title: The effects of the financial crisis and austerity measures on the Spanish health care system: a qualitative analysis of health professionals' perceptions in the region of Valencia.
abstract: The recent financial crisis has seen severe austerity measures imposed on the Spanish health care system. However, the impacts are not yet well documented. We describe the findings from a qualitative study that explored health care professionals' perception of the effects of austerity measures in the Spanish Autonomous Community of Valencia. A total of 21 semi-structured interviews were conducted with health professionals, recorded and fully transcribed. We coded all interviews using an inductive approach, drawing on techniques used in the constant comparative method. Health professionals reported increases in mental health conditions and malnutrition linked to a loss of income from employment and cuts to social support services. Health care professionals perceived that the quality of health care had become worse and health outcomes had deteriorated as a result of austerity measures. Interviewees also suggested that increased copayments meant that a growing number of patients could not afford necessary medication. While a few supported reforms and policies, such as the increase in copayments for pharmaceuticals, most opposed the privatization of health care facilities, and the newly introduced Royal Decree-law 16/2012, particularly the exclusion of non-residents from the health care system. The prevailing perception is that austerity measures are having negative effects on the quality of the health care system and population health. In light of this evidence there is an urgent need to evaluate the austerity measures recently introduced and to consider alternatives such as the derogation of the Royal Decree-law 16/2012.
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom. Electronic address: Francisco.cervero.liceras@lshtm.ac.uk.
authors.forename: Francisco
authors.initials: F
authors.lastname: Cervero-Liceras
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom. Electronic address: Martin.Mckee@lshtm.ac.uk.
authors.forename: Martin
authors.initials: M
authors.lastname: McKee
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom. Electronic address: Helena.Legido-Quigley@lshtm.ac.uk.
authors.forename: Helena
authors.initials: H
authors.lastname: Legido-Quigley
mesh_terms: D003669:Deductibles and Coinsurance / Q000191:economics; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration; D057172:Economic Recession; D005260:Female; D006282:Health Personnel; D006304:Health Status; D061889:Healthcare Financing; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D044342:Malnutrition / Q000191:economics; D036301:Qualitative Research; D011787:Quality of Health Care / Q000191:economics; D013030:Spain
keywords: Austerity measures; Financial crisis; Qualitative study; Spain