Three out of four people rate their health status as good or very good, according to the 2020/2021 National Health System (SNS) Report published by the Ministry of Health. Although the figure is reduced to one in three in the group of 85 and over. However, the perception of good health is clearly lower in people with a basic and lower educational level, especially in women. With the data available up to September 2021, the report includes some aspects related to the health system’s response to COVID-19 and reflects the situation of the SNS prior to the pandemic.
Prior to the pandemic, the assessment of the public health system by the population was 6.7 points out of 10 (year 2019). In this latest report, the rating is above 7 out of 10 and, specifically, Primary Care receives a rating of 7.3 points out of 10 and the activity of SNS hospitals is rated 7.1 points out of 10.
On the other hand, according to this report, the impact of the pandemic on older people has caused a decrease in life expectancy, so that in 2020 life expectancy at birth in Spain stands at 82.3 years , producing a decrease of more than 1 year in relation to 2019, and it continues to be higher in women (85.1 years). Cardiovascular diseases and cancer are the usual cause of more than 50% of deaths, although mortality from malignant tumors has decreased by 20% in the last decade.
Diseases and main causes of mortality in Spain
The diseases with the highest burden of morbidity analyzed include respiratory and cardiovascular diseases, mental disorders and malignant tumors:
- Five out of 100 men and two out of 100 women aged 40 and over have COPD. In turn, the groups at greatest risk for pneumonia are those aged under 5 years and those aged 70 and over, where the risk quadruples and doubles, respectively.
- Three out of 100 men and one out of 100 women have ischemic heart disease. Cerebrovascular disease increases progressively after 40 years of age, reaching the highest values ​​between 85 and 94 years of age.
- Thirty out of every 100 people suffer from some type of mental disorder, the most prevalent being anxiety disorders, sleep disorders and depression.
- The most frequent malignant neoplasm in men is that of the prostate, which affects 1 in 100 men, and in women, that of the breast, which affects 1.3 in 100 women.
The main causes of mortality are cardiovascular diseases and cancer:
- Cardiovascular diseases and cancer cause more than 50% of deaths.
- Mortality from malignant tumors has decreased by 20% in the last decade.
- Suicide in 2020 was the cause of 3,941 deaths, 270 more than the previous year. The highest rates are presented by men aged 75 and over, 5 times higher than those of women of the same age.
Life habits of Spaniards and drugs consumed
Regarding the different lifestyle habits, the document highlights that a third of the population aged 15 and over consumes alcohol regularly (at least once a week), with men being twice as regular drinkers as women. In addition, 36% of the population aged 15 and over declared themselves sedentary in their leisure time. It also explains that two out of every 10 adults are obese and five out of 10 are overweight, affecting more the less affluent social classes.
The report from the Ministry of Health states that analgesics are the most consumed drugs in Spain and that the group of drugs used in diabetes is the one that bills the highest amount in medical prescriptions from the SNS. On the other hand, antineoplastic, immunosuppressive and antiviral drugs for systemic use are the ones that represent the greatest amount in the hospital pharmacy.
Public health spending stood at 6.6% of GDP (81,590 million euros), constituting 70.7% of total health spending in 2019 and has increased by 15% since 2015. The largest public funding corresponds to public administrations regional with 92.3% (75,312 million euros) and direct payments from households represent the largest private health financing, specifically, with 73.2%.
These direct expenses (24,794 million euros) were used mainly for the purchase and co-payment of medicines, dental care and the purchase of therapeutic devices and other medical products such as glasses, contact lenses or hearing aids.
Primary Care and impact of the pandemic
The exceptional demand derived from the SARS-CoV-2 pandemic during 2020 caused that, in the analyzed period, 2.3 million COVID-19 people were treated in Primary Care and 5.3 million contacts and 40% of the diagnostic tests took place.
In addition, 4 million temporary disability processes related to COVD-19 were managed. Primary Care also stands out for its role in vaccinating COVID-19, especially in the most vulnerable groups. The document explains that in Primary Care of the SNS, 379 million consultations were attended in 2020, which represented an increase in activity of 12.3 million compared to 2019 (+3%).
During 2020, 2.3 million people affected by COVID-19 were treated at Primary Care centers and another 5.3 million contacts were monitored
Teleconsultations between professionals and patients (127 million) increased by 600% compared to the previous year and home activity (13.5 million visits) by 4%. Also noteworthy is the increase in influenza vaccination activity (+48%) and pneumococcal (+21%).
The morbidity attended shows a decrease in almost all the usual diagnoses, with a significant decrease in respiratory diseases not related to COVID-19.
With regard to specialized care, COVID-19 caused the hospitalization of 232,420 people in 2020, which generated 245,215 admissions to the SNS acute hospital network (6% required more than one admission) and a 10% have needed critical care. The average stay was 11 days, 9 in conventional hospitalization and 15 days in ICUs.
The greatest deployment of critical care resources was achieved during the first wave, on April 9, 2020, with more than 13,000 ICU beds enabled, a number 2.8 times greater than the number in operation prior to the pandemic; in some autonomous communities it quadrupled and even quintupled its previous endowment.
In 2020, the SNS has attended a total of 3,181,725 ​​hospitalizations, 573,831 less than the previous year (-15%). As a result of the pandemic, diagnoses associated with diseases of the respiratory system have increased, highlighting the significant rise in pneumonia.
Source: Ministry of Health
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