Around 1990, during a period when the Baix Vinalopó health system was grappling with bed shortages, a new inpatient unit opened at Elche university hospital. At that time, the Orihuela hospital was planned, but the additional resources it would bring could not yet be relied upon. It was striking to see this type of unit presented on TVE during the three o’clock news on Thursday, April 28, and to learn about the attention given to the La Paz hospital. The message suggested that Madrid’s healthcare system knew how to respond to extraordinary circumstances and that such a valuable unit had a lasting place in the system .
For many residents outside Madrid, the phrase Madrid is Spain within Spain can feel elusive. The president’s rhetoric, echoed by television audiences, seemed to frame Madrid as a mirror of the nation. Some observers argue that this perception obscures the diverse realities across the country, especially for people living down the M-30 who notice regional differences in healthcare delivery. This viewpoint invites a reflective consideration of how Madrid is understood in relation to the broader country .
If TVE had aimed to shed light on the benefits of the home hospitalization system, it might have highlighted communities with a deeper tradition and broader presence. Data from the Spanish Home Hospitalization Association shows that several regions maintain a substantially larger footprint. Madrid operates eight home hospitalization units, while Catalonia and the Community of Valencia each run 27 units, a scale proportional to their populations. In effect, Valencia’s region demonstrates a much more extensive adoption of home hospitalization than Madrid .
The noteworthy aspect is not merely that La Paz adopted home hospitalization, but that Madrid’s adoption occurred quite late in 2020. The first unit in Spain was established at Gregorio Marañón in 1981, after which there was a pause, leaving Madrid behind in implementing these helpful services. The situation resembles a sudden uplift that could have caused embarrassment but instead generated a sense of pride for those who saw the value and kept elevating it .
One possible explanation for Madrid’s slower start lies in funding. In the Community of Valencia, resources were managed from the outset to maximize efficiency without compromising the quality of service to citizens. In contrast, Madrid faced the luxury of distributing resources elsewhere, sometimes resulting in a perceived financial balancing act among autonomous communities. In this view, prudent resource allocation helped Valencia sustain high standards while expanding access to home hospitalization across more communities .
Experts echo the view that this model should be expanded, a sentiment voiced by Manuel Mirón, president of the Spanish Home Hospitalization Association, in public coverage. Those who anticipated the need for home hospitalization could attest not only to the quality of care but also to its humane presentation. The broader media landscape is urged to acknowledge realities beyond the closest urban center, recognizing that meaningful, efficient health care exists outside Madrid and that intelligent life thrives throughout the country .