EXECUTIVE SUMMARY

Private healthcare serves approximately 9.3 million people, a fifth of the Spanish population, including the 7.4 million who voluntarily hold double insurance and the nearly 2 million civil servants who year after year choose private healthcare through the administrative mutualism model. It also provides healthcare coverage to other segments of the population through different partnership models, agreements and concessions. In this context we can see the importance of providing objective and transparent data to citizens about the health outcomes of our extensive network of health centres, all of which provide efficient, accredited, reputable and quality private healthcare management that enables them to achieve the most stringent indicators and compare them with the most advanced countries in our geographical area; this ensures continual improvements to the quality of care we offer our patients and their families. The RESA (Private Health Outcomes Indicators) Study is now in its fifth edition. The growing participation of prestigious health centres, the transparency of the information provided and the reliability of the results means that it is currently a fully representative study of Private Healthcare and stands among studies and reports from the leading Spanish and international observatories that document health outcomes. The health centres that participated in this fifth edition account for more than 15,000 hospital beds (two-thirds of the private beds for acute care) and nearly 80% of hospital discharges for all private hospitals offering acute care. In terms of the Spanish healthcare system as a whole (public and private), nearly one in five hospital discharges for acute care occurs in a private hospital that participates in the RESA Study. The outcomes included in this new report reconfirm our trust in Spanish private healthcare:

• Efficiency, maintained over the five years of study with average stays of around 3.2 days, is consistent throughout the year with little variation.
• Accessibility to care, a known value of private care, is clearly ratified with outcomes such as:
  • Average waiting time for scheduling additional tests does not exceed 9 days, with results of under 1 week for many tests (4.7 days for a CAT scan and 7 days for musculoskeletal NMR).
  • Waiting time for additional test reports under 4 days (2 in the case of mammograms).
  • Average waiting times for consultations with the busiest specialists are between 10 and 11 days.
  • Waiting time for surgeries with 90% of patients being treated in under 30 days.
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• This accessibility is specially interesting in cases of cancer care, where it was observed that participating private health centres start treatment in under 2 or 3 weeks from the confirmed diagnosis for the most frequent cancers.
• One area that we put special emphasis on is quality of care, where the study shows excellent outcomes:
  • The private health sector has a network of health centres and services accredited or certified by leading or international institutions.
  • Patient safety is a priority of private healthcare, as part of its commitment to quality. The implementation of modern safety policies and practices is clearly on the rise and has now become common practice in most health centres.
  • Quantitative indicators show excellent outcomes like the survival rate for acute cardiac syndrome, hip replacement surgery in under 48 hours, and the implementation of the surgical check-list in line with the best international standards.
  • Patient comfort with rates of performing endoscopies under deep sedation above 90%.

In general we can confirm that the outcomes obtained in this edition of the RESA Study are once again very satisfactory, and there are some aspects that have contributed to this success. We would like to highlight the following:

• A more detailed analysis also shows that these outcomes are not just an average but reflect a trend of decreased variability among participating health centres.
• The reduction in this variability between the health centres over the years of the study, the analysis of case distribution, and the distribution of the indicators over time show that the outcomes are very consistent.

It is important to highlight here that this year the 2016 RESA Study has expanded its coverage to include three indicators for haemodialysis. The fact that 29 health centres have submitted results for these indicators speaks to the likelihood of it being well received in future editions of the study. But in addition to analysing data, this fifth edition allowed us to reflect on the positioning of the RESA Study in the context of the Spanish and international Quality and Outcomes Observatories that we reviewed when preparing it. This reflection led to some important conclusions:

• The RESA Study is part of a clearly growing international trend to foster the transparency of healthcare institutions by presenting their health outcomes to the public.
• This experience may be considered unique, as it is an initiative carried out voluntarily by a large group of private health centres.

All in all, this reflection confirms the initiative we set into motion five years ago when we took on the challenge of publishing this study with key quality data, and it motivates us to expand its use as an instrument to continuously improve quality of care. Over these five years we have not only confirmed that Spanish private healthcare has quality standards comparable with the best national and international health centres and systems, but have also observed that the private sector makes great efforts to continually improve quality of care for the benefit of patients, their families and the overall image of the Spanish healthcare system.