Report prepared by Regina Dalmau with the assistance and advice from:
National CVD Prevention Coordinator for Spain:
Dr Regina Dalmau González-Gallarza
Executive Secretary of the Spanish National Committee of Smoking Preventioncontact: email
Health care | Risk factors | Prevention methods | Prevention activities | Cardiac Rehab. | Future
The Spanish health care system provides universal coverage and is funded from taxes and predominately operates within the public sector. Provision is free of charge at the point of delivery with the exception of the pharmaceuticals prescribed to people aged under 65, which entails a co-payment estimated according to user incomes.Health competences have been totally devolved to the regional level since 2002, resulting in 17 regional health ministries with primary jurisdiction over the organisation and delivery of health services within their territory. The National Ministry of Health and Social Policy holds authority over certain strategic areas, such as pharmaceutical legislation, and as a guarantor of the equitable functioning of health services across the country.
As in other societies, cardiovascular disease is the primary cause of death in the Spanish population, accounting for 32% of all deaths. Prevalence studies of cardiovascular risk factors are of great interest to define policies for cardiovascular prevention. According to a pooled analysis with individual data from 11 studies conducted in the first decade of the 21st century in individuals aged 34-74, the most prevalent cardiovascular risk factors in Spain are:
The situation of cardiac rehabilitation in Spain is very heterogeneous, as shown in the Spanish Registry of Cardiac Rehabilitation Units (R-EUReCa) run by the Spanish Society of Cardiology. Despite the fact that the number of cardiac rehabilitation programs has risen during the last years, there are important geographical differences, and many regions lack any cardiac rehabilitation program. According to a recent study, only 36% of the Spanish cardiac care units have a Cardiac Rehabilitation Program. Moreover, there are also important differences in resources available in the existing programs (staff and facilities).Main indications for referral to Cardiac Rehabilitation Programmes (CRP) are related to ischemic heart disease, with a growing impact on other settings such as heart failure, cardiac surgery and congenital heart disease. Cardiac rehabilitation and secondary prevention programs are known to improve prognosis and quality of life in many cardiac diseases, and have been proved to be cost-effective.Therefore, the Spanish Society of Cardiology is making a particular effort in evaluating the real situation of cardiac rehabilitation in Spain and defining the minimal quality standards for a CRP, in order to close the gap between the guidelines and our real practice.
The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology
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