Andalusia has warned the 2.8 million users who did not cancel their medical appointments: “Cancel it. Another patient will appreciate it” Andalusia spain

Amidst the crisis caused by the increase in waiting lists in Andalusia and the eternal chaos in primary care, the Ministry of Health has published a tweet in which it draws attention to the absence of patients who have not canceled their appointments with their families . Doctor. According to data published on the social network X (formerly Twitter), there were 2.8 million in 2023. “If you’re not going to keep your appointment, cancel it. The other patient will appreciate it. Remember, tomorrow you may be the one who needs that appointment,” the post said. The message was immediately questioned by sector unions, who accused the board of blaming users for the abuses of the public health service rather than focusing on managing the health care system.

“The appointments that have not been canceled should be addressed, but this is a peripheral, unimportant issue; pointing it out is a way of avoiding responsibility for the management of the Ministry of Health, when the problem is that there are no doctors. “Consultations are saturated and the shock measures that have been taken, such as health care consultations (for nurses to determine whether cases of people arriving without an appointment should be referred to a professional), are not working,” Says Rafael Ojeda, president of the Medical Union of Andalusia. From the UGT, its head in the field of health and social services, Antonio Macias, in addition to condemning the fact that the Autonomous Government “has been demanding citizens for not canceling almost three million appointments alleges abuse of health care,” questions whether “the reason for so many missed appointments” has not been seriously addressed.

According to sources, the ministry has assured that these canceled appointments have a “direct impact on the increase in waiting times” in primary care, but it is believed that the department has not quantified this impact . In August last year, the Andalusian Health Service (SAS) launched a new information system called AVSAS, accessed through the Andalusian Health application, which informs citizens about scheduled appointments for consultations or testing. Settings the diagnosis (including imaging tests) at the hospital and sends a reminder as that date approaches and also allows you to cancel or change dates. In case of primary care and paediatrics, the ministry is working on a similar system, but for now the traditional system has been maintained through that application or phone call.

Antonio Fernández-Pro, from the Spanish Society of General and Family Medicine (SEMG), unit consultant, family physician and coordinator in a health center in the province of Toledo, denied the board’s thesis that the increase is due to patient absenteeism. Timings and waiting list. Rather he thinks the opposite. “This is another consequence of waiting lists, because what is healthy is not that a patient has to cancel an appointment, what is right and healthy is that they have up to 15 days to see their doctor or seek an administrative solution.” The matter does not have to wait, “clarify. “The figure of 2.8 million is also kind of imaginary, because these people have gone somewhere else to get their problem solved, to the emergency room, to the emergency room, to stand in line in the morning to see if there is space…” he adds.

“The issue of missed appointments should not be addressed through a tweet, but from a serious perspective,” says Joan Carles March, former director of the Andalusian School of Public Health. He added, “We must reduce the period of time in which appointments take place and, of course, educate the population.” CC OO’s Daniel Gutierrez agrees on two points. “The citizen has a responsibility, but the longer you extend the deadline to make an appointment, the easier it is for them to forget it, or for you not to go because you’ve already been to the emergency room or because you’ve gone to private health care,” he explains. “We must educate the population, but not only that. Appointment times are becoming longer because there are not enough doctors or pediatricians, which is why the number of patients per doctor is low. It is necessary to do so. There are not even enough administrators to answer the calls of those who want to cancel their appointments,” he further said.

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The digital divide may also impact citizens’ problems in canceling appointments. “We had to see which profile of people did not cancel scheduled appointments. Older people usually request appointments by phone and if the lines are full, they end up calling to cancel them and they don’t know how to follow the steps in the application to make it there,” He added. “Try to cancel an appointment, it’s almost impossible,” challenged Fernandez-Pro. The doctor says that depending on the type of medical center, the area and the pressure of supported care, if the absences are more and there is a saturation of patients, absenteeism will increase and will decrease if they have the ability to be treated without waiting for weeks.

Little is known about the patient profile and causes of absenteeism. According to a study presented at the last National Congress of General and Family Medicine, held last June in Grenada, those who do not attend appointments are mostly men (63% compared to 37% women) and young: 45%. Most are under 35 years of age, 45% are between 35 and 65 years of age and 10% are over 65 years of age. The data also suggests a clear relationship between greater delay in seeing a doctor and greater absenteeism.

The Letter of Rights and Duties of Citizens prepared by the Ministry of Health does not include the obligation to cancel users’ appointments. “We don’t know what the ministry is doing to deal with the problem of appointments that have not been cancelled, but, nevertheless, they have focused on users. They don’t say that because they’re not doing anything,” Macias says. “It’s ridiculous to look at absenteeism, because it’s not a structural problem, it’s a problem caused by waiting lists,” says Fernandez-Pro.

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