The National Health System Managed Nearly 80% of Hospital Admissions in 2022
The Spanish Ministry of Health has released an analysis of data related to hospitals and specialty centers in Spain, including bed capacity, annual costs, and a decade-long evolution from 2013 to 2022.
The report shows that Spain has a total of 751 hospitals, with 449 (60%) forming part of the National Health System (SNS).
Altogether, hospitals offer 155,077 installed beds, with 82.5% (126,004) within the SNS network and 17.75% (29,073) in the private sector. The total number of beds per 1,000 inhabitants decreased slightly, from 3.30 in 2013 to 3.24 in 2022. During the same period, outpatient care processes increased from 41.72% to 48.30%.
Changes in the number of healthcare professionals
SNS hospitals and their satellite centers employ 585,253 professionals, with 98.2% as permanent staff. Private hospitals employ 74,597 staff directly, while 34,379 professionals provide services through non-salaried agreements.
SNS hospitals employ 93,199 doctors, compared to 8,525 in private hospitals, for a total of 101,764 physicians.
In relative terms, including all medical services, the number of doctors per 100 beds stands at 81.3 in the SNS and 33.3 in the private sector. In 2013, these figures were 70 and 21 per 100 beds, respectively.
Similarly, nursing staff in the SNS increased from 120 per 100 beds in 2013 to 150 in 2022. For acute care hospitals, this ratio is now 172 nurses per 100 beds in the SNS. In private hospitals, nursing staff grew from 48 to 70 per 100 beds over the same period, currently reaching 91 per 100 beds in acute care facilities.
In acute care hospitals, nursing assistants also saw an increase, with 122 per 100 beds in the SNS (compared to 97 in 2013) and 87 in the private sector (up from 61 in 2013).
5.2 million hospital admissions in Spain
The SNS managed 4.1 million hospital admissions, with an average stay of 7.8 days, and performed 3.5 million surgeries, 49% of which were outpatient procedures.
Private hospitals handled 1.1 million admissions with an average stay of 5.4 days. Of these, 20% were funded by the SNS, a figure that has remained stable over the decade.
Regarding surgical activity, private hospitals performed 1.7 million surgeries, 643,182 (38%) of which were outpatient procedures. Of these, 25% were publicly funded—a decrease of three percentage points since 2013.
For specialist consultations, the SNS managed 78% of the 112 million total visits in 2022, a 24% increase compared to 2013.
Increase in emergency care
Over the decade, the number of emergency visits to hospitals rose from 25.9 million to 31.2 million annually.
In 2022, SNS hospitals handled 22.7 million emergency cases, while private hospitals treated 8.4 million. The percentage of patients admitted after emergency visits was 10.8% in public hospitals and 4.4% in private ones.
Hospital deaths totaled 236,295, representing about 50% of all deaths, a percentage that has remained stable throughout the decade.
Hospital spending driven by staff and procurement
Total hospital spending in Spain reached €60.5 billion in 2022, with €53.6 billion for public hospitals and €6.9 billion for private ones.
In public hospitals, the largest expense is personnel costs (47.3%), followed by operational expenses (36%), nearly half of which corresponds to pharmaceutical purchases.
In private hospitals, procurement represents the largest expense (43%), with pharmaceuticals accounting for 17% of this amount, followed by personnel costs (37.5%).
The annual bed cost for SNS acute care hospitals is approximately €244,847, a 17% increase since 2013.
Hospitals with more than 1,000 beds have an annual bed cost of €277,173, while those with fewer than 200 beds cost €187,369 per bed annually.
Annual Bed Cost Approaches €245,000, a 17% Increase Since 2013
Satisfaction with primary care rises to 84.2%
The Ministry also recently published the third wave of the 2024 Health Barometer, indicating that satisfaction with the public health system scored 6.1 out of 10.
The Barometer shows that 54.6% of the general population positively evaluates the functioning of healthcare in Spain. Public health system satisfaction, measured on a scale of 1 to 10, is at 6.1 points. Emergency services (061/112) and inpatient care in public hospitals received the highest ratings, at 7.31 and 7.13 points, respectively.
While those who use the services report positive experiences, general public perception remains lower for primary care and outpatient specialist consultations.
The decline in public opinion observed after the pandemic seems to have stabilized, particularly in primary care, which was previously one of the most highly rated services with a score of 7.3 out of 10.
