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20% of primary care teams (EAP) in Catalonia are considered difficult to cover in rural areas. These are positions that doctors, nurses and social workers do not usually choose to work in. In total, there are 73 EAPs out of the 378 that exist throughout the country.
To reverse this situation and promote equity in access to public health services throughout the territory, the Government of the Generalitat, through the Department of Health, has launched the Employment Plan for difficult-to-cover places in the rural area in primary care. It is a plan that will promote economic incentives and measures of a more social nature to favor the professional and personal project of professionals who already work or choose to work in these rural areas.
“It’s quite a bet, very important, so that these places with difficult rural coverage can be more attractive for professionals”, remarked the Minister of Health, Manel Balcells i Díaz, during the presentation of the plan that took place at CAP de Flix ( Ribera d’Ebre). “It is also an effort to prioritize these 73 teams so that they have an increase, in addition to those already provided for in the respective agreements, both in the ICS and the SISCAT”, he added.
The Plan foresees economic incentives that complement the current mountain one. The global impact for Health will be 11.5 million euros per year. In this sense, Family and Community Medicine doctors and pediatricians in these centers with difficult coverage will receive an annual increase of around €3,500 and nurses, midwives, and social workers , 2,000.
On the other hand, the Plan also foresees a set of measures of a more social nature to favor the professional and personal project. Thus, in the professional field, measures will be deployed such as facilitating research and teaching, continuing education, the connection with professionals in the health system and the prioritization of interconsultations, leadership and the flexibility of the day, guaranteeing the service, among others.
And in the personal sphere, the Plan envisages, in collaboration with the municipal entities, measures to promote housing, mobility, employment of the family unit or subsidies for training, among others. To carry out these measures, Health will establish collaboration agreements with different municipal entities.
In order to identify the EAPs that are difficult to cover in rural areas, Salut took into account six weighted indicators: the distance from the primary school to the hospital, high rurality, seasonal overload, guards, the distance to the local doctor’s office and the aging of the population. These indicators make it possible to determine different levels of places with difficult coverage, categorized as high, medium and low.
It is a robust method, which allows it to be updated periodically and to adequately discriminate the places with difficult structural coverage. This synthetic indicator is what has made it possible to identify, among the 378 EAPs in Catalonia, the 73 teams with difficult coverage, the vast majority of the Catalan Institute of Health (ICS). And the fact is that the ICS manages approximately 80% of the EAP in the country. Specifically, the Health study has identified 61 EAP of the ICS with difficult coverage: 36 high level and 25 medium. Of the rest of the EAP in the health system, 6 are considered high level and 6 more medium level.
