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Caring for Tolosaldea’s health

Thanks to the agreement signed with the Basque Department of Health, the Asunción Klinika hospital and the Belate and Andoain outpatient centres provide specialist healthcare coverage to the inhabitants of the Tolosaldea region. In this way, Asunción Klinika and these centres work in coordination with the Integrated Health Organisation (OSI) of Tolosaldea.

What is an Integrated Health Organisation (OSI)?

 Integrated Health Organisations are a model which was implemented in Euskadi (the Basque Country) in 2011.  It is based on grouping hospitals (Specialist Care) and health centres (Primary Care) together.  In Integrated Health Organisation (OSI) hospitals and health centres, they cooperate with each other at meeting points. The Integrated Health Organisations are as follows:

  • Bidasoa

  • Alto Deba

  • Bajo Deba

  • Goierri

  • Tolosaldea

  • Donostialdea

How to the Tolosaldea Integrated Health Organisations (OSI) work?

Founded on 1st January 2015, the Tolosaldea OSI deals with the comprehensive healthcare of the Tolosaldea region’s inhabitants, covering a population of around 66,000 users. Unlike the rest of the OSI’s in Gipuzkoa, the Tolosaldea OSI has a mixed public-private nature: Primary Care is taken care of by the health centres of Osakidetza whilst Specialist Care is done by Asunción Klinika and its outpatient centres of Belate and Andoain, in accordance with the agreement signed with the Basque Government’s Department of Health. This care includes the following services:


The leading tertiary hospital of the Tolosaldea OSI is Donostia University Hospital, just like the rest of the OSI’s of Gipuzkoa.


The Tolosaldea OSI has five Primary Care Units in the following areas:

  • Andoain

  • Billabona

  • Tolosa

  • Ibarra

  • Alegia

and a Continuous Care Point (PAC) at Tolosa health centre.  Urgent care is delivered in each Primary Care Unit during the opening hours for each centre.  Outside of these hours, all emergencies are centred in the PAC (Continuous Care Point) of Tolosa. If required, there is Emergency support (Osakidetza Service Organisation), which is the supra-territorial organisation throughout Euskadi (Basque Country).  The Andoain and Tolosa health centres have Community Mental Health Services for the population of Tolosaldea.

Once a year a Social Council takes place, in which the general public take part, represented by associations and councils. This council reports on the activity carried out during the last 12 months by the OSI, its indicators and results, and listens to suggestions from social agents.

The Tolosaldea Integrated Health Organisation is managed by Dr. Marisa Merino. 

What role does Asunción Klinika play within the Tolosaldea Integrated Health Organisation?

In accordance with the Agreement with the Basque Government’s Department of Health, Asunción Klinika serves as the regional hospital for Tolosaldea and, as such, coordinates with the Primary Care (health centres) providers of Tolosaldea to offer specialist care to the inhabitants of Tolosaldea. 

For this coordination to work without any issues and for it to be possible to assess its quality, establish new strategies and objectives and align the entire OSI (Integrated Health Organisation) in achieving this, there are numerous commissions and monitoring channels and pooling of work, which our professionals take part in. 

Specifically, these commissions are attended by Asunción Klinika’s Medical Director, Dr.  María Caballero, and the heads of service for Traumatology, Pharmacy and Internal Medicine. This last specialism is particularly relevant in OSIs and, therefore, the head of service also carries out various yearly meetings with the managers from the different outpatient centres of the Tolosaldea OSI. ​

The Nursing Supervisors, Ana Belén Martínez and Rosa Vallejo, managers of the Medium Stay Hospitalisation Unit and the Internal Medicine Floor respectively, also play an important role in the OSI. The first is the link with social services to ensure that patients who pass through the Medium Stay Hospitalisation unit, once they leave this unit, have the correct care. Rosa Vallejo, for her part, attends the commissions on Infectious diseases. 

Care Routes

Caring for Chronic Patients

Care Routes are an initiative of the Basque Government’s Department of Health which has been in place since 2013 and seeks to improve the care of chronic patients through coordination between Primary and Specialised Care.  


It is an initiative which aims to improve the diagnosis, treatment and care required by chronic patients, based on a model of stratification of the population which enables the monitoring of patients who suffer from the following chronic conditions:

  • Chronic Obstructive Pulmonary Disease (COPD)

  • Cardiac failure

  • Diabetes mellitus

  • Multi-pathology patients who require hospitalisations and continuous medical care.

For its operation in Tolosaldea, Asunción Klinika’s professionals work in coordination with Osakidetza Primary Care services of the region, within the framework of the Tolosaldea OSI.

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