BarcelonaThree years ago almost all the health systems in the world suffered the blow of the coronavirus pandemic. In Catalonia, this unprecedented emergency caused all services to break down between March and April 2020. But the consequences of those intense weeks have lasted for years. In fact, it was not until 2021 that the health authorities perceived a correction – initially timid – of the usual operation of primary care centers (CAP), hospitals or medical emergencies. Although the covid monopoly has been broken, nothing has been restored overnight. And the paradigmatic example is mental health: the indicators have not stopped worsening (at least) until 2022; and not only are there more diagnoses, but they are chronicling.
These are some of the conclusions of the new edition of the results center of the Department of Health, the tool developed by the Health Quality and Assessment Agency of Catalonia (AQuAS) to assess the quality of public health. This instrument has been in operation since 2003, but the publication of the reports was paralyzed in 2019 due to the pandemic. This Wednesday, the ministry has published previously unpublished data on all areas of care, which go from the year before the pandemic to 2022, at the end of the crisis.
The report includes a total of 257 indicators to assess the efficiency, equity and sustainability of public health providers. They are specific variables for each health area – 44 for primary care; 58 for hospital care; 49 of intermediate care; 14 for medical emergencies; 65 for mental health and addictions, and 27 for public health – and for each territory.
More disturbances and changes in attendance
The indicators of mental health and addictions are the most worrying. Based on data from CAPs and mental health centers (CSMA, in adults, and CSMIJ, in children and adolescents), a trend that experts anticipated is confirmed: more and more cases are appearing and more visits need to be made because there are a chronology of the disorder. Although care seems to be stabilizing, the number of patients has increased by 5.5% since the start of the pandemic, especially among women.
The age group most affected is that of 15 to 24 years. In the young population (18-24 years), mental health problems have shot up by 28% if you look at the data for girls. In children and adolescents, 25% more visits are made in girls and 4.6% more in boys. However, if you only look at the group of teenagers, those aged between 15 and 18, the increase in visits by a specialist for girls is 29%, while for boys it is 13%.
Regarding primary care, which was one of the areas most affected by the pandemic due to the loss of attendance, the Health report states that the number of cares is on the rise. After the boom in assistance via telephone or telematics in 2020 and the beginning of 2021, imposed by the fear of turning these healthcare environments into disease spreaders, in the period studied there was a drop in visits close to 30% face-to-face – it went from 84% face-to-face attention to 58%. On the other hand, the demand of the population aged between 20 and 55, a group that has historically made less use of CAPs, also intensified. In absolute terms, the ministry estimates an increase of half a million users between 2019 and 2022.
Regarding the hospital field, this report also records the number of hospitalizations by type. It notes that house calls doubled due to the pandemic – many of the people with mild or moderate symptoms were not admitted to hospitals due to the collapse situation – and between 2017 and 2022 this figure has more than tripled. Instead, according to this study, the effectiveness of the Stroke Code has remained at pre-pandemic levels. If you focus on medical emergencies, such as calls to 061, there was an avalanche of demand (more than a million calls) which showed that the system was not ready. Now, instead, 75% of calls are answered in less than 20 minutes, 60% in Barcelona, according to the report.
Allocate public resources
Crossing these indicators with the socio-economic information of the population in Catalonia, such as sex, age and income level, the AQuAS data draw a map that allows us to synthesize the state of health services and the response to specific demands of the population over the years. The results are updated annually and are offered in an interactive format on the website aquas.gencat.cat/ca/fem/central-resultats.
The Minister of Health, Manel Balcells, has assured that the results center is a “great instrument” for the generation of objective data that should help the department to make long-term decisions. For example, in the allocation of public resources. “We must be asymmetrical to find equity: not all primary schools and hospitals must necessarily receive the same resources for the same areas,” he defended. For example, there are more disadvantaged environments where obesity prevention needs to be strengthened or diagnostic tests intensified.
(We are working to expand this information)
2023-11-29 13:07:02
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