[Right of access to healthcare in the context of the Royal Decree-Law 16/2012: the perspective of civil society organizations and professional associations]. / El derecho de acceso sanitario en el contexto del Real Decreto-ley 16/2012: la perspectiva de organizaciones de la sociedad civil y asociaciones profesionales.

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.

The right of access to health care for undocumented migrants: a revision of comparative analysis in the European context.

BACKGROUND: The recent introduction of adjustment measures in the Spanish context by means of the Royal Decree-law 16/2012 (RDL 16/2012), which limits access to health care for undocumented migrants, raises the question about the state of the matter in different European Union member states. METHODS: Narrative review of comparative studies published between 2009 and 2012 that analyzes the right to health care for undocumented migrants in the European context. RESULTS: The review shows a high degree of variability regarding health care entitlements of undocumented migrants in different European countries, a frequent legal restriction of access to health care, as well as barriers in the effective access to health care. The studies coincide in recommending access at all health care levels, regardless of the administrative status of the person seeking treatment. The analysis of the impact of the current economic crisis on access and quality of the health care directed to undocumented migrants, as well as the knowledge of the migrants' perspective are identified as future research areas. CONCLUSIONS: Compared with other European countries, the introduction of the measures established in the RDL 16/2012 modifies the place of the Spanish Public Health Care System from being situated in the group of countries that permit undocumented migrants access to all health care levels, towards the category of highest restriction.

[Alcohol consumption in adolescents (12 to 17 years): the point of view of health professionals]. / El consumo de alcohol en la población joven (12-17 años). El punto de vista de los profesionales de la salud.

OBJECTIVE: To find out the opinions of health professionals on adolescent alcohol drinking and their evaluation of the existing legal regulation measures. DESIGN: Qualitative and exploratory study, based on semi-structured interviews. SETTING: Four cities representing four different regions in Spain: Palma de Mallorca, Granada, Barcelona and Pamplona. PARTICIPANTS: A total of 36 physicians and nurses from four Spanish regions, working in Primary Care and Emergency Care, selected by intentiones samples. MEASUREMENTS: A total of 36 deep interviews, analysed using the software Nudist Vivo 4.0. RESULTS: Health professionals accept their important role in preventing and intervening in adolescent alcohol drinking. Generally, they consider it as a public health problem. Prevention is associated with Primary Care, while the Emergency Departments act in specific situations of alohol abuse. Adolescents infrequently visit Primary Care, thus prevention must centre on education system and constant coordination between health professional and parents. Health personnel do not have sufficient knowledge on legal regulations. They consider educational measures as more efficient than sanctions. CONCLUSIONS: Specific professional training is required in order to guarantee the coordination between the health and education systems and the family.