Health technology assessment in Spain

The Spanish Constitution of 1978 established a healthcare system available to everyone and free at the point of service. The General Health Law of 198 6 also established the framework for a National Health System (NHS). The Co nstitution and the law form the regulatory framework for the devolution of healthcare services to the Autonomous Regions. All the 17 Autonomous Region s have complete power regarding public health and planning. However, respon sibilities on healthcare financing, organization, provision, and management have devolved to only seven Autonomous Regions. Financial support for heal th services comes mostly from taxes. Global budgets are a mechanism used by hospitals to control the acquisition of medium and low health technology. Major capital investments for health technology are controlled by the centr al government in 10 Autonomous Regions (population coverage of 38%) and by the Regional Health Services in the seven remaining Autonomous Regions. In 1995 a regulation for basing the introduction of new procedures and medical equipment on the assessment of safety, efficacy, and efficiency was issued . Hearth technology assessment (HTA) has a long history in Spain, beginning with the Advisory Board on High Technology in the government of Catalonia in 1984. This board evolved into the Catalan Agency for HTA (CAHTA) in 1994 . The Basque Country established a unit for HTA in 1992 (Osteba) and the An dalusian government created an agency in 1996 (AETSA). A national agency fo r HTA (AETS) was established in 1994. These different programs coordinate t heir work and together act as an Advisory Committee of the Interregional Co uncil of the NHS.