Private healthcare manages almost half (48%) of Spain’s total healthcare spending, according to the Second ASPE Report, presented this Wednesday, and which indicates that Total spending in 2022 by the private sector was 63,617 million eurosincluding in this data the activity of the hospitals; all medical and residential establishments; providers of outpatient clinics or medical products; the provision of public health programs and health insurance.
If you stick only to spending financed exclusively by the private sector—that is, to direct payments from households and insurers—, the figure is 37,289 million euros, which represents the 28% of the country’s total health spending and 3.1% of GDP, of which households represented 73% and health insurance 24%.
The study, which carries out an x-ray of Spanish private healthcare every two years, also analyzes the weight of each provider in those more than 63,000 million euros managed by the private sector, and concludes that most of that spending comes from retail and medical product suppliers (43.8%, that is, 27,879 million). The provision of outpatient care represented 26% (16,477 million); Hospitals attended to 20% of total private health spending (12,824 million); and medical and residential care establishments, 6.5% (4,132 million euros).
Regarding health provision, which includes hospitals, clinics, laboratories, residences and outpatient clinics, the figure for the sector’s activity amounted to 33,433 million euros: more than half of the private management of total health spending.
More than half of the hospitals are private
56% of all hospitals in Spain belong to the private hospital sector, which has a total of 431 hospitals, with 49,837 beds (31% of the total) and 5,977 ICU beds (20%). Due to its healthcare model, Catalonia is the community where the private hospital sector has the greatest weight, with more than half of all healthcare activities in Spain; followed by the Balearic Islands and Madrid. In contrast are Cantabria, Castilla-La Mancha and Extremadura, which are the regions with the least private sector activity.
Furthermore, the private sector has a total of 1,696 operating rooms throughout the country (more than one in three of the total), Catalonia being, once again, the autonomy with a greater number of operating rooms in private hospitals; ahead of Madrid and Andalusia.
Along these lines, the study reveals a significant increase in highly complex activities carried out in private centers: from the 4.4 million tests that were carried out in 2021 to 4.7 million in 2022. That is, a 7.7 % more in just one year. An increase that is detected in all diagnostic tests performed with high-tech equipment, such as magnetic resonance imaging, 49% of which are carried out privately; mammograms (39%); or CT scans (24%).
Also in healthcare activities, the hospital sector carries out a large number of surgical interventions in the entire Spanish healthcare system: 42% of all those performed in the Spanish healthcare system, specifically. Likewise, it manages 34% of emergencies and 30% of consultations, stays and discharges in Spain.
More than 400,000 employees and 5% of MIR positions
The report also shows that Spain already has the highest number of employees in the private sector since there are records, after increasing the number of employees by 53% in the last decade. According to data from 2024, the private healthcare sector already employs more than 462,400 professionals, of which around one in three (159,042) work in hospitals: 33% are doctors, 19% are nurses, other health workers represent 29% and 19% are non-health workers.
In the field of training, the number of hospitals with teaching accreditation has also grown (46% since 2015, to 88 this last year), as well as accredited MIR places, which are already 57% more than there were almost ten years ago, thus representing 5% of the total places for internal resident doctors offered in the country.
Waiting times
ASPE also indicates that waiting times in private healthcare are “significantly lower” than those recorded in public healthcare. Specifically, seven out of ten private patients wait less than 15 days from the moment a surgical operation is prescribed until they undergo surgery (compared to 121 days in public healthcare); and more than one in four wait less than a week.
Regarding diagnostic tests81% of private patients usually wait less than two weeks and almost half obtain the results in less than five days; compared to the average 94 days one has to wait in public to undergo a test with the same characteristics.
9,521 million for concerts
In 2022, the public administration allocated 9,521 million euros to the concert item (private provision and public service), which represents 10% of health spending. However, according to ASPE, the proportion allocated by the public administration to this item has been decreasing over the years, since in 2013 it represented almost 12% of health spending. By activity, 61% corresponds to hospital services, another 17% to specialized services, 13% to the transfer of patients, 6% to primary health services and 3% to prostheses and therapeutic devices.
Catalonia is the region that spends the most per capita on concerts (423 euros), followed by Madrid (204 euros) and the Canary Islands (36 euros); while Cantabria (63 euros), La Rioja (59 euros) and Castilla y León (57 euros) are the ones that allocate the least.