Primary health care policy and vision for community pharmacy and pharmacists in Spain
Metadatos
Mostrar el registro completo del ítemEditorial
Centro de Investigaciones y Publicaciones Farmaceuticas
Materia
Pharmacies Primary health care Delivery of Health Care Integrated Ambulatory Care Community health services Pharmacists Community Pharmacy Services Professional practice Spain
Fecha
2020-06-01Referencia bibliográfica
Gastelurrutia MA, Faus MJ, Martínez-Martínez F. Primary health care policy and vision for community pharmacy and pharmacists in Spain. Pharmacy Practice 2020 Apr-Jun;18(2):1999. [https://doi.org/10.18549/PharmPract.2020.2.1999]
Resumen
From a political and governance perspective Spain is a decentralized country with 17 states [comunidades autónomas] resulting in a
governmental structure similar to a federal state. The various state regional health services organizational and management structures
are focused on caring for acute illnesses and are dominated by hospitals and technology. In a review by the Interstate Council, a body
for intercommunication and cooperation between the state health care services and national government, there is a move to improve
health care through an integrative approach between specialized care and primary care at the state level. Community pharmacy does
not appear to have a major role in this review. Primary health care is becoming more important and leading the change to improve the
roles of the health care teams. Primary care pharmacists as the rest of public health professionals are employed by the respective
states and are considered public servants. Total health care expenditure is 9.0% of its GDP with the public health sector accounting for
the 71% and the private sector 29% of this expenditure. Community pharmacy contracts with each state health administration for the
supply and dispensing of medicines and a very limited number of services. There are approximately 22,000 community pharmacies and
52,000 community pharmacists for a population of 47 million people. All community pharmacies are privately owned with only
pharmacists owning a single pharmacy. Pharmacy chain stores are not legally permitted. Community pharmacy practice is based on
dispensing of medications and dealing with consumer minor symptoms and requests for nonprescription medications although
extensive philosophical deep debates on the conceptual and practical development of new clinical services have resulted in national
consensually agreed classifications, definitions and protocolized services. There are a few remunerated services in Spain and these are
funded at state, provincial or municipal level. There are no health services approved or funded at a national level. Although the
profession promulgates a patient orientated community pharmacy it appears to be reluctant to advocate for a change in the
remuneration model. The profession as a whole should reflect on the role of community pharmacy and advocate for a change to
practice that is patient orientated alongside the maintenance of its stance on being a medication supplier. The future strategic position
of community pharmacy in Spain as a primary health care partner with government would then be enhanced.