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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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Bogaert P, Verschuuren M, Abboud L, Lyshol H, Schmidt AE, Van Oyen H, van Oers H. Assessing European national health information systems in peer review format: lessons learnt. Eur J Public Health 2023:7188267. [PMID: 37263589 PMCID: PMC10395761 DOI: 10.1093/eurpub/ckad085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Systematic assessments of a country's health information system (HIS) help identify strengths and weaknesses and may stimulate actions for improvement. They represent a capacity-building process for the country assessed as well as for the assessor. The joint action on HISs (InfAct) developed a peer-to-peer assessment methodology adapting an established WHO support tool. The aim of this study is to identify lessons learnt and the added value of the InfAct peer assessment for the assessors. METHODS A qualitative evaluation of the peer HIS assessment was performed based on 12 semi-structured interviews: nine interviews were carried out with assessors from nine participating countries, and three with an observer (present during assessments). The interviews were carried out between May 2019 and January 2020. Interviews were analysed using qualitative content analysis. RESULTS The interviews revealed the experiences of the assessors mainly occurred in five areas: assessors strengthened their understanding of what a population-based HIS is; they strengthened their understanding of how a HIS operates in different countries; they learnt how to carry out a HIS assessment; they strengthened their organization, communication, negotiation and reporting skills and they strengthened the networks in health information within and between countries. CONCLUSION Since the assessors are key personnel in their respective national health systems, the impact of the assessment is not limited to the assessor alone but may extend to stakeholders in their country. The deployment of the InfAct HIS peer assessment, anchored in systematic HIS capacity building across European countries, is recommended.
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Affiliation(s)
- Petronille Bogaert
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | | | - Linda Abboud
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Heidi Lyshol
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Herman Van Oyen
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Public Health, Ghent University, Belgium
| | - Hans van Oers
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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