title: [Right of access to healthcare in the context of the Royal Decree-Law 16/2012: the perspective of civil society organizations and professional associations].
abstract: OBJECTIVE
  The recent publication of the Royal Decree-Law 16/2012 (RDL 16/2012), which introduces structural changes in the Spanish Public Healthcare System, can be placed in the broader context of budgetary adjustments in response to the current economic crisis. An analysis of the interrelationships among economic crisis, healthcare policies, and health reveals that citizen participation is one of several potential strategies for reducing the impact of this situation on the population. This observation raises the interest to know the citizens' perspectives on the modifications introduced by the RDL 16/2012.
  
  
  METHODS
  Narrative review of documents related to the RDL 16/2012 published by civil society organizations and professional associations in the Spanish context.
  
  
  RESULTS
  A broad citizen response can be observed to the introduction of RDL 16/2012. The documents reviewed include an analysis of changes in the healthcare model inherent to the RDL 16/2012, as well as predictions on its impact on access to healthcare, healthcare quality, and health. The civil society organizations and professional associations offer recommendations and proposals, as well as collaboration in elaborating alternative strategies to reduce costs.
  
  
  CONCLUSIONS
  The response of civil society organizations and professional associations underscores the importance of strengthening citizen participation in the development of healthcare policies aimed at maintaining the universal character and sustainability of the Spanish Public Healthcare System in the current moment of economic and systemic crisis.
authors.affiliation: Escuela Andaluza de Salud Pública, Granada, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España. Electronic address: amets.suess.easp@juntadeandalucia.es.
authors.forename: Amets
authors.initials: A
authors.lastname: Suess
authors.affiliation: Escuela Andaluza de Salud Pública, Granada, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
authors.forename: Isabel
authors.initials: I
authors.lastname: Ruiz Pérez
authors.affiliation: Escuela Andaluza de Salud Pública, Granada, España.
authors.forename: Ainhoa
authors.initials: A
authors.lastname: Ruiz Azarola
authors.affiliation: Escuela Andaluza de Salud Pública, Granada, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
authors.forename: Joan Carles
authors.initials: JC
authors.lastname: March Cerdà
mesh_terms: D003256:Community Participation; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D057172:Economic Recession; D004995:Ethics, Professional; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics / Q000331:legislation & jurisprudence*; D006301:Health Services Needs and Demand; D006806:Human Rights / Q000331:legislation & jurisprudence*; D006801:Humans; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence*; D011639:Public Opinion; D012952:Societies; D013030:Spain; D035862:Vulnerable Populations
keywords: Calidad asistencial, acceso y evaluación; Consumer participation; Derechos Humanos; Economic recession; Health care quality, access; Human Rights; International migration; Migración internacional; Participación ciudadana en salud; Poblaciones vulnerables; Recesión económica; Vulnerable populations; and evaluation