Teresa López Pavón Sevilla
Seville
Updated Wednesday, February 21, 2024-14:48
Health Andalusian waiting lists: Three times as many patients waiting more than a year for a surgical intervention
The number of patients on the waiting list for a surgical intervention in Andalusia skyrocketed in the second half of 2023, as recognized this Wednesday by the Minister of Health, Catalina García
,
who attributes what happened to a series of circumstances that have prevented Shock plans put in place by the
Andalusian Health Service
have been effective so far.
According to data from the Ministry itself, if in June 2023 there were 134,749 patients waiting for surgery within the guaranteed procedures (which are those in which the SAS itself establishes maximum delays) and, of these, 36,004 outside the decrees ( exceeding those established times); In December 2023, that figure rose to 142,507 patients, of which 53,014 were outside the guarantee decree. That represents 47.2 percent in the last half of the year.
The Health Minister has offered an explanation of what happened, attributing the situation to three circumstances: on the one hand, she assures, the
reactivation of healthcare activity
after the pandemic has triggered outpatient consultations and, therefore, the prescription has also increased. of surgical interventions by physicians.
Specifically, in 2022, 640,911 more consultations were made than in 2021 and, in 2023, 494,576 more. As a consequence of the latter, there is an increase in indications for surgical procedures. That is, in 2022 the number of indications increased by 9.58%, which meant that
38,610 more patients
were registered on the surgical waiting list than in 2021. In 2023 the increase compared to 2022 stood at 1.42%. , with
6,249 more patients
.
On the other hand, there is a "serious deficit of health professionals", which has meant that, in specific areas, such as
anesthesiology
, the Andalusian Health Service "finds it practically impossible to find specialists to replace sick leave or rest periods". The Minister of Health has insisted in this regard on the need for the Government to increase the number of
MIR places
and to make the criteria for accrediting new teaching units more flexible.
Finally, the Board has found itself without funds to renew a good part of the health agreements with private clinics in the second half of the year, since many agreements expired between January and June 2023 and their renewal became impossible due to the lack of budgets. , once the SAS had to assume the expenses derived from pending payments to Pascual Hospitals.
Between the months of January and June 2023, the ordinary concerts in Andalusia ended in five of the eight provinces: Almería, Cádiz, Huelva, Jaén and Seville, which in 2023 has meant a 40% decrease in concerted surgical activity compared to 2022, which means around 19,000 fewer surgical interventions due to concerts. Specifically, in 2022, 47,544 concert surgeries were performed. In 2023, the figure dropped to 28,497, according to data provided by the Ministry of Health.
In parallel, the Junta had to face the
debt that previous governments
of the Junta de Andalucía contracted with the Pascual Hospitals. In 2023, the Ministry of Health and Consumer Affairs paid the missing monthly payments worth 96.8 million euros. "If this money could have been used on concerted surgical interventions, around 36,400 patients could have been operated on in Andalusia in the second half of 2023, ending 2023 with a total of 16,616 patients outside the guarantee decrees," the Ministry explained. .
The result has been a substantial increase in delays, which the Board now wants to address with a
new shock plan
announced this Wednesday after the Government Council, which is endowed with
283.3 million euros
and which would have to allow a 60% reduction in the number of patients who are on waiting lists for surgery having already exceeded the guaranteed times (90, 120 and 180 days depending on the specialty).
More overtime
To this end, since October 1, 2023, the Ministry explains that a reorganization of ordinary surgical activity
is being carried out
in four key aspects: daily monitoring public hospital centers to increase ordinary surgical performance and overtime; guaranteeing
correct management of the "queue"
, that is, that the patient is intervened with the greatest delay; sizing the surgical sessions by specialties based on the pending patients for each of them, and clinically re-evaluating the patients with the most days of delay. Likewise, overtime for health professionals is increasing, through continuity of care and overtime.
In this sense, the Andalusian Government has increased, through its own resources, the budget item for
overtime
from the planned 128 million to 163.3 million, 34% more than in 2023. Thanks to this reorganization and increase in Overtime, from October 1 to January 31, almost 14,000 more patients have been operated on than in the same period in 2022. That is, 16.6% more.
Specifically, in these four months extraordinary activity in hospitals has grown by 96% more. Thus, of the 14,000 more Andalusians operated on, almost 8,000 came from overtime activity.
Despite this, more patients continue to enter than the system is capable of managing, which is why the Board has formalized
new contracts to conclude with private clinics
that allow the unmet demand to be absorbed.
New agreements with private hospitals
In this regard, the Andalusian Government has initiated a series of contracting files, "that serve as a bridge contract and that allow it to respond to citizens within the time set by the care guarantee decrees." These are low-complication surgical interventions -
cataracts, hernias, hip or knee replacement
- to focus public health resources on more complex procedures.
Thanks to these contracts, which will be launched from April, 91,248 patients will be operated on in Andalusia during 2024. These are five files under the contract modality
negotiated without advertising
that have been approved by the Government Council to cover external assistance in the five provinces that do not currently have contracts in force (Almería, Cádiz, Huelva, Jaén and Seville), in addition to two upcoming complementary files that are being evaluated in Córdoba and Granada.
In the case of Malaga, this assistance is covered with current concerts. For these contracts, the Order of February 23, 2023, which updates and develops the budgeting and pricing system for agreements and concerts signed by the SAS, will be taken into account. These contracts will have a duration of six months while the awarding of the
framework agreements
that will formally cover the longer-term agreements
is resolved .
And if this procedure were to drag on, there is the possibility of extending these contracts for another six months.
The cost of these contracts negotiated without advertising for the seven provinces amounts to
119.9 million euros,
while the plan to increase the activity of public hospitals is endowed with 163.3 million euros; which makes a total sum of 283.3 million euros.
Through this Plan, in 2024 it is expected that 341,907 patients will be able to operate in Andalusia: 229,308 through ordinary activity and overtime, and 91,248 through concerts. In this sense, as of December 31, 2024, a total of 116,261 patients are expected to be on guaranteed surgical waiting lists, of which 21,351 will be excluded from the decree. That is, the number of patients on waiting lists is reduced by 18% compared to December 2023, and the number of patients outside the decree is reduced by 60%, the Ministry points out.