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Dubas-Jakóbczyk K, Gonzalez AI, Domagała A, Astier-Peña MP, Vicente VC, Planet AG, Quadrado A, Serrano RM, Abellán IS, Ramos A, Ballester M, Seils L, Dan S, Flinterman L, Likic R, Batenburg R. Medical deserts in Spain-Insights from an international project. Int J Health Plann Manage 2024; 39:708-721. [PMID: 38358842 DOI: 10.1002/hpm.3782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/08/2024] [Accepted: 01/29/2024] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Medical deserts are a growing phenomenon across many European countries. They are usually defined as (i) rural areas, (ii) underserved areas or (iii) by applying a measure of distance/time to a facility or a combination of the three characteristics. The objective was to define medical deserts in Spain as well as map their driving factors and approaches to mitigate them. METHODS A mixed methods approach was applied following the project "A Roadmap out of medical deserts into supportive health workforce initiatives and policies" work plan. It included the following elements: (i) a scoping literature review; (ii) a questionnaire survey; (iii) national stakeholders' workshop; (iv) a descriptive case study on medical deserts in Spain. RESULTS Medical deserts in Spain exist in the form of mostly rural areas with limited access to health care. The main challenge in their identification and monitoring is local data availability. Diversity of both factors contributing to medical deserts and solutions applied to eliminate or mitigate them can be identified in Spain. They can be related to demand for or supply of health care services. More national data, analyses and/or initiatives seem to be focused on the health care supply dimension. CONCLUSIONS Addressing medical deserts in Spain requires a comprehensive and multidimensional approach. Effective policies are needed to address both the medical staff education and planning system, working conditions, as well as more intersectoral approach to the population health management.
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Affiliation(s)
| | - Ana Isabel Gonzalez
- Avedis Donabedian Instituto Universitario-UAB, Barcelona, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Alicja Domagała
- Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Maria Pilar Astier-Peña
- Centro de Salud de Universitas, Servicio Aragonés de Salud, Zaragoza, Spain
- Grupo H36_23D H36_23D Feminización y Ética de las Profesiones Sanitarias (FEPS), IIS_Aragón, Zaragoza, Spain
| | - Veronica Casado Vicente
- Centro de Salud Universitario Parquesol, Sanidad de Castilla y León, Valladolid, Spain
- Unidad Docente Universitaria de Medicina Familiar y Comunitaria, Facultad de Medicina, Valladolid, Spain
| | - Antonia-Gema Planet
- Unidad de Apoyo Técnico DA Noroeste y DA Centro, Dirección Técnica de Sistemas de Información, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de la Salud, Madrid, Spain
| | - Agueda Quadrado
- Centro de Salud de Navas Del Rey, Navas del Rey, Servicio Madrileño de la Salud, Tres Cantos, Madrid, Spain
| | - Rosa Mari Serrano
- Centre d'Atenció Primària Marià Fortuny, L'Entitat de Dret Públic Salut Sant Joan de Reus - Baix Camp, CatSalut, Servei Català de la Salut, Reus, Tarragona, Spain
| | | | - Alba Ramos
- Punto de Atención Continuada Tres Cantos, Servicio Madrileño de la Salud, Tres Cantos, Madrid, Spain
| | - Marta Ballester
- Avedis Donabedian Instituto Universitario-UAB, Barcelona, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Laura Seils
- Avedis Donabedian Instituto Universitario-UAB, Barcelona, Spain
| | - Sorin Dan
- School of Management, University of Vaasa, Vaasa, Finland
| | - Linda Flinterman
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Robert Likic
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ronald Batenburg
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Department of Sociology, Radboud University, Nijmegen, The Netherlands
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