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94-450: Vitoria-Gasteiz is a dynamic city with strengths in healthcare , aeronautics , the automotive industry , and viticulture . It is consistently ranked as one of the 5 best places to live in Spain, ranking highly in quality of life and business opportunities , it is the first Spanish municipality to be awarded the title of European Green Capital (in 2012) and it has been also recognized by

188-649: A basic framework for defining the sector, the United Nations' International Standard Industrial Classification categorizes health care as generally consisting of hospital activities, medical and dental practice activities, and "other human health activities." The last class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities, patient advocates or other allied health professions . In addition, according to industry and market classifications, such as

282-569: A challenge for the design of ICT (information and communication technology) for home care. Because statistics show that over 80 million Americans have taken time off of their primary employment to care for a loved one, many countries have begun offering programs such as the Consumer Directed Personal Assistant Program to allow family members to take care of their loved ones without giving up their entire income. With obesity in children rapidly becoming

376-612: A clear correlation between worse quality and higher spending. Expand the OECD charts below to see the breakdown: The management and administration of health care is vital to the delivery of health care services. In particular, the practice of health professionals and the operation of health care institutions is typically regulated by national or state/provincial authorities through appropriate regulatory bodies for purposes of quality assurance . Most countries have credentialing staff in regulatory boards or health departments who document

470-476: A drafting penalty. The mens race was won by Antonio Benito Lopez, of Spain. The women's race was won by Kat Matthews, of the UK. Vitoria-Gasteiz held the title of European Green Capital in 2012 due to the high proportion of green public areas, ensuring that the entire population lives within 300m of an open green space, its biodiversity and ecosystems services, as well as for the city's green policies. Vitoria-Gasteiz

564-609: A gain of 10 years since 1970. The US (78.7 years) ranges only on place 26 among the 34 OECD member countries, but has the highest costs by far. All OECD countries have achieved universal (or almost universal) health coverage, except the US and Mexico . (see also international comparisons .) In the United States , where around 18% of GDP is spent on health care, the Commonwealth Fund analysis of spend and quality shows

658-557: A hill at the site of the previous settlement of Gasteiz. The existence of Gastehiz , apparently inhabited by Vasconic people, can be traced back to the Middle Ages; it is certain that by the 11th century, prior to the foundation of Nova Victoria , the settlement was already walled. It is assumed that Sancho the Wise gave the new city its name in memory of the old settlement of Victoriacum, which must had long since been abandoned. In 1199,

752-441: A licensed independent practitioner such as a physiotherapist , or a non-physician primary care provider such as a physician assistant or nurse practitioner . Depending on the locality and health system organization, the patient may see another health care professional first, such as a pharmacist or nurse . Depending on the nature of the health condition, patients may be referred for secondary or tertiary care. Primary care

846-419: A major concern, health services often set up programs in schools aimed at educating children about nutritional eating habits, making physical education a requirement and teaching young adolescents to have a positive self-image. Health care ratings are ratings or evaluations of health care used to evaluate the process of care and health care structures and/or outcomes of health care services. This information

940-583: A major initiative to unite the Castilian nobility around the Reconquista. In 1195, after the treaty with the Almohads was broken, he came to the defence of Alarcos on the river Guadiana , then the principal Castilian town in the region. At the subsequent Battle of Alarcos , he was roundly defeated by the caliph Abu Yusuf Yaqub al-Mansur . The reoccupation of the surrounding territory by the Almohads

1034-560: A powerful ally against his uncle. In 1176, Alfonso asked his father-in-law to arbitrate the disputed border territories. While Alfonso received back much that had been taken from him, he had to pay significant monetary compensation. In 1186, he recuperated part of La Rioja from the Kingdom of Navarre . In 1187, Alfonso negotiated with Frederick I, Holy Roman Emperor , who was seeking to marry his son Conrad to Alfonso's eldest child and heiress, Berengaria . In April 1188, they agreed on

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1128-400: A primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care , health education , and every time they require an initial consultation about a new health problem. The International Classification of Primary Care (ICPC)

1222-633: A short period of time for a brief but serious illness, injury, or other health condition. This care is often found in a hospital emergency department . Secondary care also includes skilled attendance during childbirth , intensive care , and medical imaging services. The term "secondary care" is sometimes used synonymously with "hospital care". However, many secondary care providers, such as psychiatrists , clinical psychologists , occupational therapists , most dental specialties or physiotherapists , do not necessarily work in hospitals. Some primary care services are delivered within hospitals. Depending on

1316-989: A significant part of a country's economy , development, and industrialization . Health care is an important determinant in promoting the general physical and mental health and well-being of people around the world. An example of this was the worldwide eradication of smallpox in 1980, declared by the WHO, as the first disease in human history to be eliminated by deliberate healthcare interventions. The delivery of modern health care depends on groups of trained professionals and paraprofessionals coming together as interdisciplinary teams . This includes professionals in medicine , psychology , physiotherapy , nursing , dentistry , midwifery and allied health , along with many others such as public health practitioners , community health workers and assistive personnel , who systematically provide personal and population-based preventive, curative and rehabilitative care services. While

1410-652: A treaty in Seligenstadt , which made clear that she was the heiress of Castile after any sons of Alfonso and that Conrad would only co-rule as her spouse. That became relevant in her ultimate succession to the throne even though the marriage to Conrad was never consummated and later annulled. The treaty also documented traditional rights and obligations between the sovereign and the nobles in Castile. In July 1188, Alfonso convened his court in Carrión de los Condes to allow

1504-931: Is twinned with: Healthcare Health care , or healthcare , is the improvement of health via the prevention , diagnosis , treatment , amelioration or cure of disease , illness , injury , and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields . Medicine , dentistry , pharmacy , midwifery , nursing , optometry , audiology , psychology , occupational therapy , physical therapy , athletic training , and other health professions all constitute health care. The term includes work done in providing primary care , secondary care , tertiary care , and public health . Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions and health policies . Providing health care services means "the timely use of personal health services to achieve

1598-566: Is a compound name of its traditional names in Spanish and Basque , respectively. By inhabitants, it is still generally referred to as either Vitoria or Gasteiz , depending on the language spoken. More rarely, it may be referred to by Basque speakers as Vitorixe , a Basque form of the Spanish name. In 581 AD, the Visigoth king Liuvigild founded the city of Victoriacum, trying to emulate

1692-434: Is a mid-sized city, the line of which is adapted to the traditions of each historical moment. The medieval town is set in almond-shape around the hill foundation, which by its privileged position as the only elevation in the plain of Álava, became a defensive stronghold coveted by the kingdoms of Navarre and Castilla during the 11th and 12th centuries. The walled enclosure was built prior to the war between Castile and Navarre in

1786-494: Is a standardized tool for understanding and analyzing information on interventions in primary care based on the reason for the patient's visit. Common chronic illnesses usually treated in primary care may include, for example, hypertension , diabetes , asthma , COPD , depression and anxiety , back pain , arthritis or thyroid dysfunction . Primary care also includes many basic maternal and child health care services, such as family planning services and vaccinations . In

1880-601: Is also celebrated in late April. Each neighborhood has its festival, most of them between April and September. The liberal arts section of the University of the Basque Country is based in the south part of the city. Focusing on history and linguistics, the Álava campus is also home of the Faculty of Pharmacy, as well as some other technical, teaching and business related degrees. Its origins date back to 1847 when

1974-417: Is considered necessary, regardless of whether the funding is from private insurance schemes or national health insurance . Allied health professionals , such as physical therapists , respiratory therapists , occupational therapists , speech therapists , and dietitians , also generally work in secondary care, accessed through either patient self-referral or through physician referral. Tertiary care

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2068-574: Is often used as the term for the health care services that play a role in the local community. It can be provided in different settings, such as Urgent care centers that provide same-day appointments or services on a walk-in basis. Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health , and patients with all types of acute and chronic physical, mental and social health issues, including multiple chronic diseases . Consequently,

2162-536: Is planned to connect Vitoria-Gasteiz with the French border, San Sebastián and Bilbao within 35 minutes. However, work on this project has been slow and there is no date for its inaugural run. Vitoria Airport is 4th in Spain in cargo traffic, it also offers some domestic and international passenger destinations. Bilbao Airport is 50 minutes away by car, a direct bus line from Vitoria-Gasteiz will start operations in 2024. From an urban point of view, Vitoria-Gasteiz

2256-505: Is seen from the analysis carried out each year by Bloomberg. Clearly this kind of analysis is flawed in that life expectancy is only one measure of a health system's performance, but equally, the notion that more funding is better is not supported. In 2011, the health care industry consumed an average of 9.3 percent of the GDP or US$ 3,322 ( PPP-adjusted ) per capita across the 34 members of OECD countries. The US (17.7%, or US$ PPP 8,508),

2350-622: Is sometimes used as an extension of tertiary care in reference to advanced levels of medicine which are highly specialized and not widely accessed. Experimental medicine and some types of uncommon diagnostic or surgical procedures are considered quaternary care. These services are usually only offered in a limited number of regional or national health care centers. Many types of health care interventions are delivered outside of health facilities. They include many interventions of public health interest, such as food safety surveillance, distribution of condoms and needle-exchange programs for

2444-545: Is specialized consultative health care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital . Examples of tertiary care services are cancer management, neurosurgery , cardiac surgery , plastic surgery , treatment for severe burns , advanced neonatology services, palliative, and other complex medical and surgical interventions. The term quaternary care

2538-414: Is the late Roman military camp of Iruña-Veleia (cf. J. M. Lacarra). Veleia is located some 11 km north of modern Vitoria, on the banks of the same river. However, modern archeological studies of the site suggest that Veleia was last inhabited c.  5th century AD , and archeologists are still to find a 6th-century Visigothic resettlement in the site. Another theory has suggested that Victoriacum

2632-414: Is translated into report cards that are generated by quality organizations, nonprofit, consumer groups and media. This evaluation of quality is based on measures of: Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions as well as health policies . Providing health care services means "the timely use of personal health services to achieve

2726-631: The Conquest of Cuenca in 1177. The city surrendered on 21 September, the feast of Saint Matthew , ever afterwards celebrated by the citizens of the town. Alfonso took the initiative to ally all Christian kingdoms of the peninsula— Navarre , León , Portugal , and Aragon —against the Almohads . By the Treaty of Cazola of 1179, the zones of expansion of each kingdom were defined. After founding Plasencia ( Cáceres ) in 1186, he embarked on

2820-682: The Global Industry Classification Standard and the Industry Classification Benchmark , health care includes many categories of medical equipment, instruments and services including biotechnology , diagnostic laboratories and substances, drug manufacturing and delivery. For example, pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States. The United States dominates

2914-556: The Netherlands (11.9%, 5,099), France (11.6%, 4,118), Germany (11.3%, 4,495), Canada (11.2%, 5669), and Switzerland (11%, 5,634) were the top spenders, however life expectancy in total population at birth was highest in Switzerland (82.8 years), Japan and Italy (82.7), Spain and Iceland (82.4), France (82.2) and Australia (82.0), while OECD's average exceeds 80 years for the first time ever in 2011: 80.1 years,

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3008-520: The Peninsular War occurred near Vitoria-Gasteiz along the river Zadorra on 21 June 1813. An allied British, Portuguese, and Spanish army under General the Marquess of Wellington broke the French army under Joseph Bonaparte and Marshal Jean-Baptiste Jourdan . The victory assured the eventual end of French control in Spain. There is a monument commemorating this battle in the main square of

3102-505: The Roman foundations, as a celebration of the victory against the Vascones near what is assumed to be the hill occupied by the primitive village of Gasteiz. This however is not sufficiently proven, and some historians and experts believe that Victoriacum was located not on the site of present-day Vitoria-Gasteiz but nearby. Several possible locations have been proposed, the foremost of which

3196-481: The biopharmaceutical field, accounting for three-quarters of the world's biotechnology revenues. The quantity and quality of many health care interventions are improved through the results of science, such as advanced through the medical model of health which focuses on the eradication of illness through diagnosis and effective treatment. Many important advances have been made through health research, biomedical research and pharmaceutical research , which form

3290-505: The certification or licensing of health workers and their work history. Health information technology (HIT) is "the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making." Health information technology components: Alfonso VIII of Castile Alfonso VIII (11 November 1155  – 5 October 1214), called

3384-536: The social model of health and disability , which emphasizes the societal changes that can be made to make populations healthier. Results from health services research often form the basis of evidence-based policy in health care systems. Health services research is also aided by initiatives in the field of artificial intelligence for the development of systems of health assessment that are clinically useful, timely, sensitive to change, culturally sensitive , low-burden, low-cost, built into standard procedures, and involve

3478-403: The 11th century to defend the village. The defensive walls of old Gasteiz were built between the years 1050 and 1100. Because of that first defensive role, its narrow streets surrounding the oval resulted in compact rows of houses parallel both to each other and the medieval walls (of which only some sections and gates are preserved). Between the years 1854 and 1856, an epidemic of cholera served as

3572-553: The 15th century. The Villa Suso, where Martin Salinas, ambassador of Charles V dwelt (16th century). And the greatest historical treasure of Vitoria-Gasteiz: the Cathedral of Santa Maria (Old Cathedral). The history of the Cathedral of Santa María (commonly known as Old Cathedral ), is itself a synthesis of the history of Vitoria-Gasteiz. Built on the cemetery of the primitive village of Gasteiz (which today can be accessed through

3666-492: The 1853–54 academic year. It is now current headquarters of the Basque Parliament and formerly the convent of Santa Clara. The Free University opened in the wake of the revolution of 1868. The university operated from 1869, to just prior to the 1873–1874 term, largely because of the second Carlist War . Some of its most notable academics were Ricardo Becerro de Bengoa, Julián Apraiz and Federico Baraibar . The latter

3760-646: The Jewish cemetery, which became known as Judimendi, or "mountain of the Jews" in Basque . Over time, linguistically, "Judimendi" became "Judizmendi." Unique to anywhere else in Spain, the town maintained this agreement from 1492-1952, when the town undertook plans to convert Judizmendi to a public garden. The Jewish community in Bayonne heard about these plans, and convinced the city government of Vitoria-Gasteiz to commemorate

3854-559: The Neolithic remains of Aizkomendi , Sorginetxe and La chabola de la Hechicera ; Iron Age remains such as the settlements of Lastra and Buradón; antique remains such as the settlement of La Hoya and the salt valley of Añana ; and several medieval fortresses including the Tower of Mendoza and the Tower of Varona . Ludwig van Beethoven dedicated his Opus 91, often called the " Battle of Vitoria " or " Wellington's Victory ", to one of

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3948-510: The Noble (El Noble) or the one of Las Navas (el de las Navas), was King of Castile from 1158 to his death and King of Toledo . After having suffered a great defeat with his own army at Alarcos against the Almohads in 1195, he led the coalition of Christian princes and foreign crusaders who broke the power of the Almohads in the Battle of Las Navas de Tolosa in 1212, an event which marked

4042-797: The UN with the Global Green City Award (in 2019). The old town has some of the best preserved medieval streets and plazas in the region and it is one of very few cities with two cathedrals. The city also holds well known festivals such as the Azkena rock festival , FesTVal , Vitoria-Gasteiz jazz festival , and the Virgen Blanca Festivities . Vitoria-Gasteiz's vicinity is home to acclaimed wineries such as Ysios, designed by architect Santiago Calatrava , and Marqués de Riscal , by Frank Gehry . Relevant heritage sites including

4136-416: The United States, the 2013 National Health Interview Survey found that skin disorders (42.7%), osteoarthritis and joint disorders (33.6%), back problems (23.9%), disorders of lipid metabolism (22.4%), and upper respiratory tract disease (22.1%, excluding asthma) were the most common reasons for accessing a physician. In the United States, primary care physicians have begun to deliver primary care outside of

4230-575: The arrival of a tide of Christian supremacy on the Iberian Peninsula . His reign saw the domination of Castile over León and, by his alliance with Aragon, he drew those two spheres of Christian Iberia into close connection. Alfonso was born to Sancho III of Castile and Blanche , in Soria on 11 November 1155. He was named after his grandfather Alfonso VII of León and Castile , who divided his kingdoms between his sons. This division set

4324-662: The basis for evidence-based medicine and evidence-based practice in health care delivery. Health care research frequently engages directly with patients, and as such issues for whom to engage and how to engage with them become important to consider when seeking to actively include them in studies. While single best practice does not exist, the results of a systematic review on patient engagement suggest that research methods for patient selection need to account for both patient availability and willingness to engage. Health services research can lead to greater efficiency and equitable delivery of health care interventions, as advanced through

4418-501: The best possible health outcomes". Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), geographical and logistical barriers (such as additional transportation costs and the ability to take paid time off work to use such services), sociocultural expectations, and personal limitations (lack of ability to communicate with health care providers, poor health literacy , low income). Limitations to health care services affect negatively

4512-502: The best possible health outcomes". Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), geographical and logistical barriers (such as additional transportation costs and the ability to take paid time off work to use such services), sociocultural expectations, and personal limitations (lack of ability to communicate with health care providers, poor health literacy , low income). Limitations to health care services affects negatively

4606-627: The building. It resulted in five dead and over one hundred wounded by gunshot. On 20 May 1980, by decision of the Basque Parliament, Vitoria-Gasteiz became the place of the common institutions of the Basque Autonomous Community . Historically, there once was a Jewish community living in Vitoria, before the expulsion of the Jews . In 1492, the year of the expulsion, the town council agreed to maintain and respect

4700-454: The city consists of a city bus service operated by TUVISA (10 lines) and a tram network operated by Euskotren (2 lines sharing part of the way). Vitoria-Gasteiz is well connected by road with the other Basque capitals and with Madrid . The N-622 road connects with the AP-68 motorway towards Bilbao . The A-1 motorway from Madrid to San Sebastián serves Vitoria-Gasteiz. Since 2009,

4794-572: The city known as the Monument to Independence. When news came to Vienna in late July of that year, Johann Nepomuk Mälzel commissioned Ludwig van Beethoven to compose a symphony, the op. 91 Wellingtons Sieg oder die Schlacht bei Vittoria (Wellington's Victory, or the Battle of Vitoria) or Siegessymphonie . Work began on the Institute for Middle Education in 1843, with classes beginning during

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4888-532: The city was small, an expansion was planned in the neoclassical style, and little by little planning for the city has given Vitoria-Gasteiz its current form. The Old Quarter ( Alde Zaharra / Casco Viejo ), has many architectural jewels such as Bendaña Palace, the Fournier Museum of cards (erected in 1525 by Juan Lopez de Arrieta, on the site occupied before by the defensive tower built by Maeztu). The Ezkoriatza-Eskibel Palace, built by Claudio de Arciniega in

4982-401: The city. The project changed with the centuries, so that each modification was made without taking into account the previous. This was the case in the 15th century (when the church became collegiate), and finally in the 1960s, when it was decided to reverse the previous works of strengthening of the external walls and widen the windows, made purely for aesthetic reasons, which had severely damaged

5076-470: The context of global population aging , with increasing numbers of older adults at greater risk of chronic non-communicable diseases , rapidly increasing demand for primary care services is expected in both developed and developing countries. The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary health care strategy. Secondary care includes acute care : necessary treatment for

5170-426: The cousins Alfonso continued to be filled with conflict. In 1194, the papal legate negotiated a treaty between them to temporarily end the conflict. However, after Castile was defeated at the Battle of Alarcos , the younger Alfonso seized the opportunity to again attack his cousin . Castille defended itself with papal support. A more lasting peace was achieved finally by the older Alfonso's daughter Berengaria marrying

5264-438: The definitions of the various types of health care vary depending on the different cultural , political, organizational, and disciplinary perspectives, there appears to be some consensus that primary care constitutes the first element of a continuing health care process and may also include the provision of secondary and tertiary levels of care. Health care can be defined as either public or private . Primary care refers to

5358-546: The effort. The military orders also lent their support. Calatrava first, then Alarcos, and finally Benavente were captured before a final battle was fought at Las Navas de Tolosa near Santa Elena on 16 July. The caliph Muhammad al-Nasir was routed and Almohad power broken. Alfonso was the founder of the first Spanish university, a studium generale at Palencia , which, however, did not survive him. His court also served as an important instrument for Spanish cultural achievement. Alfonso and his wife Eleanor of England were

5452-447: The elevation. Summers show a significant influence of mediterranean precipitation patterns, but enough precipitation usually occurs to remain marine in nature. Sunshine levels are low by Spanish standards and the climate is humid year-round. The municipality of Vitoria has subsumed a number of rural villages, which are preserved as concejos , retaining a certain degree of administrative autonomy. In 2019, Gorka Urturan ( EAJ-PNV ),

5546-409: The excavations), the church of Santa María collapsed with the fire of 1202 and Alfonso VIII of Castile (who had conquered the city just 2 years earlier), ordered that it be rebuilt on the site of a former church. It was now to serve two very different purposes: regular religious services and weapon storage. Thus was born the Cathedral of Santa Maria, a fortress-like church that served as the entrance to

5640-467: The excuse for tearing down the gates, fortresses which provided access to the streets Run (fort of Nanclares), Shoe (fort of Soto) and Blacksmith (fort of Abendaño) and which served to protect every neighbourhood association. The entrance of the current Plaza de la Virgen Blanca was the site of Santa Clara, which was joined by the wall at the Convent of San Antonio. In the 19th century, in recognition that

5734-433: The first Escuela Normal de Maestros de Álava was established. A number of other colleges and faculties were adopted in 1978 by the emerging University of the Basque Country . European University Gasteiz , a private initiative with a focus on health and sport sciences and new technologies, opened in 2022 in the district of Salburua, after receiving official recognition from the Basque Parliament . Public transport within

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5828-454: The first to make the Alcázar of Segovia as their residence when this fortress was still at its early stages. Alfonso died at Gutierre-Muñoz and was succeeded by his surviving son, Henry I . Alfonso was the subject for Lion Feuchtwanger 's novel Die Jüdin von Toledo ( The Jewess of Toledo ), in which is narrated an affair with a Jewish subject in medieval Toledo in a time when Spain

5922-466: The highest standard of living among all cities in Spain, and first as to green areas and cultural places per capita. Vitoria-Gasteiz hosts two annual international music festivals: The Andre Maria Zuriaren jaiak/Fiestas de la Virgen Blanca festival is celebrated every year from the 4th to the 9th of August in honour of the patron saint of the city, and features a programme of special events, activities and free open-air concerts. San Prudencio Festival

6016-423: The identity of the city, and drawing on the district of San Martín, the need to accommodate the growing population has led the city to concentrate its growth in the new neighbourhoods of Lakua, Salburua and Zabalgan. The city of Vitoria-Gasteiz has received several international awards for its urban development. Also worth mentioning is the green ring, a network of parks and green spaces around the city, destined to be

6110-483: The lung of the future Vitoria-Gasteiz, and link the city with the countryside. This ring is formed of the parks Salburua, Zabalgana, Armentia, Alegria river, Gamarra, Abetxuko and Atxa-Landaberde. Each year the city hosts an Ironman triathlon, 'Ironman Vitoria-Gasteiz'. The 2024 event was an Ironman Pro-Series event in which the Ironman world champion, Sam Laidlow, competed but was disqualified, having failed to serve

6204-526: The managed care (insurance-billing) system through direct primary care which is a subset of the more familiar concierge medicine . Physicians in this model bill patients directly for services, either on a pre-paid monthly, quarterly, or annual basis, or bill for each service in the office. Examples of direct primary care practices include Foundation Health in Colorado and Qliance in Washington. In

6298-739: The memory of the cemetery. In 2004, Israeli artist Yaël Artsi created the monument "Coexistence" to be displayed at Judizmendi. In 2017, the monument was vandalized with anti-semitic graffiti twice: once in April, and once in May. In 2019, the Basque Jewish community held a ceremony to pay tribute to the city for honoring its promise to the Jews. Vitoria-Gasteiz has an oceanic climate ( Köppen climate classification : Cfb ). Winters are much cooler than in lowland coastal areas, whilst summers are similar in terms of high temperatures, with cool nights due to

6392-652: The most famous events of the Napoleonic Wars: the Battle of Vitoria , in which a Spanish, Portuguese and British army under the command of General the Duke of Wellington broke the French army and nearly captured the puppet king Joseph Bonaparte . It was a pivotal point in the Peninsular War , and a precursor to the expulsion of the French army from Spain. A memorial statue can be seen today in Virgen Blanca Square . The official name of Vitoria-Gasteiz

6486-430: The nobles to review and ratify the treaty. At that court, Alfonso knighted both Conrad and Alfonso IX of León , who would ultimately marry Berengaria. The younger Alfonso had come to seek the support and acknowledgement of his ascent to the throne of León from his older cousin. The elder Alfonso granted that in exchange for acknowledgement that the king of Castile was overlord of the king of León. The relationship between

6580-590: The old city to the 19th century neoclassical expansion of wide streets and gardens, the greatest examples of which are seen in the La Florida Park , and the Andre Maria Zuriaren Enparantza/Plaza de la Virgen Blanca , with its façade pulled viewpoints. Finally, the new quarters of Vitoria-Gasteiz were built, in accordance with a development plan favouring parks, recreation areas and quality of life. While aiming to maintain

6674-400: The organization and policies of the national health system, patients may be required to see a primary care provider for a referral before they can access secondary care. In countries that operate under a mixed market health care system, some physicians limit their practice to secondary care by requiring patients to see a primary care provider first. This restriction may be imposed under

6768-544: The patient. There are generally five primary methods of funding health care systems : In most countries, there is a mix of all five models, but this varies across countries and over time within countries. Aside from financing mechanisms, an important question should always be how much to spend on health care. For the purposes of comparison, this is often expressed as the percentage of GDP spent on health care. In OECD countries for every extra $ 1000 spent on health care, life expectancy falls by 0.4 years. A similar correlation

6862-473: The population of Vitoria-Gasteiz and the layout of its streets remained almost unchanged. And it was not until the late 18th century, when growth required the expansion of the city outside. To solve the problem of the difference in height between the original kernel on the hill, and the plain below, the arches were erected and the Plaza De España or Plaza Nueva was built, which soften the transition from

6956-553: The prevention of transmissible diseases. They also include the services of professionals in residential and community settings in support of self-care , home care , long-term care , assisted living , treatment for substance use disorders among other types of health and social care services. Community rehabilitation services can assist with mobility and independence after the loss of limbs or loss of function. This can include prostheses , orthotics , or wheelchairs . Many countries are dealing with aging populations, so one of

7050-577: The priorities of the health care system is to help seniors live full, independent lives in the comfort of their own homes. There is an entire section of health care geared to providing seniors with help in day-to-day activities at home such as transportation to and from doctor's appointments along with many other activities that are essential for their health and well-being. Although they provide home care for older adults in cooperation, family members and care workers may harbor diverging attitudes and values towards their joint efforts. This state of affairs presents

7144-465: The stability of the building. Today, the cathedral is open again, and offers visitors guided trips exposing the recent archaeological findings. It has become one of the main attractions of Vitoria-Gasteiz. Ken Follett, author of "The Pillars of the Earth", said after his stay in the city that Santa Maria was one of the three most interesting cathedrals of the world. From the Middle Ages to the 18th century,

7238-412: The stage for conflict in the family until the kingdoms were re-united by Alfonso VIII's grandson, Ferdinand III of Castile . His early life resembled that of other medieval kings. His father died in 1158. Though proclaimed king when only two years of age, Alfonso was regarded as merely nominal by the unruly nobles to whom a minority was convenient. Immediately, Castile was plunged into conflicts between

7332-410: The terms of the payment agreements in private or group health insurance plans. In other cases, medical specialists may see patients without a referral, and patients may decide whether self-referral is preferred. In other countries patient self-referral to a medical specialist for secondary care is rare as prior referral from another physician (either a primary care physician or another specialist)

7426-565: The tolled AP-1 motorway has served as an alternative route towards San Sebastián and Burgos. Vitoria-Gasteiz railway station is one of the main stops on the Madrid–Hendaye railway . Half a dozen Alvia trains link the city each day with Madrid , running partially on high-speed lines to reach Madrid in 3 hours 7 minutes. There are also connections to Barcelona . There is a complete lack of rail services to Andalusia and no direct rail link with Bilbao. The Basque Y high-speed rail network

7520-512: The town was besieged for nine months and eventually captured by the troops of Alfonso VIII of Castile , who annexed the town to the Kingdom of Castile . The town was progressively enlarged and in 1431 it was granted a city charter by King Juan II of Castile. In 1463, it was one of the five founding villas of the Brotherhood of Álava alongside Sajazarra , Miranda de Ebro , Pancorbo and Salvatierra/Agurain . The Battle of Vitoria of

7614-626: The use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates). Health care extends beyond the delivery of services to patients, encompassing many related sectors, and is set within a bigger picture of financing and governance structures. A health system , also sometimes referred to as health care system or healthcare system , is the organization of people, institutions, and resources that deliver health care services to populations in need. The healthcare industry incorporates several sectors that are dedicated to providing health care services and products. As

7708-661: The use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates). Health systems are the organizations established to meet the health needs of targeted populations. According to the World Health Organization (WHO), a well-functioning healthcare system requires a financing mechanism, a well-trained and adequately paid workforce , reliable information on which to base decisions and policies , and well-maintained health facilities to deliver quality medicines and technologies. An efficient healthcare system can contribute to

7802-414: The various noble houses vying for ascendancy in the inevitable regency. The devotion of a squire of his household, who carried him on the pommel of his saddle to the stronghold of San Esteban de Gormaz , saved him from falling into the hands of the contending factions. The noble houses of Lara and Castro both claimed the regency, as did the boy's uncle, Ferdinand II of León . In 1159 the young Alfonso

7896-401: The work of health professionals who act as a first point of consultation for all patients within the health care system . The primary care model supports first-contact, accessible, continuous, comprehensive and coordinated person-focused care. Such a professional would usually be a primary care physician , such as a general practitioner or family physician . Another professional would be

7990-543: The younger Alfonso in 1197. The annulment of this marriage by the pope drove the younger Alfonso to again attack his cousin in 1204, but treaties made in 1205, 1207, and 1209 each forced him to concede further territories and rights. The treaty in 1207 is the first existing public document in the Castilian dialect . Around 1200 when his brother in law John was on the English throne, Alfonso began to claim that Gascony

8084-682: Was also among the first teachers of Basque in Vitoria-Gasteiz as an off- syllabus subject. At the start of the Spanish Civil War Álava and Vitoria were easily captured by the rebel Nationalists led by General Angel García Benítez, assisted by Colonel Camilo Alonso Vega . Vitoria was captured on 19 July 1936. In November 1936 an attempt by Republicans to retake Vitoria was thwarted after being spotted by Nationalist reconnaissance aircraft. The 1937 Nationalist campaign in Vizcaya

8178-452: Was known to be the land of tolerance and learning for Jews, Christians, and Muslims. The titular Jewish woman of the novel is based on Alfonso's paramour, Rahel la Fermosa . Scholars continue to debate the historical truth of this relationship. The 1919 film The Jewess of Toledo by Franz Höbling is also based on this relationship. With Eleanor of England , Alfonso had 11 children: Through his daughters, Berengaria and Blanche, he

8272-405: Was located at the foot of Mount Gorbea where there is a village called Vitoriano . The town of Armentia , nowadays in the outskirts of Vitoria, has also been proposed as a possible location of Victoriacum. In either case, Victoriacum vanishes from history shortly after its foundation. In 1181, Sancho the Wise, King of Navarre founded the town of Nova Victoria as a defensive outpost on top of

8366-505: Was only by surprise that he recovered his capital Toledo from the hands of the Laras. During the regency, his uncle Sancho VI of Navarre took advantage of the chaos and the king's minority to seize lands along the border, including much of La Rioja . In 1170, Alfonso sent an embassy to Bordeaux to Henry II of England and Eleanor of Aquitaine to seek the hand of their daughter Eleanor . The marriage treaty helped provide Alfonso with

8460-465: Was part of Eleanor's dowry, though there was nothing in the marriage treaty to indicate this. In 1205, he invaded, hoping to make good on his claim. By 1208, he gave up on the venture, though his heirs would come back to this claim generations later. In 1174, he ceded Uclés to the Order of Santiago and afterwards this became the order's principal seat. From Uclés, he began a campaign which culminated in

8554-459: Was put briefly in the custody of García Garcés de Aza , who was not wealthy enough to support him. In March 1160 the Castro and Lara met at the Battle of Lobregal and the Castro were victorious, but the guardianship of Alfonso and the regency fell to Manrique Pérez de Lara . Alfonso was put in the custody of the loyal village Ávila . At barely fifteen, he began restoring his kingdom to order. It

8648-458: Was quickly commenced with Calatrava falling first. For the next seventeen years, the frontier between Moor and Castilian was fixed in the hill country just outside Toledo. Finally, in 1212, through the mediation of Pope Innocent III , a crusade was called against the Almohads. Castilians under Alfonso, Aragonese and Catalans under Peter II , Navarrese under Sancho VII , and Franks under the archbishop of Narbonne, Arnaud Amalric , all flocked to

8742-451: Was re-elected to a four-year term as Mayor in coalition with the PSOE . The current municipal council composition is as follows: The economy of Vitoria-Gasteiz is diverse, and many manufacturing companies and logistic centers have operations there, including Mercedes-Benz , Michelin , Gamesa , and Heraclio Fournier , the latter being headquartered there. The city is often ranked as one with

8836-589: Was supported by 80 German aircraft based at Vitoria, where the Condor Legion fighter wing was concentrated. During the Spanish transition to democracy , the Church of St. Francis of Assisi was the scene of a police shooting on March 3, 1976 during a peaceful labour assembly. Under the orders of Interior Minister Manuel Fraga , the police shot tear-gas into the church where 5,000 demonstrators and others had met, firing on them as they struggled their way out of

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