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Care Services Portfolio of the Nationwide Well being System in Spain

The Widespread Services Portfolio of the Nationwide Well being System is the set of methods, applied sciences or procedures, understood as such every one of many strategies, actions and sources primarily based on information and scientific experimentation, by which well being advantages are made efficient.

What's

The Portfolio incorporates the fundamental and customary services essential to present satisfactory, complete and steady well being care to all customers of the Nationwide Well being System.

The Widespread Services Portfolio of the Nationwide Well being System should assure complete care and continuity of care offered to customers, whatever the stage of care at which they're cared for always.

Royal Decree-Legislation 16/2012, of April 20, on pressing measures to ensure the sustainability of the Nationwide Well being System and enhance the standard and security of its services, differentiates:

The fundamental frequent portfolio of care services , totally coated by public funding.
The supplementary frequent portfolio that features these advantages whose provision is made by outpatient dishing out and is topic to consumer contributions . (Pharmaceutical profit, prosthetic orthotics profit, dietary product profit and non-urgent medical transport).
The frequent portfolio of ancillary services .

Major Care

The Major Care Services Portfolio responds to the catalog of advantages for residents of the Nationwide Well being System primarily based on the well being issues and desires felt by the inhabitants. In it, preventive and well being promotion actions are prioritized, basic pillars of Major Care, and care for extremely prevalent well being issues that may be handled by the primary stage of care.

Specialised care

Specialised care contains help, diagnostic, therapeutic and rehabilitation and care actions, in addition to these of well being promotion, well being schooling and illness prevention, the character of which advises that they be carried out at this stage. Specialised care will assure the continuity of complete care for the affected person , as soon as the chances of major care have been overcome and till the affected person could be reintegrated at that stage.

Affected person entry to hospital emergency care -which is offered twenty-four hours a day to sufferers affected by an acute medical scenario that requires speedy consideration from the hospital services- is carried out by referral of the first care doctor or specialised or for causes of urgency or very important danger which will require therapeutic measures unique to the hospital surroundings.

Specialised care is offered, every time the affected person's circumstances permit it, in hospitalization, outpatient clinics and in day hospitals.

Specialised help in exterior consultations

Contains care, diagnostic, therapeutic and rehabilitation actions, in addition to these for well being promotion, well being schooling and illness prevention, that are offered on the stage of specialised care on an outpatient foundation, together with:

Preliminary evaluation of the affected person.
Indication and efficiency of exams and diagnostic procedures.
Indication, efficiency and follow-up of the remedies or therapeutic procedures that the affected person wants.
Indication and, the place applicable, administration of treatment, parenteral or enteral diet, cures, consumables and different medical gadgets which can be essential.
Indication of orthoprosthesis and its well timed renewal, in accordance with the provisions of the Portfolio of frequent services for orthoprosthesis provision.
Discharge info containing diagnostic info and procedures carried out to facilitate correct affected person follow-up and continuity and security of care and care.

Specialised help in day hospital, medical and surgical

Contains care, diagnostic, therapeutic and rehabilitation actions, aimed toward sufferers who require continued specialised care, together with main outpatient surgical procedure, which don't require the affected person to remain in a single day within the hospital, together with:

Indication and efficiency of exams and diagnostic procedures.
Indication, efficiency and follow-up of therapeutic or rehabilitation remedies or procedures that the affected person wants, together with outpatient surgical procedure and chemotherapy remedies for most cancers sufferers.
Nursing care essential for satisfactory affected person care.
Implants and different orthopedics and their well timed renewal.
Treatment, medicinal gases, transfusions, cures, consumables and different medical gadgets which can be essential.
Publish-surgical resuscitation and, if essential, after invasive diagnostic procedures.
Parenteral or enteral diet.
If relevant, feeding, in response to the prescribed weight-reduction plan.
Discharge info with directions for proper follow-up of remedy and institution of mechanisms that make sure the continuity and security of care and care. The indication for the usage of this useful resource corresponds to the specialist doctor liable for affected person care.

Inpatient hospitalization

Contains medical, surgical, obstetric and pediatric help or the efficiency of diagnostic remedies or procedures, to sufferers who require continued care that require hospitalization, together with:

Indication and efficiency of diagnostic exams and procedures, together with neonatal examination.
Indication, efficiency and follow-up of the remedies or therapeutic procedures or surgical interventions that the affected person wants, no matter whether or not or not their want is attributable to the explanation for his or her hospitalization.
Treatment, medicinal gases, transfusions, cures, consumables and different medical gadgets which can be essential.
Nursing care essential for satisfactory affected person care.
Implants and different orthopedics and their well timed renewal.
Intensive or resuscitation care, as applicable.
Remedy of attainable issues which will come up throughout the care course of.
Rehabilitation remedies, when applicable.
Parenteral or enteral diet.
Meals, in response to the prescribed weight-reduction plan.
Fundamental lodge services straight associated to the hospitalization itself.
Discharge info with directions for proper follow-up of remedy and institution of mechanisms that make sure the continuity and security of care and care.

Entry to specialised care underneath hospitalization is carried out by indication of the specialist doctor or by hospital emergency services, when the affected person foreseeably wants particular and steady care, which can't be offered on an outpatient foundation or at residence.

Help for major care in early hospital discharge and, the place applicable, hospitalization at residence

It contains the diagnostic and therapeutic actions that have to be carried out in a coordinated method by major and specialised care as a consequence of procedures initiated on the specialised care stage and that each ranges, by consensus, agree that they are often facilitated on the residence stage, in order to ensure continuity within the care offered to the consumer after hospital discharge, in accordance with the particular packages established and the group of every well being service. In circumstances the place the affected person is in a medical scenario that requires steady consideration and doesn't current medical instability that would pose a danger in its evolution, the well being service could go for hospitalization at residence. Contains:

Complete evaluation of the affected person's wants, previous to discharge, to make sure continuity of care after discharge.
Institution of a care plan that features preventive measures, directions for proper remedy follow-up, hygienic-dietary suggestions, symptom management and basic care. Mechanisms that make sure the continuity and security of care should even be established.
Entry to diagnostic exams and procedures that can't be carried out on the affected person's residence.
Finishing up and monitoring the remedies or therapeutic procedures that the affected person wants.
Indication and, the place applicable, administration of treatment, enteral or parenteral diet, cures, consumables, orthopedics and different medical gadgets which can be essential.
Info and recommendation to individuals associated to the affected person, particularly the principle caregiver.

Indication or prescription, and the efficiency, the place applicable, of diagnostic and therapeutic procedures

It contains complete, individualized, and steady care for individuals with superior illness who aren't inclined to receiving remedy for healing functions and with a restricted life expectancy (generally, lower than 6 months), in addition to individuals related to them. Its therapeutic goal is the development of the standard of life, with respect to its system of beliefs, preferences and values.

This care, particularly humanized and customized, is offered on the affected person's residence or on the well being heart, if essential, establishing the mandatory mechanisms to ensure continuity of care and coordination with different sources and in accordance with the protocols established by the corresponding well being Service. Contains:

Identification of terminally ailing sufferers in response to the diagnostic standards and the pure historical past of the illness.
Complete evaluation of the wants of sufferers and caregivers and institution of a written care plan that features preventive measures, hygienic-dietary suggestions, symptom management and basic care.
Frequent evaluation and management of bodily and psychological signs, finishing up the mandatory examinations and diagnostic procedures and indicating the pharmacological and non-pharmacological remedy of ache and different signs. Info and help to the affected person within the completely different phases of the method.
Info, well being recommendation, counseling and help for individuals linked to the affected person, particularly the principle caregiver.

Palliative care for the terminally ailing

Identification of terminally ailing sufferers in response to the diagnostic standards and the pure historical past of the illness.
Complete evaluation of the wants of sufferers and caregivers and institution of a written care plan that features preventive measures, hygienic-dietary suggestions, symptom management and basic care.
Frequent evaluation and management of bodily and psychological signs, finishing up the mandatory examinations and diagnostic procedures and indicating the pharmacological and non-pharmacological remedy of ache and different signs. Info and help to the affected person within the completely different phases of the method.
Info, well being recommendation, counseling and help for individuals linked to the affected person, particularly the principle caregiver.

Psychological well being care

It contains the prognosis and medical monitoring of psychological issues, psychopharmacotherapy, particular person, group or household psychotherapies (excluding psychoanalysis and hypnosis), electroconvulsive remedy and, the place applicable, hospitalization. Psychological well being care, which can assure the mandatory continuity of care, contains:

Preventive actions and promotion of psychological well being in coordination with different well being and non-health sources.
Analysis and remedy of acute psychological issues and exacerbations of power psychological issues, together with outpatient remedy, particular person or household interventions and hospitalization when essential.
Analysis and remedy of power psychological issues, together with complete care for schizophrenia, encompassing outpatient remedy, particular person and household interventions, and rehabilitation.
Analysis and remedy of addictive behaviors, together with alcoholism and compulsive playing.
Analysis and remedy of psychopathological issues in childhood/adolescence, together with care for kids with psychosis, autism and behavioral issues generally and consuming issues particularly (anorexia/bulimia), together with outpatient remedy, psychotherapeutic interventions in hospital throughout the day, hospitalization when essential and the reinforcement of wholesome behaviors.
Consideration to psychological well being issues derived from conditions of danger or social exclusion.
Info and recommendation to individuals associated to the affected person, particularly the principle caregiver.

Rehabilitation in sufferers with recoverable useful deficit

It contains the procedures for prognosis, analysis, prevention and remedy of sufferers with useful deficit, aimed toward facilitating, sustaining or restoring the best attainable diploma of useful capability and independence to the affected person, with a purpose to reintegrate them into their ordinary surroundings.

It contains the rehabilitation of circumstances of the musculoskeletal system, the nervous system, the cardiovascular system and the respiratory system, by physiotherapy, occupational remedy, speech remedy that's straight associated to a pathological course of that's being handled within the Nationwide Well being System. and technical strategies (orthoprosthesis, included within the Portfolio of frequent services for orthoprosthetic provision).

Pressing Care

Pressing care is that which is offered to the affected person in circumstances the place their medical scenario requires speedy well being care. Will probably be offered each in well being facilities and outdoors them, together with the affected person's residence and on-site care, 24 hours a day , by medical and nursing care, and with the collaboration of different professionals.

Entry to pressing care

The process and organizational mannequin for emergency care will likely be established by the competent well being administrations, in order that entry to the service is carried out on the applicable time and place to facilitate care tailored to the wants of every affected person. Pressing care is known as complete and steady care that's offered by major and specialised care, and by services particularly devoted to pressing care.

The coordination of the completely different individuals in emergency care will likely be carried out, by the phone numbers 112, 061 or others, by the emergency and well being emergency coordination facilities, which can assure, 24 hours a day, accessibility and coordination of sources. out there for this sort of care.

Likewise, the coordination of well being services in catastrophe plans and collaboration with emergency and emergency services depending on completely different administrations and establishments, similar to Civil Safety, Fireplace Prevention and Extinction Corps, State Safety Corps and Forces will likely be strengthened. or others, within the conditions which can be required.

The Portfolio of frequent services for the supply of pressing care contains:

Phone care, by the well being emergency coordinating facilities, which incorporates the medical regulation of the demand for care, assigning probably the most applicable response to every well being emergency; info and steerage or well being recommendation.
The preliminary and speedy analysis of sufferers to find out the dangers to their well being and life and, if essential, their classification to prioritize the healthcare they require. The analysis could be accomplished by referring the sufferers to a well being care heart if essential, to hold out the mandatory examinations and diagnostic procedures to ascertain the character and scope of the method and decide the speedy actions to observe to take care of the emergency scenario.
Finishing up the exact diagnostic procedures and the medical-surgical therapeutic procedures essential to adequately attend to every emergency well being scenario.
Monitoring, remark and reassessment of sufferers, when their scenario requires it.
Medical transport, land, air or sea, assisted or unassisted, as required by the medical scenario of the sufferers, in these circumstances through which it's essential for his or her satisfactory switch to the well being heart that may optimally attend to the emergency scenario.
Info and recommendation to sufferers or, the place applicable, companions, in regards to the care offered and the measures to be adopted on the finish of stated care, in accordance with present laws.
As soon as the emergency scenario has been handled, the sufferers will likely be discharged or referred to probably the most applicable stage of care and, when the seriousness of the scenario so requires, hospital admission, with the related medical stories to ensure continuity of care.
The communication to the competent authorities of these conditions that require it, particularly within the case of suspicion of gender violence or mistreatment of minors, the aged and other people with disabilities.

medical transport

Medical transport is the one that's carried out for the motion of sick individuals for solely medical causes whose scenario prevents them from transferring in atypical technique of transport and that's carried out in autos specifically conditioned for this goal.

Prosthetics and orthotics provision

The ortho-prosthetic service consists of the usage of well being merchandise, implantable or not, whose goal is to completely or partially substitute a physique construction, or to switch, right or facilitate its perform. You'll perceive the exact parts to enhance the standard of life and autonomy of the affected person. This provision will likely be offered by the well being services or will give rise to monetary assist , within the circumstances and in accordance with the laws established by the competent well being administrations.

Reimbursement of bills

The reimbursement of bills is the reimbursement of the bills produced within the circumstances of pressing, speedy and very important well being care and pharmacy bills, which have been attended outdoors the Nationwide Well being System, as soon as it has been verified that they may not be utilized in a well timed method. services of the previous and that it doesn't represent a misuse or abusive use of this exception.

Reference guidelines

See reference laws

Royal Decree 1030/2006, of September 15, which establishes the Portfolio of frequent services of the Nationwide Well being System and the process for updating it. Consolidated textual content as a consequence of the next portfolio replace guidelines:

Order SAS/1904/2009, of July 8, by which the Portfolio is up to date in relation to transplants.
Order SAS/1466/2010, of Could 28, relating to exterior elements of cochlear implants and myoelectric prostheses.
Order SPI/573/2011, of March 11, which updates the eye to the donation and serine modules.
Order SSI/1640/2012, of July 18, which updates breast prostheses, cushions to forestall stress ulcers and excludes L-glutamine modules.
Order SSI/1329/2014 , of July 2, which updates the supply with dietary merchandise.
Order SSI/2065/2014 , of October 31, which modifies annexes I, II and III of Royal Decree 1030/2006, of September 15, which establishes the portfolio of frequent services of the Nationwide System of Well being and the process for its replace.
SSI Order 1356/2015 , of July 2, which modifies annexes II, III and VI of Royal Decree 1030/2006, of September 15, which establishes the portfolio of frequent services of the Nationwide Well being System and the process for its updating, and the monitoring research of methods, applied sciences and procedures are regulated
Order SSI/366/2018 , of April 5, which modifies Order SSI/2366/2012, of October 30, which establishes the frequent billing issue for dietary merchandise, and the annexes I and III of Royal Decree 1205/2010, of September 24, which establishes the bases for the inclusion of dietary meals for particular medical makes use of within the provision of dietary merchandise of the Nationwide Well being System and for the institution of its most financing quantities.
Order SCB/1242/2018 , of November 19, which modifies annexes I, II and III of Royal Decree 1205/2010, of September 24, which establishes the bases for the inclusion of dietary meals for particular medical makes use of within the provision of dietary merchandise from the Nationwide Well being System and for the institution of their most financing quantities.
Order SCB/45/2019 , of January 22, which modifies annex VI of Royal Decree 1030/2006, of September 15, which establishes the portfolio of frequent services of the Nationwide Well being System and the process for its replace, the process for inclusion, alteration and exclusion of the provide of ortho-prosthetic merchandise is regulated and the correction coefficients are decided.
Order SCB/480/2019 , of April 26, which modifies annexes I, III and VI of Royal Decree 1030/2006, of September 15, which establishes the portfolio of frequent services of the Nationwide System of Well being and the process for its replace.

Order SCO/3422/2007, of November 21, which develops the process for updating the portfolio of frequent services of the Nationwide Well being System.