Reading a Spanish prescription and hospital discharge report

Terms used

• CIP — The CIP is the personal identification number printed on your public health card.
• Informe de alta — The informe de alta is the report a hospital gives you on discharge, summarising your stay and treatment.
• Pauta — The pauta is the dosing schedule: how much medicine to take, how often and how.
• TSI — The TSI code is your contribution category, which sets the percentage of medicine cost you pay.
• EFG — EFG marks a generic medicine that works the same as the original brand.

Key rules

• Active ingredient: A public prescription usually names the ingredient, and the pharmacist gives you the cheapest matching option.
• Reference price: If your medicine costs more than the reference price, you pay the difference.
• TSI code: Your TSI code, from 001 to 006, sets the percentage you pay at the pharmacy.
• Discharge report: Read the diagnoses, treatment at discharge and follow-up appointments first.

What a medication sheet shows

A medication sheet (hoja de medicación or plan de tratamiento) lists everything your doctor has prescribed in the public system. The layout changes from region to region, but you will usually find these parts:

• You: your name, date of birth and CIP, the number on your health card.
• The drug: the active ingredient and/or brand, the strength, the form (tablet, capsule) and the pack size.
• The pauta: the dosing schedule. It gives the dose, how often, and how to take it.
• How long and how much: the treatment duration, the number of packs, and the start and end dates of the plan.
• Dispensations: how many times the pharmacy has handed over the medicine, and when.
• The prescriber: name, collegiate (professional registration) number, centre, signature and issue date.
• Contribution category: a code such as TSI 001 to 006. It sets the percentage you pay at the pharmacy.
• A barcode or code that the pharmacy scans.

Abbreviations you will meet

So "1 comp c/12h vo" means one tablet by mouth every 12 hours. Timings like "1-0-1" or "desayuno-cena" mean one dose at breakfast and one at dinner.

Active ingredient or brand

Public-system prescriptions are normally written by active ingredient (principio activo, also called DCI), not by brand. The pharmacist then gives you the cheapest option available. Exceptions exist, for example biological medicines and drugs with a narrow safe range.

If a brand is prescribed and a generic with the same composition exists, the pharmacist must switch you to the cheapest one at or below the reference price. The doctor can block this for certain medicines. If the price is above the reference price, you pay the difference. EFG on a box means it is a generic. Private prescriptions may name a brand.

Reading the informe de alta

The informe de alta is the report the hospital gives you when you leave. Hospitals set out the sections a little differently, but expect these:

1. Your details, the hospital and the service that treated you.
2. Admission and discharge dates.
3. Reason for admission and your medical history.
4. Main and secondary diagnoses. The main one is the reason for the stay.
5. Procedures carried out.
6. Clinical course (evolución): what happened during the stay.
7. Test results.
8. Discharge destination, for example home.
9. Treatment at discharge: the medicines to take now, often in the same format as a medication sheet.
10. Recommendations and follow-up appointments.
11. The doctor's signature.

Start with the diagnoses, the treatment at discharge and the follow-up appointments. These are the parts you must act on.

Before you leave the hospital

Check that the treatment section is complete and readable. Ask about anything you do not understand, and ask for follow-up dates in writing. Keep the report: a new doctor in Spain or at home will want it. The documents and questions below cover what to bring and common queries.

Documents you need

• Medication sheet (hoja de medicación or plan de tratamiento) from your doctor in the public health system. It shows the drug, dose, duration, number of packs and your contribution category.

• Hospital discharge report (informe de alta) from the hospital that treated you. It lists the diagnoses, procedures, clinical course, treatment at discharge and follow-up appointments, and carries the doctor's signature.

• Health card (tarjeta sanitaria), to match the CIP number printed on your medication sheet.

Frequently asked questions

Why does my prescription name only an active ingredient and not a brand?

Prescriptions in the public health system are written by active ingredient (principio activo), with only a few exceptions such as biological medicines. The pharmacist then gives you the cheapest available option. Ask the pharmacist if you want to know which brand you are receiving.

What happens if my doctor prescribes a brand and a generic exists?

The pharmacist must swap it for the cheapest generic at or below the reference price (precio de referencia), unless the doctor marks the medicine as non-substitutable.

What does c/8h mean on a dosing line?

C/8h means take the dose every 8 hours, and c/12h and c/24h work the same way. Other common marks are comp for tablet, caps for capsule, gts for drops, SOS or si precisa for as needed, and en ayunas for on an empty stomach.

What is the TSI code on my medication sheet?

The TSI code (001 to 006) is your contribution category, and it sets the percentage of the medicine price that you pay. You will find it on the sheet along with your CIP, the health card number.