care professionals. a health area may be exclusively focused on primary care or may include specialists as well. some autonomous communities use different term, such as direction of a sector (dirección de sector), or of a comarca, district, department, or other territorial unit used in that autonomous community. basic health zones cardiac auscultation, a protocol used in primary care for initial diagnosis of diseases and syndromes of the heart. although the autonomous communities differ among themselves in layering subdivisions of their health areas, all eventually come down to a health zone (zona de salud) or basic health zone (zona básica de salud) as the unit for a primary health care team. in andalusia, for example, each existing basic health zone takes care of a population between 5,000 and 20,000 inhabitants. the basic health zone is served by a single general hospital and specialists' center. primary care article 12 of the law of cohesion establishes the concept of "primary care," the basic level of patient care that guarantees the comprehensiveness and continuity of care throughout the patient's life, acting as manager and coordinator of cases and regulator of issues. primary care includes health promotion, health education, prevention of illness, health care, maintenance and recuperation of health, as well as physical rehabilitation and social work. primary health care includes service provided either on-demand, scheduled, or urgently, both in the clinic as well as in the patient's home. specialized care article 13 of the law of cohesion regulates characteristics of health care offered in spain by medical specialists, which is provided at the request of primary care physicians. this may be in-patient hospital care or out-patient consultation at specialist centers or day hospitals. it includes care, diagnosis, therapy, rehabilitation and certain preventive care, as well as health promotion, health education and prevention of illness whose nature makes it appropriate to handle at this level. specialized care guarantees the continuity of integrated patient care once the capabilities of primary care have been exhausted and until matters can be returned to that level. insofar as patient condition allows, specialized care is offered in out-patient consultation and in day hospitals. as of 2010, spain recognizes fifty distinct medical specialties. social-health care article 14 of the law of cohesion defines social-health care (atención sociosanitaria) as the combination of care for those patients, generally those with a chronic illness, whose would benefit from the simultaneous and synergistic provision of health services and social services to increase their personal autonomy, palliate their limitation or hardships, and facilitate their social reinsertion. this group includes: a) longterm health care. b) health care connected to convalescence. c) rehabilitation after illness registered health professionals 2000 data from the ine (spain's national institute of statistics) counts 616,232 individuals credentialed by a professional association as health care professionals. the largest number of these are nursing professionals; that is also the profession with the highest percentage of women. the following table is a breakdown of some of the ine statistics. no exact breakdown is available to indicate what number of these might be related to mental health and psychotherapy or clinical psychology. registered health professionals 2008 type of associationmalesfemalestotal physicians 119,018 94,959 213,977 dentists 14,575 11,122 25,697 podiatrists 2,292 2,735 5,027 physiotherapists 10,102 21,127 31,229 nursing professionals 41,719 208,420 250,139 veterinarians 16,806 11,382 28,188 pharmacists 18,409 43,566 61,975 total 222,922 413,321 616,232 health establishments healthcare centers royal decree 1277/2003, of 10 october, establishes the general bases for authorization of health centers, services and establishments. it defines "healthcare center" (centro sanitario) as the organized combination of technical means and installations in which trained professionals, identified by their official certification or professional qualification, undertake basic health care activities with the purpose of improving people's health. these may be integrated into one or more health services, which constitute its healthcare portfolio. consultorios certain healthcare centers (centros sanitarios) are referred to as consultorios, a term roughly equivalent to british english "surgery" or american english "doctor's office." these are offices that, while not full-fledged health centers (centros de salud), nonetheless provide care beyond primary care. some terms used are consultorios rurales, consultorios locales, and consultorios periféricos (respectively, rural, local and "peripheral"; that last means a center located in a community other than the main settlement of a municipality), but other terms may exist, analogous to those that refer to various types of health centers. according to the 2008 national catalog of hospitals (catálogo nacional de hospitales 2008), spain in 2007 had a total of 10,178 consultorios that allowed health professionals to provide more local services than the health centers in their respective zones, with the purpose of bringing basic services closer to people who reside in nuclei dispersed through rural areas that tend to have an older than average population. health centers health center in ansoáin (navarre) a health center (centro de salud, distinct from the smaller "healthcare center" centro sanitario) in spain's sns is main physical and functional structure devoted to coordinated global, integral, permanent and continuing primary care, based in a team of health care professionals and other professionals who work there as a team. health centers basically practice the general medicine or family medicine, providing a unity of care in which a specialist in community and family medicine is responsible to provide preventive care, health promotion, diagnosis and basic treatment on an outpatient basis. according to the 2008 national catalog of hospitals (catálogo nacional de hospitales), in 2007 spain had 2,913 health centers. specialized centers specialized centers are healthcare centers where different health care professionals provide services to particular group identified by common pathologies, age, or other common characteristics. among these are: dental clinics focused on care of the teeth and mouth. centers for assisted human reproduction biomedical teams focused on assisted reproductive technology. centers for voluntary interruption of pregnancyprovide abortion services in legally permitted cases. hemodialysis machine. centers for major outpatient surgery provide surgery and subsidiary services including general, local and regional anesthesia and sedation. for surgeries that require only brief post-operative care and therefore do not require overnight hospitalization. dialysis centers for patients with failed kidneys. diagnostic centers dedicated to diagnostic, analytic and imaging services. mobile health care centerscarry human and technical means for the purpose of health care activities. transfusion centers carry out all activities related to the extraction and verification of human blood and its components, and of treatment, storage, and distribution. tissue banks conserve and guarantee the quality of tissues after they are obtained and until they are used as allografts or autografts. medical inspection centers (centros de reconocimiento médico), where examinations and other tests of ability are carried out for applicants or holders of medical and other health care permits or licenses. mental health centers diagnose and treat mental illness on an outpatient basis. specialized health care establishments specialized health care establishments are private centers that provide a suite of health care products, ranging from medicines to sophisticated prostheses. these establishments are grouped by specialty and, on that account, must have accredited or certified technical personnel. among these establishments are: pharmacies private establishments operated in the public interest, subject to health care planning established by the autonomous communities, which provide the public with basic services recognized in article 1 of law 16/1997, of 25 april, that regulates pharmacy services (ley 16/1997, de 25 de abril, de regulación de los servicios de las oficinas de farmacia). botiquines(singular: botiquín) are authorized to hold, conserve and dispense medicines and health care products in places where there would be special difficulties of accessibility of a pharmacy. optometric offices (ópticas) evaluate visual capacity using optometric techniques; crafting, sale, verification and control of adequate means for the prevention, detection, protection, and improvement of visual acuity. orthopedia centers dispense orthopedic health care products such as prostheses and orthotics, technical devices to alleviate loss of autonomy, functionality, or physical capacity. audioprosthesis centers dispense health care products, intended for the correction of auditory deficiencies, such as hearing aids, with adaptation individualized to each patient. hospitals hospital general torrecárdenas, almería. asisa private clinic in seville. children's hospital in seville. a hospital is a health care establishment that provides inpatient care and specialized (and other) care, providing such services as are needed in its geographical area. a hospital can be a single structure or a hospital complex, even including branch buildings off of its main campus; it can also integrate any number of specialized centers. a similar concept to a hospital is a clinic. in spain, a clinic (clínica) is a health center, typically a private one, where patients can receive health coverage in a broad range of specialties. some of these clinics include very up-to-date operating theaters capable of providing minimally invasive surgery, and "hospitalization zones" where patients can recuperate on an inpatient basis. in large spanish cities, there are numerous clinics. these are the facilities that are normally used by health care professionals whose medical societies cover it: asisa, adeslas, etc. the general health law of 1986 establishes that the level of specialized care provided in hospitals and their dependent specialty centers will focus care on complex health problems. hospital centers will develop, besides their functions strictly related to health care, functions of health promotion, prevention of illnesses and investigation and teaching, in accord with the programs of each area of health, with the object of complementing their activities with those developed by the primary care network. as elsewhere in the world, the size of hospitals in spain is often gauged by the number of "installed beds" (camas instaladas). this is the number of hospital beds with fixed locations; at any given time, some beds may be out of commission. general and specialized hospitals general hospitals treat a broad range of pathologies and typically provide services including surgery, obstetrics and gynecology, and pediatrics. other hospitals are more specialized. the following list includes most of the common types of specialized hospitals in spain, but is not intended to be exhaustive. surgical hospitals medical-surgical hospitals maternity hospitals children's hospitals maternity and children's hospitals (materno-infantil) psychiatric hospitals hospitals for illnesses of the thorax oncological hospitals ophthalmic hospitals traumatological and rehabilitation hospitals psycho-physical rehabilitation hospitals geriatric and longterm care hospitals leprological and dermatological hospitals health care contracts spanish government-run healthcare administrations sign health care contracts (conciertos sanitarios) with privately run entities that provide health care services. they are regulated by the provisions of the general health law and the current rules of government contracting. there are some special cases where the relation between the hospital and the managing entity is regulated by a special arrangement called a convenio de vinculación or convenio singular ("linkage convention" or "singluar convention"). in catalonia there are also centers integrated into the network of hospitals for public use (red de hospitales de utilización pública, xhup) as outlined in the supplement to decree 124/2008 of the department of health of the autonomous government of catalonia (anexo del decreto 124/2008 del departamento de salud de la generalitat de catalunya). patrimonial dependency the patrimonial dependency (dependencia patrimonial) of a hospital (or other health care facility) is the individual or other juridical entity that owns, at least, the building occupied by the facility. hospitals that are under the dependency of spanish social security belong primarily to the general treasury of social security, although there is a special group within social security for the mutuals of accidents and occupational diseases (mutuas de accidentes de trabajo y enfermedades profesionales, matep). there are also a few cases where patrimony is shared by two or more public entities on a consortium basis. the 2009 national catalog of hospitals contains information about the patrimonial dependency of hospitals, summarized as follows; hospital complexes are each counted here as a single hospital: patrimonial dependency number of centers number of beds civil, public (sns) 301 103,655 ministry of defence 8 1,458 matep 22 1,741 private, charitable 120 19,980 private, non-charitable 349 33,458 total 804 160,292 40 percent of stays in private hospitals are arranged and paid for by the public system. the 2008 national catalog of hospitals gives the following breakdown of types of hospitals. type of care number of hospitals number of beds beds per 100,000 population percent in thepublic system acute illness 591 131,510 290.5 72.1% psychiatric 90 16,028 35.5 37.5% geriatric 119 12,945 28.7 34.2% high technology resources positron emission tomography (pet) scan of a typical brain.