Reformas pendientes en la organización de la actividad sanitaria

The recent evolution of the healthcare organization in Spain is outlined, analyzing and illustrating with examples, healthcare innovation. The emphasis of the article is placed on healthcare management, both in terms of its quality and in the consideration of the impact of this quality on health outcomes. The limitations of public management, which influence the characteristics of healthcare management, are addressed, and the relative institutional deterioration of Spain is recalled in order to propose the measures that will allow improving the quality of its government. It concludes with two chosen big ways of improvement of healthcare management: the one centered in the public financing and the ones that pursue to make individually attractive what is socially convenient.