Basque health system reform is presented as reference model in care to chronic patients.

II Congress of health care to the patient chronic.

-risk stratification, the development of ICT and the widespread introduction of models of history electronic are common tools in tackling the disease chronic.

-lifestyle, demographic ageing and the success achieved in the clinical management of diseases such as certain types of cáncer or AIDS, are the main causes of the increase in the prevalence of diseases Chronicles.

-today, throughout the national health system is a test where every experience brings new knowledge.

Santiago Compostela, February 2010.- growth in chronic diseases is a tangible reality. When assessing the reasons for this situation, the President of the Scientific Committee of the II Congress of health care to the chronic patient, Félix Rubial, points out that the phenomenon is certainly multifactorial, and within that multifactorial should be searching, obviously, genetic factors – individual susceptibility-; environmental factors that can influence the emergence and development of certain chronic (such as the climate, pollution, etc.) processes; and the lifestyle is well known the relationship physical inactivity and obesity, smoking and cancer, bad dietary habits, diabetes – ”. Also influence the demographic ageing and to a lesser extent, the rise of incurable diseases is a consequence also of own success of the health system, than diseases that at other times were already deadly (AIDS, certain types of cancer …), nowadays have sputum due to the technical progress achieved ”.

From this point of view is essential ” reorient the health system. Live in acute medicine (the tyranny of the acute as some authors defined). We are reasonably effective and efficient in the management of the acute condition, because the entire system is designed to do this, but we are tremendously ineffective and inefficient in the management of chronic ”.

In the view of Felix Rubial there is an extrapolated model to the health of all Spain. The stratification of risk, given the enormous development statewide primary care, together with the development of ICT and the introduction of generalized models of electronic medical history, for example, is a good example of this, and should become, it is doing, in a common strategy ”.

Said Felix Rubial is the own health Minister of the Basque Government, Rafael Bengoa, who best describes the current situation that illustrates the need for change. Accurate analysis concludes that all the elements that are part of the healthcare process have undergone change processes ”.

From this perspective, Rubial subscribes to the opinion of Bengoa when talking about experiments by a patient changes more active in making decisions about your care and has a greater knowledge about their own illness. This situation generates a doctor-patient relationship different from the traditional relationship of Agency. In addition, the patient is accustomed to the management of new technologies to complete knowledge about their disease ”.

The scientist delves into their analysis. Is more frequent coexistence in the same patient for two or more chronic situations: the pluripatología. all these people placed greater expectations and demands on the quality of their care ”.

The pattern of diseases has also changed. There is a higher prevalence of chronic diseases that affect the impact of comorbidity and the pluripatología. The changes also affect the technology that today allow monitoring at a distance, the telecuidado and the telemedicine and they give the clinical decision support systems. In addition, electronic medical history allows access online, from anywhere in the health network, to information on the health of the patient. the development of personalized health information systems complete the table ”.

With regard to Galicia, the specialist explains that Galician health authorities have been aware from the outset the need to tackle the problem with serenity but with energy. Some of the health policy guidelines are clearly aimed at the improvement of care for chronic patients. Thus, the promotion of integrated management to redefine objectives of the different medical devices, the involvement of professionals in the decision-making process through the development of the organizational model, focused on management by processes and clinical management and the establishment of strategies for minimization of the variability of clinical practice are measures taken by Galicia for deal with the situation ”.

On the initiatives taken by the Health Minister of the Basque Government, Rafael Bengoa, Félix Rubial specifies that it expects its results with huge anticipation. Deep knowledge of Rafael Bengoa of the reality of the chronic and his approach and his firm political will reorient the system constitute elements of a great value and will serve as a safe – together with other strategies in other communities – as a source of which nurture in the present and the future. At the moment throughout the national health system is a huge test in which the number and quality of the experiences that are testing requires that all we are in continuous contact with the purpose of sharing knowledge and assess its viability ”.