The wait time for gynecological surgeries has shot up 78% since 2012 | Society



The Spanish health system has managed to maintain its levels during the crisis, but one of its indicators has tremendously accused the impact of the cuts: the waiting lists. The data from The Spanish health in figures 2018,that was presented yesterday in Madrid, they attest: of the 17 indicators that varied more than 30% in the last five years, 15 correspond to delays in the waiting time or in the number of people waiting. The one that has grown the most, the time until undergoing gynecological surgery: 78.18% more between 2012 and 2017.

Variations of so much impact are rare in a solid system that has endured the crisis quite well, even at the cost of overloading its workers, said yesterday Juan del Llano, president of the Gaspar Casal Foundation and co-author of the study that has published the Círculo of Health. The other responsible for the work, the economist Alicia Coduras, warns that in such a short period of time only variations of more than 10% can be considered significant. In total, the work collects data from more than 150 indicators, from birth rates to health spending going through screening, relapse, causes of illness and death. As an example of the resistance of the system, only 27 increase or decrease more than 20% (and, of these, 17 do it above 30%). Of these 27, 19 are parameters that are worse, and 18 of them correspond to delays or people on waiting lists.

Interestingly, the greatest improvement in the average is given in the previous step: the wait for a specialized gynecology consultation, which fell in the same period by 32.91%. The biggest drop, 64.89%, occurred in Asturias, and, in the opposite extreme, in Castilla y León rose 15.38%. The consultations for which the most time has to be expected are those of dermatology (66.12%) and otorhinolaryngology (60.29).

Among the surgeries with great increase in delay are those of otorhinolaryngology (60.29%) and traumatology (44.44%). On the contrary, the average waiting time for an operation of the cardiovascular system has dropped by 21.88% on average. This is logical, said Codura, because it seems that during the crisis the efforts of the health administrations have prioritized the most serious pathologies and relegated the attention of those that are less so.

Improvement in infectious

Among the indicators that have changed most in the last five years, there is good news in the incidence (new cases) of several infectious diseases.

Hepatitis B. The cases have fallen by 20.92%, with a record in Aragon (88.24%).

Tuberculosis. The incidence has fallen 21.36% (48.6% in Navarra).

HIV It has fallen 26.77% (66.14% in Extremadura).

Among the 17 indicators that go higher there are two that do not correspond to the waiting lists. One, the rate of magnetic resonances that are made, which rises 33.34%. The community in which it grows the most is La Rioja (89.76%) and Navarra, the least (7.9%). But the latter does not have to be negative, because the community has a powerful health system that may already have offered all the necessary resonances before the crisis.

The other indicator that has changed more than 30%, that of notifications due to adverse effects of medications, does not have a clear interpretation: if they are detected more and hazards are avoided, it is positive, but if what it indicates is that there are less safe drugs, It is negative.

In addition to the greater susceptibility of the waiting lists to the crisis, the work collects another fundamental aspect, on which it warns that it is necessary to be vigilant: the great variability between the autonomous communities. For example, although the wait for a gynecological operation has increased 78% on average, in Navarra it dropped by 46.38%, and in Extremadura it rose by 75.38%, a divergence of 120 points.

These differences can be detected in practically all the parameters. To take the most basic, spending on health, rose in five years by 3.45% on average, with an increase of 27.33% in Castilla-La Mancha and a fall of 19.6% in Cantabria. If you take what the communities spend per person, the average is 1,379.56 euros, with a fork that goes from 1,160.65 in Andalusia to 1,652.63 in the Basque Country, 42% more.

In practically all the indicators there are cases of extreme differences. For example, the Canary Islands double the diabetes rate of the Balearic Islands (10.99 and 4.85 respectively); Castilla-La Mancha quadruples the rate of patients waiting for a traumatology operation in Madrid (6.33 for 1.57); the infant mortality rate of Cantabria (3.43) is almost double that of La Rioja (1.83). That is why the main conclusion of the work, apart from the solidity of the system, is that its greatest challenges are the equity of the system and the aging of the population.

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