EVOLUTION OF THE ACCESSIBILITY OF HEALTH CENTERS IN SPAIN. MONITORING OF THE LAST SEVENTY YEARS

INTRODUCTION: The accessibility of the population to health centers in Spain has evolved to over the past decades, linked to the welfare state and changes in the health skills. The aim of this review is to describe the evolution of accessibility and its impact on the population. METHODOLOGY: We used bibliographic databases to search for articles related to the purpose of reviewing and between 1940 and 2013. We have selected those items with higher quality and that helped to build the review of the proposed topic. RESULTS: The accessibility to health centers in Spain is linked to the performance of public attention in the last seventy years. On the one hand, the appearance of Compulsory Health Insurance (SOE) and the creation of Social Security made almost all of the Spanish population had health coverage. On the other hand, the application of principles such as justice and equity brought to the surface many hospitals with the aim of bringing the most assistance to the population. In the early twenty-first century, with an enormous growth of hospitals and a global economic crisis, we see the need to locate health facilities under the principle of spatial economic efficiency or economic rationality. CONCLUSIONS: In a current environment of crisis, the consequences of hyperaccessibility are analyzed (unsustainable health system, population polypharmacy, etc. ) and a more efficient healthcare system is searched. It is also necessary to consider the relationship between the hyperaccessibility and the frequent attendance of population to the health services, and the relationship between hyperaccessibility and polypharmacy.