Health is considering creating a shared budget between CAP and hospitals to resolve the chaos of referrals.

BarcelonaAt the beginning of the legislative period, Salvador Illa's government created the Committee for Evaluation, Innovation, and Operational Reform of the Health System (Cairos) with the task of rethinking the health system for the future. During this time, it has promoted several pilot projects, such as the new Comprehensive Reference Health Centers (CSIR), which are a new model of primary care designed to replace the CAP, or a plan to collect dependency aid in less than two months (Currently, the wait is over a year). The Department of Health's goal is to evaluate these initiatives and, if they work, gradually extend them to the entire system. According to ARA, another of the reforms Cairos is working on is the creation of a shared financing model between primary care and hospitals, which, above all, aims to eliminate unnecessary referrals.

"The idea is that, in the end, the system will agree to provide care in the most efficient and appropriate way to the place where the patient is best served," said Rafa Ruiz, Strategic Director of Primary Care and Community Health for the department, during a conference on the future of primary care centers organized this Tuesday. Ruiz made it clear that the measure is still in its very early stages and needs to be fine-tuned, but the committee's and department's objective is clear: to improve coordination between the different levels of care in the healthcare system to care for patients according to their needs and to ensure they do not have to travel to different centers when they can receive all their care in one center.

This shared funding between CAPs and hospitals is designed only for a specific type of patient who, due to their health status, frequently visits the healthcare system. Currently, there are patients common between the two levels of care who do not end up receiving the care they need due to a lack of coordination. For example, a family doctor may refer a patient to a specialist for a test or check-up, only for the hospital to return the patient to the outpatient clinic. "It is unacceptable that a primary care physician makes a referral and the patient returns to the center without a response that at least clarifies what their family doctor requested," Ruiz argued.

The strategic director declined to elaborate on which types of patients will be affected by the measure because they are still being defined, but he did clarify that they are people who "circulate throughout the system," so "young people who occasionally visit the system" would not be affected by the new operation. Given the healthcare data, the people who most frequently visit health centers are chronically ill, elderly, or patients with various pathologies. However, the Health Department has not yet specified which groups this change would benefit.

"No one should lose anything"

Regarding the impact the measure will have on the budget for primary care and hospitals, Ruiz assured that it will not entail any cuts to accounts. "The idea is for the resources to be the same as they are now. Therefore, no one should lose anything, no one should gain anything," he stated. For now, the department and Cairos leaders are finalizing the patient profile and which interventions will be affected by this shared budget, and once they have finalized the budget, they will explain it to the providers in each region.