Health Care Austerity Measures in Times of Crisis: The Perspectives of Primary Health Care Physicians in Madrid, Spain

Int J Health Serv. 2016;46(2):283-99. doi: 10.1177/0020731415625251. Epub 2016 Jan 28.


The current financial crisis has seen severe austerity measures imposed on the Spanish health care system, including reduced public spending, copayments, salary reductions, and reduced services for undocumented migrants. However, the impacts have not been well-documented. We present findings from a qualitative study that explores the perceptions of primary health care physicians in Madrid, Spain. This article discusses the effects of austerity measures implemented in the public health care system and their potential impacts on access and utilization of primary health care services. This is the first study, to our knowledge, exploring the health care experiences during the financial crisis of general practitioners in Madrid, Spain. The majority of participating physicians disapproved of austerity measures implemented in Spain. The findings of this study suggest that undocumented migrants should regain access to health care services; copayments should be minimized and removed for patients with low incomes; and health care professionals should receive additional help to avoid burnout. Failure to implement these measures could result in the quality of health care further deteriorating and could potentially have long-term negative consequences on population health.

Keywords: austerity; financial crisis; spain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Deductibles and Coinsurance / economics
  • Delivery of Health Care / economics*
  • Economic Recession*
  • Health Services Accessibility / economics*
  • Humans
  • Interviews as Topic
  • Physicians / psychology*
  • Primary Health Care / economics*
  • Qualitative Research
  • Quality of Health Care
  • Spain