Defining a good death: Perspectives of patients, relatives, and health care professionals in the Catalan context-A qualitative study.

Health systems often lack integrated, person-centered end-of-life care. Improving this care is a key priority for decision-makers in the Catalan context. This study aimed to understand how key stakeholders in the healthcare sector-patients, family members, and healthcare professionals-define the concept of a 'good death' and identify their key common elements in Catalonia, Spain.

Hospital variation in quality indicators for patient blood management in total knee and hip arthroplasty: a retrospective cohort study.

Background: Anaemia, blood loss, and blood transfusion are critical aspects of patient care in major orthopaedic surgery. We assessed hospital adherence to guideline-recommended Patient Blood Management (PBM) care, analysed variations between hospitals, and validated two composite indicators of hospital PBM performance in patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).

Methods: This retrospective cohort study included all primary TKA and THA procedures performed during 2021 across 39 hospitals in Spain.

Effect of CPAP Treatment on Cardiovascular Outcomes.

Introduction: Randomized controlled trials (RCT) have not demonstrated a role for continuous positive airway pressure (CPAP) on the secondary prevention of major cardiovascular events in obstructive sleep apnea (OSA) patients. However, participants in RCTs are substantially different from real-world patients. Therefore, we aimed to assess the effect of CPAP treatment on major cardiovascular events in real-world OSA patients.

Health inequalities in childhood diseases: temporal trends in the inter-crisis period.

Background: Since 2008, children in Catalonia (Spain) have suffered a period of great economic deprivation. This situation has generated broad-ranging health inequalities in a variety of diseases. It is not known how these inequalities have changed over time.

The influence of general practitioner and patient sex on the treatment of major depression.

Biological and sociocultural factors may lead to a significant gender bias in the treatment of major depression and thus contribute to accentuating gender inequalities. However, the influence of the general practitioner's (GP's) sex on the prescription of antidepressants has not been adequately assessed in previous work and remains unclear. This retrospective cohort study aims to determine the influence of GP and patient sex on the treatment of major depression.

Gender bias in pediatric care: Health professionals' opinions and perceptions.

Introduction: Gender bias in healthcare is understood as a misconception of the differences between males and females that may generate healthcare disparities and discrimination against one sex. However, is not well known how this implicit bias is manifested in pediatric clinical praxis. Thus, the goal of this study is to explore and analyse the attitudes of health personnel toward a possible gender bias in pediatric care in Catalonia.

Living longer in declining health: Factors driving healthcare costs among older people.

Background: Developed countries are facing challenges in caring for people who are living longer but with a greater morbidity burden. Such people are likely to be regular users of healthcare.

Objectives: Our analytical aim is to identify factors that explain healthcare costs among: (1) people over 55 years old; (2) the top 5% and 1% high-cost users among this population; (3) those that transition into the top 5% and 1% from one year to the next; (4) those that appear in the top 5% and 1% over multiple years; and (5) those that remain in the top 5% and 1% over consecutive years.

Socioeconomic inequalities in waiting times for planned and cancer surgery: Evidence from Spain.

Waiting times act as a non-price rationing mechanism to bring together the demand for and the supply of public healthcare services and ensure equal access independently of ability to pay. This study tests for the presence of socioeconomic inequalities in waiting times for ten publicly-funded planned and cancer surgeries in Catalonia (Spain) in 2015-2019. Socioeconomic status (SES), measured by four categories (very low, low, middle, high), is based on co-payment levels for medicines which depend on patient's income.

Air Pollution and Birth Outcomes: Health Impact and Economic Value Assessment in Spain.

Air pollution is considered an ongoing major public health and environmental issue around the globe, affecting the most vulnerable, such as pregnant women and fetuses. The aim of this study is to estimate the health impact and economic value on birth outcomes, such as low birthweight (LBW), preterm birth (PTB), small for gestational age (SGA), attributable to a reduction of PM levels in Spain. Reduction based on four scenarios was implemented: fulfillment of WHO guidelines and EU limits, and an attributable reduction of 15% and 50% in annual PM levels.

How should healthcare be reported in Catalonia? Qualitative study with healthcare leaders.

Background: The Results Centre is the name of a project that, since 2012, has been openly publishing the results of each healthcare centre in Catalonia, with the idea of promoting benchmarking among centres and transparency toward society. As the project evolves, it has become increasingly necessary to adapt its contents and formats. The objective of this study is to identify the preferences and expectations of healthcare leaders regarding the Results Centre.

Understanding public procurement within the health sector: a priority in a post-COVID-19 world.

Every year, over 250,000 public authorities in the European Union (EU) spend about 14% of GDP on the purchase of services, works and supplies. Many are in the health sector, a sector in which public authorities are the main buyers in many countries. When these purchases exceed threshold values, EU public procurement rules apply.

[Results Centre of Social and Health Care Network in Catalonia. Evolution 2013-2018].

Objective: The Results Centre's (RC) mission is to measure, evaluate and disseminate the results achieved by the different agents of the health system, based on relevant measures. The purpose of this research is to describe the evolution of indicators used in the social and health care network RC (RC-SH), including some indicators sensitive to nursing practice.

Method: Observational, descriptive cross-sectional study based on data from 6 RC-SH reports (2013-2018).

The impact of an easy access drug supply management policy law on the consumption and abuse of opioids in Catalonia: A population-based study.

Background: Over the last two decades, the rise in opioid prescription has worsened health outcomes worldwide, increasing both levels of abuse and mortality rates. In order to reduce the scale of this public health problem, new policies have been implemented in many countries. In 2012, Spain adopted new legislation on opioid prescription (the ROE law), which meant that practitioners no longer needed to obtain extra authorisation in order to prescribe strong opioids.

Do hospitals have a higher mortality rate on weekend admissions? An observational study to analyse weekend effect on urgent admissions to hospitals in Catalonia.

Background: 'Weekend effect' is a term used to describe the increased mortality associated with weekend emergency admissions to hospital, in contrast with admission on weekdays. The objective of the present study is to determine whether the weekend effect is present in hospitals in Catalonia.

Methods: We analysed all urgent admissions in Catalonia in 2018, for a group of pathologies.

Geographical, Socioeconomic, and Gender Inequalities in Opioid Use in Catalonia.

In recent years, worldwide opioid use has seen a sharp increase, especially for the treatment of chronic non-cancer pain. Catalonia is no exception to this trend. However, no recent studies have addressed the socioeconomic and gender inequalities in opioid use in the different geographical areas of Catalonia.

Trends in healthcare resource use and expenditure before and after ischaemic stroke. A population-based study.

Introduction: Despite improved survival rates, stroke represents an increasing healthcare and socioeconomic burden. We describe the main characteristics of patients with ischaemic stroke and resource use and associated expenditure one year before and 3 years after stroke, using a population-based dataset.

Methods: The information technology systems of the Catalan Health Service were used to identify patients with ischaemic strokes occurring between January 2012 and December 2016.

Determinants of the number of days people in the general population spent at home during end-of-life: Results from a population-based cohort analysis.

Background: The number of days spent at home in the last six months of life has been proposed as a comprehensive indicator of high-value patient-centered care; however, information regarding the determinants of this outcome is scarce, particularly among the general population. We investigated the determinants of spending time at home within the six months preceding death.

Methods: Population-based, retrospective analysis of administrative databases of the Catalan government.

Socioeconomic inequalities in 29 childhood diseases: evidence from a 1,500,000 children population retrospective study.

Background: Socioeconomic position (SEP) powerfully affects health status in the childhood population. However, the knowledge of which diseases are more affected by SEP and whose outcomes could be improved by having a more equitable society remains uncertain on a population basis.

Methods: We measured socioeconomic and gender inequalities in the pre-COVID-19 era for 29 diseases in the entire childhood population in Catalonia to identify which diseases are most impacted by inequalities.

Frequency of health-care service use and severity of illness in undocumented migrants in Catalonia, Spain: a population-based, cross-sectional study.

Background: In Spain, legislation was passed in 2012 excluding undocumented migrants from the public health-care system. Catalonia was one of the Spanish regions that did not implement this legislation, and continued to guarantee access to health care to the whole population. We aimed to analyse health-care use and health status among undocumented migrants in Catalonia, and compare health-care use and health status with legal residents classified according to their socioeconomic position (SEP).

The experience of Catalonia measuring nurse-sensitive indicators: Trends study 2012-2018.

Aim: To describe nursing-sensitive indicators measured in Catalonia.

Background: In Catalonia, since 2012, under the umbrella of the Results Centre, outcomes of every health care setting have been published and made open to health care professionals and citizens.

Methods: Trends study of nursing-sensitive indicators was based on data collected systematically from each setting from 2012 to 2018.

Advance directives and real-world end-of-life clinical practice: a case-control study.

Background: Advance directives (ADs) have been legally regulated to promote autonomy over health decisions among patients who later lose decision-making capacity.

Aims And Objectives: To analyse the differences in clinical practice at end of life among people who had completed an AD versus those who had not.

Methods: Retrospective case-control study (1:2), matched by age, sex, year, cause of death and region of residence.

Measuring health inequalities: a systematic review of widely used indicators and topics.

Background: According to many conceptual frameworks, the first step in the monitoring cycle of health inequalities is the selection of relevant topics and indicators. However, some difficulties may arise during this selection process due to a high variety of contextual factors that may influence this step. In order to help accomplish this task successfully, a comprehensive review of the most common topics and indicators for measuring and monitoring health inequalities in countries/regions with similar socioeconomic and political status as Catalonia was performed.

Longitudinal Analysis of Causes of Mortality in Continuous Positive Airway Pressure-treated Patients at the Population Level.

Randomized controlled trials do not support a role for continuous positive airway pressure (CPAP) in preventing major cardiovascular events or mortality in patients with obstructive sleep apnea (OSA). However, these trials' setting does not apply to most CPAP-treated patients. We aimed to assess the effect of CPAP on mortality in real-world patients.

Relationship between parents' mental disorders and socioeconomic status and offspring's psychopathology: A cross-sectional study.

Mental disorders (MD) are one of the main causes of the disease burden worldwide. Associations between socioeconomic status (SES) and presence of MD in parents have been related with increased odds of MD in offspring. However, there is a lack of population-based research in this field.