ICS: CATALONIAN HEALTH INSTITUTE

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• ICS CATALONIAN HEALTH INSTITUTE

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INTRODUCTION

• Spanish Health System National Health System
• Reformed in 1984 to become the current Primary
  Health System
• Federal type government where each region manages
  its own budget. Catalonia since 1981

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CATALONIAN HEALTH CARE

• CATSALUT acts like a public insurance company.
  It is directly dependent on the Catalan
  Government.
• Integrates all resources (public or private) into
  the Public Health Offer.

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Primary Health Care in Catalonia
CatSalut
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ICS CATALONIAN HEALTH INSTITUTE

• Its the biggest primary health care supplier
  (with approximately 85 of the services)

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ICS ORGANIZATION
Management
PHC division
7 PHC Subdivision
Barcelona City
Dreta
4 PHC Services
Congrés
10 PHC Centres
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1. Who are we?
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SAP DRETA PRIMARY CARE SERVICES

• 10 PHC Centres
• Support Units
• Radiology
• Laboratory
• Special units
• Mental Health
• Paliative Home Care
• Phisiotherapy

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CONGRÉS 9C
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CONGRÉS PRIMARY CARE CENTRE

• Created in 1997
• Population 32.648 inhabitants
• 27 older than 65
• gt 15 years old
• The PHC with the oldest population in Barcelona

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CONGRÉS STAFF

• Director 1
• Head of nursing 1
• Medical staff 20
• Pediatricians 2
• Nursing staff 17
• Social worker 1
• Dentist 1
• Head of admin. 1
• Admin. staff 17
• Womens health 3 gynae, 3midw.
• Mental Health 2 psych.

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PERSONNEL FEATURES

• Personnel size decided by the institution
• Jobs entry by public competition (there is no
  free personnel selection)
• (1800 3000 Euros / month) x 14 doctor
• (1200-1800 Euros/ month ) x 14 nurse
• Salary payment, with incentives related to
  quantity/quality work and also years worked
• Work hours 7 hours x 5 days (plus saturdays on
  rota)

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2. Who do we care for?
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POPULATION FEATURES

• Aged population
• High morbimortality

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3. How do we organize?
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GENERAL ORGANIZATION

• Each Basic Unit of Care (doctor and nurse) does 4
  surgery based sessions and 1 home visit session
  per week
• Each doctor and nurse have a population of 2000
  clients under their care

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3.1. Access
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CONTACT OUR SERVICES

• Appointments directly requested by the patient
  or requested by the health team
• Number of visits per day limited to 35 ( 7 -10
  minutes/visit)
• Urgent visits handled by 1 member of the team
  every day
• On call hours carried out by a different team

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3.2. Surgery Sessions
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TEAM ACTIVITY
Office/ Home visits
9 - 14 h.
Team sessions
14 - 15 h.
Office/ Home visits
15-20 h.
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3.3. Home Care
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HOME CARE

• Scheduled Acute and Chronic home visits ATDOM
  Programme
• Support teams (PADES) Paliative Home Care

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3.4. Specialized Care
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The specialist in the centre

• The hospital specialist comes to the centre to
• Visit
• Provide consultancy services
• To teach
• Hours of work adjusted to Primary Care Team
  needs

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3.5. Community
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TALKS TO THE COMMUNITY

• Talks on Health
• One per month
• Based on topics that the clients find interesting

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4. Teaching
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TEACHING

• Teaching scheme started in 1978
• Specialists in Family Medicine
• Four years of formation
• Every Registrar has its own tutor in Primary Care
  
• Acreditation needed for tutors and teaching
  centres

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5. Research
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RESEARCH

• Important role in the professional curriculum
• Foundation that supports research in primary
  care Goll i Gurina.
• Different research lines depending on preferences