone is served by a single general hospital and specialists' center. Article 12 of the Law of Cohesion establishes the concept of "primary care," the basic level of patient care that guarantees the comprehensiveness and continuity of care throughout the patient's life, acting as manager and coordinator of cases and regulator of issues.
Primary care includes health promotion, health education, prevention of illness, health care, maintenance and recuperation of health, as well as physical rehabilitation and social work. Primary health care includes service provided either on-demand, scheduled, or urgently, both in the clinic as well as in the patient's home.
Article 13 of the Law of Cohesion regulates characteristics of health care offered in Spain by medical specialists , which is provided at the request of primary care physicians. This may be in-patient hospital care or out-patient consultation at specialist centers or day hospitals.
It includes care, diagnosis, therapy, rehabilitation and certain preventive care, as well as health promotion, health education and prevention of illness whose nature makes it appropriate to handle at this level. Specialized care guarantees the continuity of integrated patient care once the capabilities of primary care have been exhausted and until matters can be returned to that level. Insofar as patient condition allows, specialized care is offered in out-patient consultation and in day hospitals.
As of , Spain recognizes fifty distinct medical specialties. This group includes:. The largest number of these are nursing professionals; that is also the profession with the highest percentage of women. The following table is a breakdown of some of the INE statistics. No exact breakdown is available to indicate what number of these might be related to mental health and psychotherapy or clinical psychology.
It defines "healthcare center" centro sanitario as the organized combination of technical means and installations in which trained professionals, identified by their official certification or professional qualification, undertake basic health care activities with the purpose of improving people's health.
These may be integrated into one or more health services, which constitute its healthcare portfolio. Certain healthcare centers centros sanitarios are referred to as consultorios , a term roughly equivalent to British English "surgery" or American English "doctor's office. A health center centro de salud , distinct from the smaller "healthcare center" centro sanitario in Spain's SNS is main physical and functional structure devoted to coordinated global, integral, permanent and continuing primary care, based in a team of health care professionals and other professionals who work there as a team.
Health centers basically practice the general medicine or family medicine , providing a unity of care in which a specialist in community and family medicine is responsible to provide preventive care, health promotion, diagnosis and basic treatment on an outpatient basis.
Specialized centers are healthcare centers where different health care professionals provide services to particular group identified by common pathologies, age, or other common characteristics.
Among these are:. Specialized health care establishments are private centers that provide a suite of health care products, ranging from medicines to sophisticated prostheses. These establishments are grouped by specialty and, on that account, must have accredited or certified technical personnel.
Among these establishments are:. A hospital is a health care establishment that provides inpatient care and specialized and other care, providing such services as are needed in its geographical area. A hospital can be a single structure or a hospital complex, even including branch buildings off of its main campus; it can also integrate any number of specialized centers. A similar concept to a hospital is a clinic. Some of these clinics include very up-to-date operating theaters capable of providing minimally invasive surgery , and "hospitalization zones" where patients can recuperate on an inpatient basis.
In large Spanish cities, there are numerous clinics. These are the facilities that are normally used by health care professionals whose medical societies cover it: ASISA , Adeslas , etc. The General Health Law of establishes that the level of specialized care provided in hospitals and their dependent specialty centers will focus care on complex health problems.
Hospital centers will develop, besides their functions strictly related to health care, functions of health promotion, prevention of illnesses and investigation and teaching, in accord with the programs of each area of health, with the object of complementing their activities with those developed by the primary care network.
Spanish National Health System
Public intervention in collective health problems has always been of interest to governments and societies, especially in the control of epidemics through the establishment of naval quarantines , the closing of city walls and prohibitions on travel in times of plague , but also in terms of hygienic and palliative measures. Al-Andalus — Muslim -ruled medieval Spain—was distinguished by its level of medical knowledge relative to the rest of Europe, particularly among the physicians of the Golden age of Jewish culture in Spain. In the years after the Reconquista , the Real Tribunal del Protomedicato regulated the practice of medicine in Spain and in its colonies. However, the system of medical faculties at the various universities was very decentralized.
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Call: Email: info example. A health card tarjeta sanitaria for the Andalusian Health Service. As an interferometer, it allows to accurately measure the amplitude and phase of an optical signal with respect to a reference signal. Compared to buck converters, the required inductor is greatly reduced, as well as the switch stress. The fully implicit FSI approach uses coincidents nodes on the fluid-structure interface, so that loads, velocities and displacements are convenko at the same location and at the same time.
A health card tarjeta sanitaria for the Andalusian Health Service. Greater responsiveness to portion size was associated with higher levels of overeating. God Bless you man. This graph contrasts total health care spending with public spending, in US dollars adjusted for purchasing power parity in Switzerland.
A health card tarjeta sanitaria for the Andalusian Health Service. Nanodielectrics seem to be the promise of a mayor technological breakthrough. SNS may refer to: These may be provided in external consultations, day hospitals, or on an inpatient basis. Primary care services constitute the majority of the services of the SNS; this is true of health promotion and education, prevention of illness, hands-on health care, health maintenance, recuperation, rehabilitation, and social work. This law attempts to establish collaboration of public health authorities with respect to benefits provided, pharmacy, health professionals, research, health information systems, and the overall quality of the health system. The audit of environmental impact includes and takes into account natural factors, such as water, soil, atmosphere, flora and fauna, and also cultural factors. This relationship is finally verified experimentally.