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{{ANEEtiqueta|palabrasclave=covid-19, pandemic, covid19, total population establecimientos sanitarios, population densityhealth staff, rural settlement, human concentration out-of-hospital emergency, population structuremedical staff, old peopleprimary care centres, household size, life years, settlement density, scattered population, prevalence hospitals according to the purpose of COPDcare, prevalence of obesityhospital beds, prevalence of hypertension, prevalence of diabeteshospitales según dependencia funcional, heart failurenursing staff, AIDS, prevalence of chronic kidney diseasehospital beds alloted to ICUs|descripcion= Cartographic presentation Analysis of resources for health before the arrival of populationthe pandemic through maps, settlement statistical graphs and comorbiditiestables from the National Atlas of Spain|url=valor}}{{ANEObra|Serie=Monographs from the National Atlas of Spain|Logo=[[File:Logo Monografía.jpg|left|50x50px|link=]]|Título=The COVID-19 pandemic in Spain|Subtítulo=First wave: from the first cases to the end of June 2020|Año=2021|Contenido=New content}}{{ANENavegacionCapitulo (monografía COVID-19)|estructura temática=Thematic structure|seccion=[[The COVID-19 pandemic in Spain|The COVID-19 pandemic in Spain]]|capitulo=Resources for health servicies before the pandemic}}{{ANENavegacionHermanos|anterior=[[Population, human settlements and comorbidities]]|siguiente=[[First COVID-19 cases]]}}This chapter presents the main material and human resources that were available to the health services in Spain before the pandemic. Nevertheless, this is not an easy task: on the one hand, the aim of this publication is not to compile a detailed inventory, so some data have not been included (e.g. data on masks, personal protective equipment, diagnostic determinants, respirators, etc.); on the other hand, the information is dispersed in a large number of sources.

<li style="display: inline-block"><div style="text-align:right"><div style="color:MediumBlue"><div style="padding-top: 0em; padding-right: 13em; padding-bottom: 0.2em; padding-left: 0em>'''MAIN HEALTH CENTRES'''</div>{{ANENavegacionCapitulo (monografía COVID-19)|estructura temáticacellspacing="0" cellpadding="0" style=Thematic structure"margin-top: 0; margin-right: 0px; margin-bottom: 0em; margin-left: 20px; float:right" |seccionstyle=[[La pandemia COVID"vertical-align: top; border-style: solid; border-width: 1px; border-19 en España|The COVIDcolor: #A7A7A7; background-19 pandemic in Spain]]color:#ffffff" |capitulo<div style=Resources for health services before the pandemic}}"padding-top: 0.1em; padding-right: 0.5em; padding-bottom: 0.3em; padding-left: 0.5em; font-size: 100%; text-align: center; float:right">

This chapter presents the main material <div style="padding-top: 0.0 em; padding-right: 0.5em; padding-bottom: 0.3em; padding-left: 0.5em; font-size: 95%; text-align: left"><small style="color:#959595">Source: Health on Data and human National Catalogue of Hospitals 2020. Ministry of Health</small>|}</div></div> <div><ul style="text-align: left; float:left"> <li style="display: inline-block">[[File:Spain_Primary-health-care-centres_2019_map_18527_eng.jpg|left|thumb|300px|Map: Primary health care centres. 2019. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Primary-health-care-centres_2019_map_18527_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Primary-health-care-centres_2019_map_18527_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18527.s18527&t=A02&view=map8 Interactive version].]]</li><li style="display: inline-block">[[File:Spain_Physical-resources-for-out--of--hospital-emergency-services_2020_map_18526_eng.jpg|left|thumb|300px|Map: Physical resources that were available to the health for out-of-hospital emergency services in . 2020. Spain before . [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Physical-resources-for-out--of--hospital-emergency-services_2020_map_18526_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Physical-resources-for-out--of--hospital-emergency-services_2020_map_18526_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r13103.r13103&t=A02&view=map8 1] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c13112.c13112&t=A02&view=map9 2].]]</li></ul></div>Emergency health care also played an important role during the first wave of the pandemic. Nevertheless, this This service is not an easy task: on the one handprovided by hospital emergency services, out-of-hospital emergency centres and the aim coordination of this publication is not to compile a detailed inventory, so some data have not been included (e061 and 112 emergency telephone numbers.g. data The map on masks, personal protective equipment, diagnostic determinants, respirators, etc[[:File:Physical resources of out-of-hospital emergency services.); on jpg|''Physical resources of out-of-hospital emergency services'']] shows the other hand, out-of-hospital emergency centres and the information is dispersed in a large number coordination of sources061 and 112 emergency telephone numbers. The first link in the health care chain is the [[:File:Primary Health Care Centres.jpg|''Primary Health Care Centres'']], which is supported by clinics and health centres. There are 10,080 clinics and 3,051 health centres in total in Spain. This map accurately shows the patterns of the human settlement system: clinics are more present in the Northern Plateau and in mountain areas, as they are ideal for habitats with sparsely populated human settlements, whilst health centres are more present in larger municipalities, i.e. along the Northern coast, along the Mediterranean coast, in the Southern Plateau and in major towns in Aragón and Castile and León (Castilla y León).Emergency health There were 837 hospitals in Spain in 2020, which are mapped according to two criteria: [[:File:Hospitals according to membership.jpg|''Hospitals according to membership'']] and [[:File:Hospitals according to the purpose of care.jpg|''Hospitals according to the purpose of care'']]. According to the membership criterion, 63.2% were public, i.e. they belonged to the National Health System. However, private hospitals had a significant presence in some provinces: around two thirds of hospitals in Cádiz were private, as well as over 50% of them in León, Palencia, Valladolid, Madrid, Málaga, Las Palmas and Santa Cruz de Tenerife. When classifying hospitals according to the purpose of care, acute care also played hospitals (general and specialised hospitals) were clearly dominant, with an important role during average presence of 70.6% throughout Spain. Medium and long-stay hospitals and mental health and drug addiction treatment hospitals were located in the provinces with the first wave largest amount of population. Another relevant aspect is the hospital capacity prior to the pandemic. The map on [[:File:Hospital beds according to membership.jpg|''Hospital beds according to membership'']] shows all available beds, including those allotted to intensive care units. The map on ICU beds shows only those in intensive care units (ICU). There were 157,249 hospital beds in Spain towards the beginning of 2020, i.e. a national average of 3.3 beds per thousand inhabitants. The northern half of the country stood out above the national rate, especially the provinces of León, Palencia, Burgos, Gipuzkoa, Saragossa (Zaragoza), Teruel, Lleida, Tarragona and Barcelona. Moreover, the dominance of the public service in the northern half of Spain was clear. 4,915 out of the total amount of hospital beds were allotted to intensive care units (ICU). This service is provided by means that 3.2% of the total amount of hospital emergency servicesbeds were ICU beds at national level. However, it shall be noted that this figure rose to over 4% in the southern half of Spain. 81.5% of the nearly 5, out000 ICU beds belonged to public hospitals.  <div><ul style="text-align: center; float:center"> <li style="display: inline-block">[[File:Spain_Hospitals-according-to-membership_2019_map_18604_eng.jpg|left|thumb|300px|Map: Hospitals according to membership. 2019. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Hospitals-according-to-membership_2019_map_18604_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Hospitals-according-to-membership_2019_map_18604_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18604.s18604&t=A02&view=map9 Interactive version].]]</li><li style="display: inline-block">[[File:Spain_Hospitals-according-to-the-purpose-of-care_2019_map_18360_eng.jpg|left|thumb|300px|Map: Hospitals according to the purpose of care. 2019. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Hospitals-according-to-the-purpose-of-care_2019_map_18360_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Hospitals-according-to-the-purpose-of-hospital emergency centres care_2019_map_18360_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18360.s18360&t=A02&view=map9 Interactive version].]]</li><li style="display: inline-block">[[File:Spain_Hospital-beds-according-to-membership_2019_map_18609_eng.jpg|left|thumb|300px|Map: Hospital beds according to membership. 2019. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Hospital-beds-according-to-membership_2019_map_18609_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Hospital-beds-according-to-membership_2019_map_18609_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18609.s18609&i2=c12967.c12967&t=A02&t2=A02&view=map9 Interactive version].]]</li><li style="display: inline-block">[[File:Spain_Hospital-beds-allotted-to-ICUs_2020_map_18412_eng.jpg|left|thumb|300px|Map: Hospital beds allotted to ICUs. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Hospital-beds-allotted-to-ICUs_2020_map_18412_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Hospital-beds-allotted-to-ICUs_2020_map_18412_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18412.s18412&i2=c12947.c12947&t=A02&t2=A02&view=map9 Interactive version].]]</li></ul></div> <div><ul style="text-align: center"><li style="display: inline-block"><div style="text-align:center"><div style="color:MediumBlue"><div style="padding-top: 0.5em; padding-right: 0.5em; padding-bottom: 0.1em; padding-left: 0em>'''HOSPITAL BED CAPACITY'''</div>{| cellspacing="0" cellpadding="0" style="margin-top: 0; margin-right: 0px; margin-bottom: 0em; margin-left: 0px; float:center" | style="vertical-align: top; border-style: solid; border-width: 1px; border-color: #A7A7A7; background-color:#ffffff" |<div style="padding-top: 0.1em; padding-right: 0.5em; padding-bottom: 0.3em; padding-left: 0.5em; font-size: 100%; text-align: center; float:center"> {| style="margin-right: 0px; margin-left: 0px; font-size:12px; float:center"|- | style="color:MediumBlue; background:LightGoldenrodYellow; text-align:center; border: solid; border-width: 1px; width:275px" | '''Hospital beds according to membership''' || style="color:MediumBlue; background:LightGoldenrodYellow; text-align:center; border: solid; border-width: 1px" | 157.249 || style="color:MediumBlue; background:LightGoldenrodYellow; text-align:center; border: solid; border-width: 1px; width:275px" | '''Hospital beds allotted to ICUs. ICUs with respirator (1)''' || style="color:MediumBlue; background:LightGoldenrodYellow; text-align:center; border: solid; border-width: 1px"| 4.915|-| style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px; width:250px"| Public hospitals || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px" | 126.801 || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px; width:250px"| Public hospitals || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px" | 4.006|-| style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px; width:250px" | Private hospitals || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px" | 30.448 || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px; width:250px"| Private hospitals || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px" | 909|}<div style="padding-top: 0.2 em; padding-right: 0.5em; padding-bottom: 0.0 em; padding-left: 0.5em; font-size: 100%; text-align: left"><small style="color:#959595">(1) Not including newborns</small> </div><div style="padding-top: 0.0 em; padding-right: 0.5em; padding-bottom: 0.3em; padding-left: 0.5em; font-size: 100%; text-align: left"><small style="color:#959595">Source: National Catalogue of Hospitals and Statistics on Specialised Care Centres. Ministry of Health</small>|}</div></ul></div> With regard to human resources, data from two different sources have been used. On the one hand, the Labour Force Survey from the National Statistics Institute has been used. The [[:File:Medical Staff.jpg|''Medical Staff'']] and [[:File:Nursing and Midwifery Staff.jpg|''Nursing and Midwifery Staff'']] maps have been drawn up using these data. These maps show the staff by region, making no difference between those working at the National Health System and those working at private health insurances. The National Statistics Institute offers the coordination joint figures for some regions as their disaggregation could have been affected by sampling errors. <li style="display: inline-block"><div style="text-align:right"><div style="color:MediumBlue"><div style="padding-top: 0em; padding-right: 7em; padding-bottom: 0.2em; padding-left: 0em>'''NATIONAL HEALTH SYSTEM STAFF'''</div>{| cellspacing="0" cellpadding="0" style="margin-top: 0; margin-right: 0px; margin-bottom: 0em; margin-left: 20px; float:right" | style="vertical-align: top; border-style: solid; border-width: 1px; border-color: #A7A7A7; background-color:#ffffff" |<div style="padding-top: 0.1em; padding-right: 0.5em; padding-bottom: 0.3em; padding-left: 0.5em; font-size: 100%; text-align: center; float:right"> {| style="margin-right: 0px; width:100%;margin-left: 0px; font-size:12px; float:right"|-!colspan="2" style="color:MediumBlue; background:LightGoldenrodYellow; text-align:center; border: solid; border-width: 1px;| '''National Health System medical staff'''|-| style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px; width:350px"| Primary health care || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px" | 42.774|-| style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px; width:350px"| Hospitals (1) || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px" | 85.467|-| style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px; width:350px"| Emergencies (2) || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px" | 3.276|-!colspan="2" style="color:MediumBlue; background:LightGoldenrodYellow; text-align:center; border: solid; border-width: 1px;| '''National Health System nursing staff'''|-| style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px; width:350px"| Primary health care || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px" | 38.016|-| style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px; width:350px"| Hospitals (1) || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px" | 153.433|-| style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px; width:350px"| Emergencies (2) || style="background:#ffffff; color:#000000; text-align:center; border: solid; border-width: 1px" | 3.333|}<div style="padding-top: 0.1 em; padding-right: 0.5em; padding-bottom: 0.0 em; padding-left: 0.5em; font-size: 100%; text-align: left"><small style="color:#959595">(1) Associated doctors and nurses, not including collaborating personnel</small> </div><div style="padding-top: 0.2 em; padding-right: 0.5em; padding-bottom: 0.0 em; padding-left: 0.5em; font-size: 100%; text-align: left"><small style="color:#959595">(2) Doctors and nurses of 112 and 061 and 112 emergency telephone numbers</small> </div><div style="padding-top: 0. 0 em; padding-right: 0.5em; padding-bottom: 0.1em; padding-left: 0.5em; font-size: 100%; text-align: left"><small style="color:#959595">Source: Statistics portal. Management Intelligence Area. Ministry of Health</small>|}</div></ul></div>On the other hand, statistics from the Ministry of Health on medical and nursing personnel have been used. However, they only include staff working at the National Health System. This data source is not comparable to the above-mentioned National Statistics Institute data source, as it uses a different data collection methodology. Nevertheless, these Ministry of Health statistics do include the different tasks of the professionals: primary care, hospitals and emergency services. The map on Physical resources [[:File:National Health System medical staff.jpg|''National Health System medical staff'']] included 131,517 professionals towards the beginning of out-2020. 32.5% of-hospital these worked in primary care, 65% in hospitals and 2.5% in 112 and 061 emergency telephone number services . The information for this indicator is mapped by region and shows the out-different rates per thousand inhabitants. The national average is 2.8 doctors per thousand inhabitants. Most of the regions in the northern half of-hospital emergency centres Spain are above the average. Andalusia (Andalucía) and the coordination Canary Islands (Canarias) are the regions with the lowest ratios. The [[:File:NNational Health System nursing staff.jpg|''National Health System nursing staff'']] included 191,452 professionals, distributed unevenly across the above-mentioned three sectors. 78.8% of 061 this personnel worked in hospitals, whilst 19.5% worked in primary care and 1.7% of the staff worked in 112 and 061 emergency telephone numbersnumber services. The amount of nursing staff follows a very similar spatial pattern to that of doctors: the national average lies by 4.1 per thousand inhabitants, and the regions that exceed this average are in the northern half of Spain. In addition to human and material resources, another actor that played a crucial role during the first wave of the pandemic shall be mentioned: solidarity. It came from different sources, sometimes driven from above by public and private organisations, sometimes from within society itself, either individually or in groups. It would be preposterous to assess whether the resources that existed prior to the pandemic were proportional to the challenge this new situation presented. It is worth noting that the scale and severity of the impact was very difficult to foresee, so it was necessary to optimise all available resources and to be very diligent in providing new ones in extremely difficult times. It shall be noted that the public authorities and Spanish society in general responded to the challenge of the pandemic with the forces available at the time and with an extraordinary spirit of solidarity.<div><ul style="text-align: center"> <li style="display: inline-block">[[File:Spain_National-Health-System-medical-staff_2019_map_18445_eng.jpg|left|thumb|300px|Map: National Health System medical staff. 2019. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_National-Health-System-medical-staff_2019_map_18445_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_National-Health-System-medical-staff_2019_map_18445_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18445.s18445&i2=c12955.c12955&t=A02&t2=A02&view=map10 Interactive version].]]</li><li style="display: inline-block">[[File:Spain_National-Health-System-Nursing-staff_2019_map_18446_eng.jpg|left|thumb|300px|Map: National Health System Nursing staff. 2019. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_National-Health-System-Nursing-staff_2019_map_18446_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_National-Health-System-Nursing-staff_2019_map_18446_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18446.s18446&i2=c12959.c12959&t=A02&t2=A02&view=map10 Interactive version].]]</li><li style="display: inline-block">[[File:Spain_Medical-staff_2020_map_18423_eng.jpg|left|thumb|300px|Map: Medical staff. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Medical-staff_2020_map_18423_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Medical-staff_2020_map_18423_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s18445.s18445&i2=c12955.c12955&t=A02&t2=A02&view=map10 Interactive version].]]</li><li style="display: inline-block">[[File:Spain_Nursing-and-midwifery-staff_2020_map_18424_eng.jpg|left|thumb|300px|Map: Nursing and midwifery staff. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Nursing-and-midwifery-staff_2020_map_18424_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Nursing-and-midwifery-staff_2020_map_18424_eng.zip Data]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r12950.r12950&i2=c12951.c12951&t=A02&t2=A02&view=map10 Interactive version].]]</li></ul></div> {{ANEAutoria|Autores= José Sancho Comíns}}{{ANESubirArriba}}{{ANENavegacionHermanos|anterior=[[Population, human settlements and comorbidities]]|siguiente=[[First COVID-19 cases]]}} {{ANEPaginaDescargas (monografía COVID-19)}}[[es:Recursos sanitarios antes de la llegada de la pandemia]][[Category:Social facilities]]