Cesar Hernandez, Director General of Services Portfolio.
The A portfolio of general primary care services is immersed in the updating phase and after the first meetings between the Ministry of Health, representatives of the autonomous communities and the scientific societies of primary, family medicine and paediatrics, it was possible to close incorporating new diagnostic processes for the portal to the National Health System (SNS).
As revealed to Medical writing sources close to the negotiations, they will “triple” the number of diagnostic tests this can be done in primary care compared to this document. This ‘inclusion’ of tests has now been ‘closed’ and embodied in a draft which will later be referred to the Inter-Territorial Council of the National Health System (Cisns) and which is expected to be given final approval. before the end of the legislative term of the present government of Spain.
The last major update to the SNS service portfolio took place at the start of the year with the inclusion of new neonatal and prenatal screenings and the expansion of oral health care. However, in terms of diagnostic tests performed at the first level of care, it has not changed since 2006.
What diagnostic tests will be included?
Health wants these negotiations to be conducted in complete secrecy and has specifically asked its members not to distribute the agreed draft. However, Medical writing has been able to learn about any of the diagnostic tests that will be included which meet the basic requirements for new procedures identification of pathologies carried out in recent years by primary care physicians.
Among these innovations are test for infectious diseases such as strep or the flu. The latter, for example, can be done from the hospital, but not in the Main. Other popular ones will be included, such as dermatoscopies, which are not done in all autonomous regions. “Some regions do not even think of having a dermatoscope in the health center and it is a minimal thing for the family doctor to see the patient’s skin lesion,” sources close to the negotiations said.
Another of the diseases that will have more diagnostic tests at the first level of care are respiratory. Tests such as oximetry, which is very useful in the fight against smoking, or new types of spirometry, key to monitoring respiratory pathologies, will be a reality in all primary care centers.
It should be remembered that currently the portfolio of primary care services has eight diagnostic procedures funded: history and physical examination; spirometry, measurement of peak expiratory flow and pulse oximetry; cardiovascular examinations: electrocardiography, oscillometry and/or doppler; ENT examinations: otoscopy, indirect laryngoscopy and qualitative acumetry; correction of visual acuity and fundus; analytical determinations by dry technique, including reflectometry; obtaining biological samples and psychoaffective and social tests, morbidity and quality of life.
Funding for the acquisition of devices
The authorization of new diagnostic processes implies the acquisition of new devices, and it is the Ministry of Health that has already taken a step in this direction. Carolina Darias recently announced the development of a new The “Inveat Plan” focuses on primary care which will be co-financed between the central government and the autonomous communities. It is, he said, a strategy aimed at acquiring state-of-the-art diagnostic equipment.
In addition, part of the €172 million the government approved this month for first level care will go in the same direction: acquiring diagnostic equipment to improve resolution capacity. A measure that doctors requested as one of the partial solutions to progress in the de-bureaucratization of primary care.
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