More than 80% of people who have used the public health system rate the care they received positively

The Ministry of Health has published the results of the first wave of the Health Barometer 2025, a survey carried out in collaboration with the Sociological Research Centre (CIS), which provides key information on the public's perception of the health system. This edition is based on 2,452 interviews conducted in April 2025.

Overall assessment of the health system and public satisfaction

The overall assessment of the functioning of the public health system in Spain remains stable with respect to previous waves. According to data from the Health Barometer 2025, 53.9% of the population considers that the system works well or fairly well, while 45.1% believe that it needs major or in-depth changes. This stability in overall perception exists, however, alongside a certain polarisation of opinions, reflecting citizens' expectations and the ongoing challenges in aspects such as waiting times and accessibility.

When looking at the opinion of people who have used public health services in the last 12 months, perception improves significantly. 80.7% of the population reported having gone to primary care and 44.7% to hospital care. At both levels of care, more than 80% of users rate the care received positively, which reinforces confidence in the system based on direct experience.

This contrast shows that people's perceptions of the performance of the health system are more critical when not based on recent use of its services. On the other hand, those who have actually accessed public healthcare report a high level of satisfaction, highlighting in particular the professionalism, safety and trust conveyed by healthcare professionals. This difference suggests that direct experience with the system helps to consolidate a more favourable and realistic view of the way it operates.

Assessment of services and levels of care

The 061 and 112 emergency services (7.34 points) and inpatient hospital care (7.10) top the list of the best rated services. They are followed by primary care and hospital consultations, although the latter are rated lower.

80.7% of the population have visited a public primary care doctor in the last 12 months, and 44.7% have been seen by a hospital specialist. At both levels of care, more than 80% of users rate the care received positively, highlighting the confidence and safety conveyed by the healthcare staff. In hospitalisation, 9.9% of the population has been admitted to hospital in the last year, and 81.4% rate their experience positively. In the emergency department, used by 48.4% of respondents, the degree of satisfaction was 72.8%.

Mental health: care received and citizens' perceptions

20.6% of the population has required healthcare for mental health reasons in the last year. Of these, 52% went to public healthcare, 11.6% through private insurance and 30.3% by direct payment.

In the public sector, care was mainly provided by psychiatrists (38.6%), family doctors (37.5%) and psychologists (16.6%). 60.5% were satisfied with the care received and 85.1% said it was the same or better than expected, although 24.3% said their situation did not improve.

Access to diagnostic tests and waiting times

The Barometer explores for the first time access to certain diagnostic tests for a new health problem. 23.1% of the population reported having had an ultrasound scan in the last year, 16% a CT scan, 15.2% an MRI scan and 4.8% a colonoscopy.

Waiting times vary significantly: 54.9% of ultrasound scans and 55.5% of CT scans were performed within one month of being requested, while the percentage drops to 40.1% for colonoscopies. The last of these tests, according to those interviewed, has the longest average waiting time (113 days), compared to an average of 37 days for MRI.

Problems of accessibility and inequalities

24.3% of the population stated that they had, on some occasion, had problems in accessing their family doctor. Of these cases, more than half eventually went to the emergency department, while another 30% did not attend the appointment on the date assigned to them because they no longer needed care at that point.

Coordination between levels of care is rated positively by 51.8%, while 34.1% of those surveyed consider that the waiting list situation has worsened over the last year.

In addition, 4.6% say that they have had to stop taking a prescribed medicine for financial reasons.

Confidence in the public sector, even among those with private insurance

19.7% of the people interviewed have private health insurance taken out by themselves or by a member of their family, and 9.7% have it through their company. This figure reflects the fact that a part of the population resorts to private insurance, in many cases, in search of quicker access to care or convenience in accessing certain health services. However, this choice does not necessarily imply a distrust of the public system, but is often complementary in nature.

In fact, more than 60% of those with private health insurance consider that, in the event of a serious health problem, public health care would offer better treatment. This confirms that, even among those with private coverage, there remains a high level of confidence in the ability of the public system to deliver. The perception of safety, efficiency and professional quality consolidates the public health service's position as the main reference point for dealing with complex clinical situations.

Digital health technologies and perception of artificial intelligence

32.7% of the population has accessed their medical records in the public health system, while 34.4% are unaware of this possibility and 20.6% do not have or do not know how to use digital media. 49.7% of citizens use an electronic certificate for administrative procedures, which facilitates access to services such as electronic medical records.

The National Health System's interoperable electronic prescription system is known by 66.2% of the population, but only 20.3% have used this functionality. In addition, 43.2% know that their clinical history can be consulted by health professionals in other autonomous communities in the event that they need health care.

Regarding artificial intelligence, 53.4% have heard of its application in health. The majority of those interviewed are in favour of the patient being informed about its use (85.5%) and being able to refuse the use of their data in its development (77.5%). 68% consider specific legislation on the use of AI in healthcare to be necessary.

Non official translation