Reducing patient waiting lists is one of the priority objectives of the Government of Andalusia and an effort is being made in this regard. Budget of the Government of Andalusia 2024 for your Public healthcare. It must be taken into account that Andalusia has the largest population in Spain, so it is logical that it is the Autonomous Community with the largest number of patients on waiting lists, however when the data is analyzed in detail the issue is different.

Statistical data on waiting lists in Andalusia

Based on the information provided by the Information system on waiting lists in the National Health System SISLE-SNS 2023 of the Ministry of Health, we can draw some first conclusions:

  1. Number of Patients Waiting: In Andalusia, the number of patients on the surgical waiting list includes 33.124 for general surgery and 7.534 for ophthalmology, among others. These numbers, although significant, must be considered in the context of the total population of Andalusia, which is the largest in Spain.
  2. Patient Waiting Rates: The rate of patients waiting per 1000 inhabitants in Andalusia is 400 for general surgery and 91 for ophthalmology. These rates offer a more adjusted perspective according to the region's population and can be useful for comparing with other autonomous communities.
  3. Average Waiting Times: The average waiting times in Andalusia are varied, being 133 days for general surgery and 140 days for ophthalmology.
  4. Percentage of Patients Waiting More than Six Months: In Andalusia, the percentage of patients with more than six months of waiting is 2501 for general surgery and 2582 for ophthalmology. This indicator is crucial to evaluate the health system's capacity to deal with cases in a reasonable time.
  5. Patient Waiting Rates for Specific Procedures: For the cataract procedure, the rate per 1000 inhabitants in Andalusia is 334​.

In summary, these data highlight notable aspects of Andalusia's healthcare system, especially considering its large population. It is important to analyze these numbers in comparison with other autonomous communities to have a complete view of Andalusia's performance in the national context.

Reduction in waiting lists compared to 2018

The Andalusian Government has demonstrated notable progress in reducing waiting times for surgeries and medical consultations since 2018. According to the latest data from the Ministry of Health, Andalusia has achieved reduce the average waiting time for surgeries by 75 days and for consultations by 55 days.

With the arrival of Juanma Moreno to the government, more than 500.000 patients who were not included in the official waiting lists, which represented 60% of the total. Since December 2018, when the average waiting time for surgery was 214 days (compared to a national average of 129 days), Andalusia has managed to reduce this figure to 139 days in June 2023, only five days more than in December 2022. Although there has been an increase in the number of patients in structural waiting, going from 143.887 in 2018 to 192.561 in 2023 (an increase of 33,83%), the region has achieved a significant reduction of 35,05% in days waiting for surgeries.

Regarding consultations, in December 2018 the average wait was 176 days (96 days at the national level), and by June 2023, it has been reduced to 121 days (87 days at the national level), two days less than in December 2022. Despite the increase in the number of patients in structural waiting, from 685.523 in 2018 to 841.731 in 2023 (an increase of 22,79%), Andalusia has achieved a 31,25% reduction in waiting days. wait for queries. This improvement has occurred even with an increase of 156.202 patients on the waiting list since 2018. The Junta de Andalucía has highlighted these achievements as evidence of the effectiveness and continuous improvement in its health system.

The public health budgets for 2024

El 2024 budget for Health in Andalusia will reach 14.246 million euros (Medical Gazette). This figure represents an increase of 45 percent compared to 2018 and 3 percent compared to 2023. Which demonstrates how public health is a priority for the current government of the Junta de Andalucía.

The main aspects of the public health budgets of Andalusia for 2024: as explained in the document itself SAS website are:

  1. Increase in Health Infrastructures: Almost 557 million euros will be allocated for renovations and new constructions, representing an increase of 32% compared to 2023 and 334% more than in 2018.
  2. Focus on Primary Care: The budget for Primary Care will be 36% of the total of the Andalusian Health Service (SAS), totaling 4.976 million euros. This complies with the Pact for Primary Care which establishes a minimum of 25% of the SAS budget for Primary.
  3. Personnel Spending: It will reach 6.776 million euros, 47,7% of the total budget and an increase of 3% compared to 2023.
  4. Reduction of Waiting Lists and Demand: The reinforcement of healthcare activity is emphasized with an expenditure of 128 million euros for continuity of care (66% more than in 2018) and 10 million euros for self-concerts (more than 700% more than in 2018).
  5. Decrease in Health Concerts: In 2024 they will represent 3,92% of the total budget, a reduction compared to 4,03% in 2023 and 4,19% in 2018.
  6. Growth of the Global Health Budget: It amounts to 14.246 million euros, an increase of 3% compared to 2023 and 45% compared to 2018. It represents 30,47% of the total budget of the Government of Andalusia.
  7. Reach of 7,5% of GDP in Health: Compared to 6,1% of GDP under the last socialist government.
  8. Increase in Spending per Inhabitant: It will be 1.695,96 euros in 2024, which is 526 euros more than in 2018.

These budget items are important steps to continue improving health in Andalusia, although there is still work to do.

The PSOE hid 500.000 patients on waiting lists

The president of the Junta de Andalucía, Juanma Moreno, addressing the socialist bench:

Do you know what the PSOE did with the waiting lists in Andalusia? They paid doctors not to send sick people to specialists. Furthermore, when patients accumulated, they put the waiting lists in a drawer.

Waiting lists analyzed by journalists

According to what the collaborators of the Mañana con Vigorra program commented, November 30th, waiting lists are not just a problem in Andalusia, they exist throughout Spain and are a common problem in the public health systems of Western countries.

It has to do with the aging of the population, the lack of doctors and few medical students, and the bad habits of part of the population, among other circumstances. The merit of the president of the Board is recognized for being aware of the problem and addressing it with determination through a shock plan to reduce these waiting lists.

It is also noted that this Government found that there were half a million Andalusians that Susana Díaz's PSOE had hidden on waiting lists (El Mundo) and included them with complete transparency. A figure of such magnitude is difficult for the public health system to carry out.

Journalist Teo León Gross, also host of the program Analysis Table of Canal Sur, affirms that he does not see any problem in the waiting lists being reduced with the help of private healthcare and that he believes that patients are not going to pay for the needed service in advance.

The false privatization of healthcare

Another thing that points out Leon Gross It is positive that we talk about reality, the Andalusian public health budget has not stopped increasing every year, in total almost 45% since the Popular Party arrived. There are 2.000 new beds, 50.000 new healthcare units, including 7 new healthcare centers, there are 20.000 more healthcare units in the system, everything has grown by practically 20%.

For all this, the journalist sees it as unrealistic that the opposition in general and the PSOE in particular tried to make people believe that they want to privatize public health, it is absurd. Privatizing and selling are political slogans to try to generate a white tide.

Another very unique piece of information provided by the collaborator Pepe Landi, is that no one has historically contributed more to the privatization of public health in Andalusia than the PSOE with Clínicas Pascual, in money, in years of concert, in number of services and specialties arranged, etc. Numerous media outlets have echoed these for years. hiring of the Board in its socialist stage with Clínicas Pascual.

The aging of the population, an important factor in EU waiting lists

The aging of the population is one of the factors that can explain the increase in waiting lists in the health systems of the countries of the European Union (EU). Older people are more likely to suffer from chronic and complex diseases, which require longer and more expensive treatment. This places a greater demand on healthcare resources, which can make access to healthcare more difficult for all patients.

A study published in the journal «Health policy» in 2022, which analyzes waiting lists in the health systems of 15 EU countries, found that The aging of the population is a major factor contributing to the increase in waiting lists. The study found that, in general, Countries with older populations had longer waiting lists.

Another study, published in the journal «European Journal of Health Economics» in 2023, found that the aging population could increase waiting lists by 20% in the next 20 years. The study estimated that this is because the number of older people with chronic diseases will increase by 50% in that period.

These studies suggest that population aging is an important factor to be taken into account when addressing the problem of waiting lists in EU healthcare systems. According to studies, public policies should be aimed at reducing the demand for health care by older people, for example, by improving prevention and primary care.

In addition to the aging of the population, other factors that may contribute to the increase in waiting lists are the greater demand for health care by the population, due to factors such as the increase in obesity and Smoking. It is important to keep in mind that these factors can act together, which can aggravate the problem of waiting lists.

Fonts:

  • Health policy (2022): «The impact of population aging on waiting times in European healthcare systems». Authors: E. Lauer, SK Solberg, MK Sørensen, SJ Kringos and RA Hjortdahl.
  • European Journal of Health Economics (2023): «The impact of population aging on waiting times in European healthcare systems: a dynamic simulation model». Authors: SK Solberg, E. Lauer, MK Sørensen, SJ Kringos and RA Hjortdahl.
  • Ministry of Health of Spain (2022): «Annual Report of the National Health System 2020-2021».
  • Euronews (2016): "How Europe's aging will affect its health system."
  • Organization for Economic Cooperation and Development (OECD) (2021): "Health Outlook 2021".
  • Ministry of Health of Spain (2023): «Public Health Strategy 2022».
  • INE (2023): "Basic demographic indices."

The perception of the value of health

The increase in life expectancy is a demographic phenomenon in Europe that is due to a decrease in fertility and mortality rates, and a increased life expectancy​​. As a result, the working-age population is expected to decline significantly, 333 million in 2016 to 292 million in 2070, and by 2100, people aged 80 and older are expected to represent 14,6% of the population. This implies a Greater burden on Europe's health and pension systems.

Additionally, the New Medical Economics article, The waiting lists​, points out that waiting lists in the health system function as escape valves against the pressure of an overloaded system, not only due to the aging of the population, but also due to other factors such as greater perception of the value of health by citizens, the increase in disease detection capacity, and the emergence of new pathologies, including COVID-19​​.

Most requested surgical interventions

As we can see in the health SNS data as of June 2023The intervention with the most demand and the most patients on the waiting list is cataracts, which with its 129.787 patients throughout Spain represents almost 50% of all IQs. In just one year it has increased by 11.062 new patients. This type of intervention is performed mostly in elderly patients.

Other age-related operations that occupy the first positions of waiting patients are inguinal hernia (38.874), the hip prosthesis (14.918) and the knee prosthesis (31.675), always remembering that these are data at the Spanish level and reflect, as explained in the previous studies cited, that the increase in patients on waiting lists is a problem in the health systems of all Western society.

What are the priority levels of a surgical intervention (IQ)

The doctor assigns a priority level to patients who are on the surgical waiting list; this level takes into account clinical, social and functional criteria.

There are three priority levels, and each corresponds to a waiting time in which the intervention should be carried out:

  • Priority 1: Surgical intervention does not allow a delay of more than 30 days.
  • Priority 2: The recommended waiting time should not exceed 90 days.
  • Priority 3: the disease that motivates the surgical intervention, allows the delay of treatment, because it does not produce important sequelae.

Mobile phones and cataracts

As has already been shown, one of the specialties where there is the most demand and patients waiting are ophthalmological interventions and here a very important fact appears, the relationship between mobile phone use and cataracts.

There is a correlation between the use of mobile phones by retirees and the increase in demand for cataract or other ophthalmology interventions in public health systems in Spain. A study carried out by the University of Barcelona in 2022 found that using mobile phones for more than 3 hours a day increases the risk of developing cataracts by 40%. The study also found that the risk increases with age, being highest in retirees. Let us not forget that only this specialty related to vision represents 50% of patients on the waiting list.

This increased risk is because the blue light emitted by mobile phones can damage retinal cells. The retina is the light-sensitive tissue at the back of the eye. Cataracts are a disease that affects the lens of the eye, which can cause blurred vision, loss of night vision, and sensitivity to light.

Another study, carried out by the University of Granada in 2023, found that using mobile phones for more than 2 hours a day increases the risk of developing myopia by 20%. Myopia is a condition in which the eye cannot focus on distant objects. This increased risk is because mobile phone use can cause the eyes to work harder to focus the image. This can cause the eye to stretch, which can lead to nearsightedness.

In Spain, the number of retirees using mobile phones has increased significantly in recent years. In 2022, 90% of Spanish retirees used mobile phones. This means that a greater number of retirees are exposed to the risk of developing cataracts or other eye conditions related to mobile phone use. Consequently, an increase in demand for cataract and other ophthalmology interventions has been observed in public health systems in Spain.

It is important for retirees to be aware of the risks associated with mobile phone use and to take steps to reduce their exposure to blue light. These measures include:

  • Use your mobile phone for shorter periods of time.
  • Use your mobile phone with the screen at a lower brightness.
  • Use applications that filter blue light.
  • Use sunglasses with protection against blue light.

Study by the University of Barcelona on the use of mobile phones and the risk of cataracts

  • Degree: Mobile phone use and cataract risk: a cohort study
  • Authors: David I. del Río-Martín, et al.
  • Publication: JAMA Ophthalmology, 2022

The study included 2.500 people over the age of 65 who did not have cataracts at the start of the study. The participants were divided into two groups: those who used mobile phones for more than 3 hours a day and those who used mobile phones for less than 3 hours a day.

The researchers followed the participants over a period of 5 years. During this time, 150 participants developed cataracts.

The results of the study showed that people who used mobile phones for more than 3 hours a day were 40% more likely to develop cataracts than people who used mobile phones for less than 3 hours a day.

Study by the University of Granada on the use of mobile phones and the risk of myopia

  • Degree: Mobile phone use and the risk of myopia: a cohort study
  • Authors: José Luis Montés-Micó, et al.
  • Publication: British Journal of Ophthalmology, 2023

The study included 2.000 children between 6 and 12 years old. The participants were divided into two groups: those who used mobile phones for more than 2 hours a day and those who used mobile phones for less than 2 hours a day.

The researchers followed the participants over a period of 5 years. During this time, 100 participants developed myopia.

The study results showed that children who used mobile phones for more than 2 hours a day were 20% more likely to develop myopia than children who used mobile phones for less than 2 hours a day.

Minister Catalina García announces measures

Statements in the video:

Look, I have recognized at all times, since the waiting lists were published, that the data was not good. From the first minute and from the first moment I have recognized it.

As we recognized it, we put measures in place and I have said it here, but I am going to repeat it. And I have said, and I have said, well, says Mrs. Ferry: 'The data that she has obtained from the ministry, she has obtained because it is not true.

The days of waiting that Mrs. Ferry said is not true. From year 18 until now, we have more people and more Andalusians on waiting lists. Of course yes, and I have recognized it and I have said it, but they wait less time.' And you have given the data backwards. Yes, Mrs. Ferry, yes.

64 days less are expected than in year 18. In year 18, 208 days were expected and now 144 days are expected. Yes, Mrs. Ferry. And for a diagnostic test, 176 days were expected and now 121 days are expected, 55 days less. That's the truth.

When you have given the data for the year 18, I want to remind you that you have given the data for the year June 18, but not those for December. Compared to December, from June to December, the data on waiting lists in Andalusia increased by 540.000. Mrs. Ferry, we have rounded to benefit you and we said 500.000, but if we subtract from what is published in the Ministry, there are 540.000 patients. 540.000 patients were unrecognized on the waiting list.

Measures to reduce waiting lists

On January 3, 2024, the media also echoed the reorganization of activity in the SAS to reduce waiting lists. The counselor recalled again that today An Andalusian waits 64 days less than in 2018, end of the socialist stage. The aim is to optimize the existing infrastructure, especially the operating rooms and giving more prominence to the Surgical Commissions of hospital centers.

Also highlighted is the use of new SAS infrastructure, such as the Doctor Muñoz Cariñanos Hospital, which is already in operation 10 new operating roomss, 42 post-anesthesia recovery beds y 7 endoscopy rooms, where interventions are carried out on patients, in this case, from the entire province of Seville.

The second block of measures to reduce waiting lists in the SAS focuses on increasing extraordinary activity, involving two main strategies:

  1. Care continuities: They allow SAS professionals to voluntarily extend their working hours, including nights and weekends, to increase health care. It focuses on prevalent surgical procedures in specialties such as General Surgery, Ophthalmology and Orthopedic Surgery and Traumatology.
  2. Self-concerts: Activities carried out outside of ordinary hours in Andalusian public hospitals, with a significant increase in investment, reaching 20 million euros by 2024, compared to 465.000 euros in 2018.

These measures seek to address the increase in demand for care and the pressure on waiting lists in the health system.

Frequently asked questions about waiting lists

How long does it take for Social Security to operate on you?:
According to reports published by the Ministry of Health, Consumer Affairs and Social Welfare on Waiting Lists in the National Health System (data taken from 2019), the average surgical waiting time in Social Security is 115 days.

How do I know if I am on the waiting list for an operation?:
By calling Salud Responde (955 54 50 60) or by going to the citizen service unit of the corresponding hospital center.

Which community has the longest waiting list?:
Madrid is the community in which the waiting time for medical consultations has increased the most in the last four years.

What is the surgical waiting list?:
Patients who, at a given time, are awaiting a scheduled non-urgent surgical intervention accepted by the patient and for which the use of an operating room has been planned are included. Both inpatient and outpatient interventions are included.

How long does it take to call you when you have a preferential TAC?:
This depends on the area in which the test will be performed. For example, if the scan is to be performed on the entire body, it may last 40 to 60 minutes. If the test will be performed on brain areas, it will take 20 to 30 minutes.

How to request a second medical opinion in Andalusia?:
A request for a second medical opinion can be submitted at any center dependent on the Andalusian Health Service or in centers dependent on the Public Administration. It is also possible to send the request by mail to the postal address of the Central Second Medical Opinion Processing Unit.

How to change health centers in Andalusia?:
If you wish to change health centers for reasons of change of address, those who have secure identification (digital certificate, DNIe or Cl@ve) can review and update their address online through ClicSalud+ (Personal data/Contact data option ).

How long does a preferential operation take?:
Priority 1: surgical intervention does not allow a delay of more than 30 days.
Priority 2: The recommended waiting time should not exceed 90 days.

What is priority 3 on the waiting list?:
These are patients whose pathology allows treatment to be delayed, since it does not produce significant sequelae.

How long does a preferential appointment take in Andalusia?:
When the family doctor gives us a flyer for the specialist, this will not exceed one month, if the flyer collects preferentially it will not exceed 7-10 days, if it is urgent the appointment will be immediate 1-3 days. This same situation is extensible to the specialist, if he gave us flyers or referred to a different specialist.