April 10, 2021

The most serious patients are concentrated in public hospitals | Society

The most serious patients are concentrated in public hospitals | Society

Almost five million citizens (4,862,353) were discharged from a hospital in Spain in 2017, according to the data published by the INE. Of these, 3.5 million were treated in the public health system, and 1.3 million in the private sector. But its characteristics are not homogeneous: the proportion of income for cancer or cardiovascular diseases, the two that cause the most deaths (30% of 400,000 per year) it is greater in the centers that depend on public health, which indicates that they attend, proportionally, to more more serious patients and whose treatment is more expensive.

Specifically, admissions discharges whose main cause were tumors account for 10.23% of those issued in the public, compared to 7.53% of private. For cardiovascular diseases, the ratio is 13.98% to 8.90%. If the third most frequent cause of death is added, respiratory diseases, the proportion is from 37% to 26%. In summary, public hospitals devote a third of their effort to the three groups of more serious diseases (which cause more deaths), and private centers, a quarter.

The data of the INE only allow to go back until 2011. Then there was a 36.1% of income for the three most deadly diseases in the public and 26.8% in the private one. A difference of 9.3 points. This ratio dropped to 9 in 2013, but since then it has been growing to 10.8 points now, which indicates that -always proportionally taking into account that they are systems of very different size and endowment of health centers-, little to little, the public is concentrating the most serious (and most expensive) pathologies.


Source: National Institute of Statistics (INE).

There is another group of ailments, those of the digestive system, which cause many hospital admissions (they are the second most frequent, with 604,000, only behind cardiovascular diseases). In this case both systems dedicate a similar effort (they are 12% of the discharges).

Seen from the opposite extreme, private hospitals receive many more cases of musculoskeletal and connective tissue diseases (arthritis, tendonitis, osteoporosis). They gave in 2017 for this reason 12.7% of their discharges, compared to 5.2% of the public. The private sector also devotes proportionally more attention to diseases of the genitourinary system, income from external causes (accidents, poisonings) and a generic section of "factors that influence health status and contact with health services", such as people at risk potential health care due to his history of contagious or family diseases, or those who attend for matters related to assisted reproduction.

In what there is almost no difference is in the average stay by hospital admission. Those almost five million people admitted accumulated more than 36 million stays. Those who went to a public hospital were in this 7.4 days on average; those who went to a private, 7.8.


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