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Vol. 14. Issue 5.
Pages 311-312 (September - October 2018)
Vol. 14. Issue 5.
Pages 311-312 (September - October 2018)
Letter to the Editor
DOI: 10.1016/j.reumae.2017.10.001
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Status of Rheumatology in Spain in 2017: 2.0 Rheumatologists per 100 000 Population
Estado de la reumatología en España en 2017: 2,0 reumatólogos por 100.000 habitantes
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Carlos Sanchez-Piedraa, Beatriz Yoldib, Marta Valeroc, José Luis Andreud, Federico Díaz-Gonzáleza,e,
Corresponding author
, Juan Jesús Gómez-Reinoa, on behalf of the Grupo de trabajo BIOBADASER Fase III
a Unidad de Investigación, Sociedad Española de Reumatología, Madrid, Spain
b Servicio de Reumatología, Hospital Universitari Dexeus-Grupo Quirón Salud, Barcelona, Spain
c Servicio de Reumatología, Hospital Ramón y Cajal, Madrid, Spain
d Servicio de Reumatología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain
e Servicio de Reumatología, Hospital Universitario de Canarias, Canarias, Santa Cruz de Tenerife, Canarias, Spain
Related content
Reumatol Clin. 2018;14:38210.1016/j.reumae.2018.10.015
Carlos Sanchez-Piedra, Beatriz Yoldi, Marta Valero, José Luis Andreu, Federico Díaz-González, Juan Jesús Gómez-Reino
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Table 1. Rheumatologists by Spanish Autonomous Community. Rate of the Number of Rheumatologists per 100 000 Population.
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To the Editor,

The commission on professional relations, private practice and services to the members of the Spanish Society of Rheumatology (SER) is searching to offer updated data on the status of our specialty in Spain. For this purpose, we commissioned the Research Unit of the SER to estimate the number of rheumatologists currently available in Spain per 100 000 population, assuming that 95% of the rheumatologists are members of the SER.

The number of specialists available per 100 000 population is an indicator of the health recourses that are utilized for the evaluation and organization of health care systems.1,2 While this data is objective, there is certain controversy as to its true utility since there is no suitable standard in our neighboring countries.3

Table 1 shows the number of rheumatologists per 100 000 population in each of the Spanish autonomous communities and the sum total. The figure for Spain as a whole reaches a ratio of 2 rheumatologists per 100 000 population. The autonomous community with the highest ratio is the Community of Madrid, with 4.8 rheumatologists per 100 000 population, and the lowest rate is that of Castile and Leon, with 0.6 rheumatologists per 100 000 population.

Table 1.

Rheumatologists by Spanish Autonomous Community. Rate of the Number of Rheumatologists per 100 000 Population.

Autonomous community  Numbers of full members per AC  Population by AC in 2017a  Proportion of rheumatologists per 100 000 population 
Andalusia  140  8 478 439  1.7 
Aragon  29  1 191 533  2.4 
Principality of Asturias  27  983 186  2.7 
Cantabria  23  530 271  4.3 
Castile-La Mancha  20  2 280 518  0.9 
Castile and Leon  14  2 494 790  0.6 
Catalonia  184  5 309 173  3.5 
Ceuta  84 963  2.4 
Community of Madrid  211  4 374 970  4.8 
Valencian Community  81  3 597 647  2.3 
Extremadura  16  1 481 480  1.1 
Galicia  60  2 690 328  2.2 
Balearic Islands  13  675 595  1.9 
Canary Islands  39  1 614 686  2.4 
La Rioja  275 034  2.9 
Melilla  84 509  1.2 
Region of Murcia  29  1 274 834  2.3 
Chartered Community of Navarre  12  534 490  2.2 
Basque Country  39  1 868 855  2.1 
Total  –  46 771 345  2.0 
a

Data from the Spanish Institute of Statistics.

The results obtained in the analysis, using the database of members of the SER, assuming that 95% of the rheumatologists are members, establish a rate of 2.16 rheumatologists per 100 000 population, which, in practice, signifies the stagnation in the availability of rheumatologists in Spain. Our results are in keeping with those of the work carried out at the University of Las Palmas in the Canary Islands with data from 2006.4 The results we encountered are also similar to those reported by Pérez and López-Valcárcel in 2008, who moreover offer ratios according to autonomous communities.5 The figures presented here are the first offered for Spain from those works. The analysis carried out in this report does not enable us to determine the reasons for this stagnation in the number of rheumatologists in Spain since 2008, but a possible factor could be the present economic circumstances, with major restrictions.

This situation occurs in a context of an aging population, a determining factor that has motivated, among others, the introduction of EPISER 2016, a project that studies the prevalence of rheumatic diseases 16 years after launching the first version of the same study.6 The increasing prevalence of rheumatic diseases in a context of an aging population can translate into an increase in the demand for health care and into the need for more human recourses to attend to this situation.7,8 The data obtained in EPISER, in combination with the results of this work, may be useful in decision making in the context of health systems.

This report has certain limitations. Although the database utilized is based on the information provided by members of the SER, there can be some imprecisions, aside from the margin of error, which has been considered minimal. For the analysis of these results, we must take into account that it has been assumed that 95% of the rheumatologists in Spain are members of the SER and are included in the organization's database. A deviation of 10% (that is, that there were another 95 rheumatologists not included in the database of members of the SER) would suppose that the number of rheumatologists per 100 000 population in all of Spain could reach 2.2. To achieve 2.5 rheumatologists per 100 000 population in all of Spain, there would have to be 221 rheumatologists not associated with the SER.

In conclusion, although the interpretation of the number of specialists per 100 000 population may be controversial, the results of this report enable us to evaluate how rheumatology is facing the health care challenges that are being presented in recent years, and that will not be detained in the near future. The potential sociodemographic changes, which could affect the prevalence of rheumatic diseases, make further work necessary to enable us to analyze not only the present situation, but to also consider the future outlook of rheumatology in Spain.

References
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U.S. Department of Health and Human Services.
Physician workforce policy guidelines for the United States, 2000–2020. Sixteenth report.
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Steady state—finding a sustainable balance point: international review of health workforce planning.
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Dificultades, trampas y tópicos en la planificación del personal médico.
Gac Sanit, 22 (2008), pp. 393-395
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Oferta y necesidad de médicos especialistas en España (2006-2030).
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Oferta y necesidad de especialistas médicos en España (2008-2025).
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EPISER 2016 study: why another epidemiological study?.
Reumatol Clin, 13 (2017), pp. 1-3
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Estratificación pronóstica y abordaje asistencial de los pacientes pluripatológicos.
Rev Clin Esp, 217 (2017), pp. 410-419
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P. Lázaro y de Mercado, A.J. Blasco Bravo, I. Lázaro y de Mercado, S. Castañeda, J.C. López Robledillo.
La Reumatología en la Comunidad de Madrid: disponibilidad actual de reumatólogos y necesidades futuras aplicando un modelo predictivo.
Reumatol Clin, 9 (2013), pp. 353-358

Please cite this article as: Sanchez-Piedra C, Yoldi B, Valero M, Andreu JL, Díaz-González F, Gómez-Reino JJ, en representación del Grupo de trabajo BIOBADASER Fase III. Estado de la reumatología en España en 2017: 2,0 reumatólogos por 100.000 habitantes. Reumatol Clin. 2018;14:311–312.

Copyright © 2017. Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología
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