Skip to main content

Advertisement

SpringerLink
Log in

Comparative analysis of balneotherapy in European public health systems: Spain, France, Italy, and Portugal

  • Original Paper
  • Published:
International Journal of Biometeorology Aims and scope Submit manuscript

Abstract

Balneotherapy comprises the use of natural mineral waters for health and/or well-being purposes. When balneotherapy is offered by the public health system, some countries with Latin-based languages call it social thermalism. The aim of this study is to compare balneotherapy in health systems of Spain, France, Italy, and Portugal. The study involves a qualitative systematic review of the literature using the systematic search flow method. Twenty-two documents, from 2000 to 2022, were included and its findings were described in seven categories: the first outlines the historical characterization of social thermalism in the systems analyzed and the others outline the components of the health systems: coverage/access, health financing, workforce, inputs and techniques, organization and regulation, and network provision of services. The models of insurance and social security that cover part of the thermal treatment are highlighted. Doctors with competence in medical hydrology constitute the majority of the workforce. Similarities regarding inputs and techniques are observed, with variation in the number of days of the balneotherapy treatment cycle. In the regulation of services, the Ministry of Health of each country is prominent. The provision of services is mainly performed in specialized care in accredited balneotherapy establishments. Despite the limitations of the method, the comparisons made may serve to support public policies for balneotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. Denomination given due to the priority use of partial or local applications of mineral waters, for a brief period, for therapeutic purposes. Among the various techniques employed are as follows: wraps, compresses, poultices, steam baths, walking barefoot through water or in moist herbs (HORNO, 2010).

References

  • Álvarez LA, Rodríguez CL (2015) Presentación. Rev Agua Territorio 6:8–11

    Google Scholar 

  • Antonelli M, Donelli D (2018) Effects of balneotherapy and spa therapy on levels of cortisol as a stress biomarker: a systematic review. Int J Biometeorol 62:913–924. https://doi.org/10.1007/s00484-018-1504-8

    Article  Google Scholar 

  • Antonelli M, Donelli D, Fioravanti A (2018) Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: a systematic review and meta analysis. Rheumatol Int 38(10):1807–1824

    Article  Google Scholar 

  • Bernardino N, Camarero S, Cruz I, Merlo C, Navarro N, Redondo C et al (2018) Una mirada multidisciplinar en el Balneario de Cofrentes: Perfiles y propuestas profesionales. Bol Soc Esp Hidrol Méd 33(1):77–88

    Article  Google Scholar 

  • Cantista P (2010) O termalismo em Portugal. An Hidrologia Méd 3:79–107

    Google Scholar 

  • CNETh (2019) Les chiffres clés de la médecine thermale. Conseil National des Etablissements Thermaux https://www.medecinethermale.fr/curistes/la-medecine-thermale-aujourdhui/le-thermalisme-en-chiffres.html Accessed 12 Nov 2019

  • Republica Portuguesa (2018) Portaria n.º 337-C/2018 – Diário da República n.º 251/2018, 1º Suplemento, Série I de 2018–12–31. Saúde. Diário da repubica eletrônico https://dre.pt/dre/detalhe/portaria/337-c-2018-117537590. Accessed 17 Feb 2021

  • FEDERTERME (2019) Federazione Italiana delle Industrie Termali e delle Acque Minerali Curative https://www.federterme.it/ Accessed 12 Nov 2019

  • Ferenhof HÁ, Fernandes RF (2016) Desmistificando a revisão de literatura como base para redação científica: método SSF. Rev ACB 3:550–563

    Google Scholar 

  • Fioravanti A, Iacoponi F, Ellisai B, Cantarini L, Galeazzi M (2010) Short- and long-term effects of spa therapy in knee osteoarthritis. Am J Phys Med Rehabil 89(2):125–132

    Article  Google Scholar 

  • Forestier R, Tabone W, Palmer M, Jeambrun P, Chareyras J, Guerrer D, Fabry R, Françon A (2017) A Crenobalterapia na França: visão geral. In: Hellmann F, Rodrigues, DMO (ed) Termalismo e crenoterapia no Brasil e no mundo. Unisul, Palhoça, pp 166–186

  • Freire NA (2013) How to manage French thermalism specificities? Int Bus Res 6(3):29

    Google Scholar 

  • Gutenbrunner C, Bender T, Cantista P, Karagülle Z (2010) A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology, and climatology. Int J Biometeorol 54:495–507

    Article  Google Scholar 

  • Hellmann F, Drago LC (2017) Termalismo e crenoterapia: potencialidades e desafios para a saúde coletiva no Brasil. J Manag Prim Health Care 8(2):309–321

    Article  Google Scholar 

  • HydroGlobe (2013) Definition of a global framework for hydrotherapy. A FEMTEC – FORST joint project with the cooperation of ISMH and the technical support of WHO. Essentials from the final report. http://termasworld.com/documentos/hydroglobe.pdf. Accessed 14 Sep 2019

  • IMSERSO (2019) Termalismo del Imserso: un programa com grandes beneficios sociales. Informe anual IMSERSO 2019. Instituto de Mayores y Servicios Sociales. https://imserso.es/documents/20123/84540/informeanual2019.pdf/d8db2791-d487-b4c1-fd68-a514105874c7. Accessed 24 January 2023

  • INATEL (2001) Programas “Turismo Sénior” e “Saúde e Termalismo Sénior” em Portugal – 1995/2000. Estudo de Impacto Sócio-Económico. Fundação INATEL, Lisboa

  • INPS(2018) Instituto Nazionale della Previdenza Sociale. https://www.inps.it/NuovoportaleINPS/default.aspx?itemdir=51848&lang=IT. Accessed 13 Nov 2019

  • Jeambrun J, Francon A (2010) Duracion de los tratamientos termales: sictuacion actual en Europa. Bol Soc Esp Hidrol Méd 25(1):7–3

    Google Scholar 

  • Lobato LVC, Giovanella L (2012) Sistemas de saúde: origens, componentes e dinâmica. In: Giovanella L, Escorel S, Lobato LVC, Noronha JC, Carvalho AI (eds) Políticas e Sistemas de saúde no Brasil. Editora Fiocruz/Centro Brasileiro de Estudos de Saúde, Rio de Janeiro, pp 89–120

    Chapter  Google Scholar 

  • Maraver F (2017) Aguas mineromedicinales. Importancia terapéutica. Classificación. Mecanismo de acción. In: Armijo F, Ejeda J, Gestal J, Maraver F, Megías AM, Meijide-Faílde R, Ródenas C, Vázquez I (ed) Vademécum de las águas mineromedicinais de Galícia. Universidade de Santiago de Compostela, Santiago de Compostela pp 21–30

  • Mateo A (1994) Impacto del Programa de Termalismo Social en la reducción del gasto farmacéutico. EMER-GFK y Servicio de Termalismo Social del IMSERSO, Madrid

    Google Scholar 

  • Megías AM (2020) ¿Es la desmedicalización del Programa de Termalismo Social del IMSERSO una forma de blanquear su privatización? Bol Soc Esp Hidrol Méd 35(1):9–13

  • Megías AM, Martín AP (2014) 25 años de Termalismo Social en España en cifras. Bol Soc Esp Hidrol Méd 29(1):43–64

  • Megías AM, Gil F, Corvillo I, Armijo F, Maraver F (2016) El uso de técnicas balneoterápicas en curistas participantes en el programa de termalismo del Imserso en balnearios de Extremadura en 2015. Bol Soc Esp Hidrol Méd 31(1):128–130

  • Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. PLoS Med 6(6):e1000097. https://doi.org/10.1371/journal.pmed1000097

    Article  Google Scholar 

  • Moure OM (2008) El Programa de Termalismo Social del IMSERSO: la promoción del turismo activo en la tercera edad a través del agua. El caso de Galicia. Rev Med Naturista 2:143–147

    Google Scholar 

  • Moure OM (2010) Estudio de la sensación de mejoría de una población balnearia de la tercera edad tras la cura termal (balneario de Molgas-Baños de Molgas, 2010). Rev Med Naturista 4(2):37–42

    Google Scholar 

  • Moure OM, Peiró PS, Lucas MO (2013) El programa de termalismo social del IMSERSO. Evolución y tendencias de futuro. Aposta: Rev Cienc Sociales 59:1–24

    Google Scholar 

  • Pittler MH, Karagülle MZ, Karagülle M, Ernst E (2006) Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials. Rheumatol Oxford 45(7):880–884

    Article  CAS  Google Scholar 

  • Quintela MM (2004) Saberes e práticas termais: uma perspectiva comparada em Portugal (Termas de S. Pedro do Sul) e no Brasil (Caldas da Imperatriz). Hist Cienc Saúde- Manguinhos 11(1):239–260

    Article  Google Scholar 

  • Ramos ARCCV (2005) O Termalismo em Portugal: Dos factores de obstrução à revitalização pela dimensão turística. PhD thesis, Universidade de Aveiro, Aveiro, Portugal

  • República Portuguesa (2020) Atividade termal no âmbito da saúde - Despacho nº 8221/2020, de 25 de agosto, 2020. Economia e Transição Digital, Saúde e Ambiente e Ação Climática - Gabinetes da Secretária de Estado do Turismo e dos Secretários de Estado da Saúde e Adjunto e da Energia.Diário da Republica Portuguesa. https://dre.pt/dre/detalhe/despacho/8221-2020-140976415. Accessed 15 Feb 2021

  • Roques CF (2012) Balneotherapy research in France. Anales De Hidrología Médica 5(2):161–173. https://doi.org/10.5209/rev_ANHM.2012.v5.n2.401971

    Article  Google Scholar 

  • Roques CF (2014) Balneotherapy in France. Bol Soc Esp Hidrol Méd 29(2):222–223

    Article  Google Scholar 

  • Santos I, Cantista P, Vasconcelos C (2016) Balneotherapy in rheumatoid arthritis-a systematic review. Int J Biometeorol 60(8):1287–1301

    Article  Google Scholar 

  • SNS (2019) Tratamentos Termais. Serviço Nacional de Saúde. https://www.sns.gov.pt/noticias/2019/01/02/tratamentos-termais/. Accessed 25 Feb 2020

  • Strangio D, Teodori M (2015) Le Termedi Viterbo: dal termalismo sociale ai progetti di rilancion el segno del turismo del benessere. Agua Y Territorio 6:80–96

    Article  Google Scholar 

  • Teixeira SCC (2013) O Termalismo Clássico na Atualidade: O Caso das Termas de Vizela. MSc thesis, Universidade de Coimbra, Coimbra, Portugal

  • Torres AH et al (2006) Técnicas y Tecnologías en Hidrología Médica e Hidroterapia. AETS - Instituto de Salud Carlos III, Madrid

    Google Scholar 

Download references

Funding

The corresponding author received funding for this research by the Master’s program of the Federal University of Santa Catarina, Brazil, sponsored by CAPES—Coordination of Superior Level Staff Improvement, who provided financial support. This study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Portaria CAPES 76/2010.

Author information

Authors and Affiliations

  1. Public Health Graduate Program, Department of Public Health, Federal University of Santa Catarina, Campus Universitário Reitor João David Ferreira Lima, S/N, Trindade, Florianópolis, Santa Catarina, 88040-900, Brazil

    Natalia Nair Soares de Oliveira

  2. Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil

    Fernando Hellmann & Mauro Serapioni

  3. University of Porto, Porto, Portugal

    Pedro Cantista

  4. Professional School of Medical Hydrology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain

    Francisco Maraver

Authors
  1. Natalia Nair Soares de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fernando Hellmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pedro Cantista
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Francisco Maraver
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mauro Serapioni
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

NNSO: conceptualization, data collection and analysis, first draft of the article. FH: conceptualization, data collection and analysis, review of the first version of the article, writing of the final version. PC, FM, MS: critical analysis of the second and remaining versions of the article.

Corresponding author

Correspondence to Natalia Nair Soares de Oliveira.

Ethics declarations

Declarations

We declare that this manuscript has not been published previously, in whole or in part, nor is it currently being considered for publication elsewhere.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Oliveira, N.N.S., Hellmann, F., Cantista, P. et al. Comparative analysis of balneotherapy in European public health systems: Spain, France, Italy, and Portugal. Int J Biometeorol 67, 597–608 (2023). https://doi.org/10.1007/s00484-023-02438-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00484-023-02438-y

Keywords

Search

Navigation