Measuring population health using health expectancy estimates from morbidity and mortality databases.

The progressive incorporation of quality of life indicators in health planning meets a critical need: The evaluation of the performance of health services, which are under stress by multiple causes, but in particular by an ageing population. In general, national health plans rely on health expectancies obtained using the Sullivan method. The Sullivan health expectancy index combines age-specific mortality rates and age-specific prevalence of healthy life, obtained from health surveys.

A 14-Year Longitudinal Analysis of Healthcare Expenditure on Dementia and Related Factors (DEMENCOST Study).

Background: The large number of dementia cases produces a great pressure on health and social care services, which requires efficient planning to meet the needs of patients through infrastructure, equipment, and financial, technical, and personal resources adjusted to their demands. Dementia analysis requires studies with a very precise patient characterization of both the disease and comorbidities present, and long-term follow-up of patients in clinical aspects and patterns of resource utilization and costs generated.

Objective: To describe and quantify direct healthcare expenditure and its evolution from three years before and up to ten years after the diagnosis of dementia, compared to a matched group without dementia.

Prevalence of rheumatic diseases in Baix Empordà.

Background: In Spain, the prevalence of different rheumatic diseases is known mainly through the EPISER studies coordinated by the Spanish Society of Rheumatology and based on surveys in a population sample. The aim of our study is to describe the prevalence in 2016 of different rheumatic diseases in the population residing in Baix Empordà according to healthcare coding records.

Materials And Methods: Observational, descriptive and cross-sectional study carried out on the population attended from 2016 to 2017 in SIBBE (Serveis de Salut Integrats del Baix Empordà), an organizational service that includes all the healthcare facilities in the Baix Empordà area with a unique information system.

Survival, effect measures, and impact numbers after dementia diagnosis: a matched cohort study.

Background: Knowledge on survival after diagnosis is important for all stakeholders. We aimed to estimate the survival and life expectancy after a dementia diagnosis, and to quantify the impact of dementia subtypes on mortality.

Methods: Retrospective matched cohort study using a linkage between a dementia-specific registry and two primary care electronic medical records databases.

[Morbidity and self-perception of health, two different approaches to health status].

Objective: To determine the degree of association between perceived health status and that obtained from information on attended morbidity.

Method: The population of four health areas of the Baix Empordà region (Catalonia, Spain) (N=91,067) was studied in 2016, by means of a sample of 1202 individuals. A health survey was conducted on sample individuals.

Ageing and healthcare expenditures: Exploring the role of individual health status.

In 1999, Zweifel, Felder, and Meiers questioned conventional wisdom on ageing and healthcare expenditure (HCE). According to these authors, the positive association between age and HCE is due to an increasing age-specific mortality and the high cost of dying. After a weighty academic debate, a new consensus was reached on the importance of proximity to death when analysing HCE.

Analysing the Costs of Integrated Care: A Case on Model Selection for Chronic Care Purposes.

Background: The objective of this study is to investigate whether the algorithm proposed by Manning and Mullahy, a consolidated health economics procedure, can also be used to estimate individual costs for different groups of healthcare services in the context of integrated care.

Methods: A cross-sectional study focused on the population of the Baix Empordà (Catalonia-Spain) for the year 2012 (N = 92,498 individuals). A set of individual cost models as a function of sex, age and morbidity burden were adjusted and individual healthcare costs were calculated using a retrospective full-costing system.

[Assessment of the effectiveness of a proactive and integrated healthcare programme for chronic complex patients].

Objective: To assess the effectiveness of a proactive and integrated care programme to adjust the use of health resources by chronic complex patients (CCP) identified as potential high consumers according to a predictive model based on prior use and morbidity.

Methods: Randomized controlled clinical trial with three parallel groups of CCP: a blinded control group (GC), usual care; a partial intervention group (GIP) reported in the EMR; a total intervention group (GIT), also reported to primary care (PC). Conducted in an integrated health care organization (IHCO), N=128,281 individuals in 2011.

[Effectiveness and economic impact of a program of integrated care with telemedicine support on insulin-treated type 2 diabetic patients (Study GITDIABE)].

Aim: To evaluate if insulin-treated type 2 diabetic patients with blood glucose self-monitoring (DIA), included in a program of integrated management of diabetes mellitus (DM), achieve a better level of metabolic control with telemedicine support than with conventional support, after 12 months follow-up. The impact on the use and cost of healthcare services, pharmaceutical expenditure, and consumption of test strips for blood glucose, was also assessed.

Design: A prospective parallel cohorts study.

[Predicting individual risk of high healthcare cost to identify complex chronic patients].

Objective: To develop a predictive model for the risk of high consumption of healthcare resources, and assess the ability of the model to identify complex chronic patients.

Methods: A cross-sectional study was performed within a healthcare management organization by using individual data from 2 consecutive years (88,795 people). The dependent variable consisted of healthcare costs above the 95th percentile (P95), including all services provided by the organization and pharmaceutical consumption outside of the institution.

Late rectal and bladder toxicity following radiation therapy for prostate cancer: Predictive factors and treatment results.

Aim: This study aimed at investigating factors associated to late rectal and bladder toxicity following radiation therapy and the effectiveness of Hyperbaric Oxygen Therapy (HBOT) when toxicity is grade ≥2.

Background: Radiation is frequently used for prostate cancer, but a 5-20% incidence of late radiation proctitis and cystitis exists. Some clinical and dosimetric factors have been defined without a full agreement.

Estimating lifetime healthcare costs with morbidity data.

Background: In many developed countries, the economic crisis started in 2008 producing a serious contraction of the financial resources spent on healthcare. Identifying which individuals will require more resources and the moment in their lives these resources have to be allocated becomes essential. It is well known that a small number of individuals with complex healthcare needs consume a high percentage of health expenditures.

[An analysis of the diabetic population in a Spanish rural are: morbidity profile, use of resources, complications and metabolic control].

Objective: To describe the characteristics of a diabetic population, morbidity profile, resource consumption, complications and degree of metabolic control.

Design: Cross-sectional study during 2010.

Location: Four Health Areas (91.

[Measurement of morbidity attended in an integrated health care organization].

Introduction: Understanding the quality, costs and outcomes of healthcare services requires precise determination of the morbidity in a population. Measurement of morbidity in a population and its association with the services provided remains to be performed. The aim of this article was to present our experience of using clinical risk groups (CRGs) to measure morbidity in an integrated healthcare organization (IHO).

Hybrid risk adjustment for pharmaceutical benefits.

This paper analyses the application of hybrid risk adjustment versus either prospective or concurrent risk adjustment formulae in the context of funding pharmaceutical benefits for the population of an integrated healthcare delivery organisation in Catalonia during years 2002 and 2003. We apply a mixed formula and find that, compared to prospective only models, a hybrid risk adjustment model increases incentives for efficiency in the provision for low risk individuals in health organisations, not only as a whole but also within each internal department, by reducing within-group variation of drug expenditures.

[Nursing care in women with breast disease: organization of a specific nurses' clinic].

Breast surgery can be highly stressful for women due to the high symbolic value that it represents in bio-psycho-social terms. Before setting up a nurses' breast disease clinic, nurses felt that women were being discharged after surgery with excessive worries and doubts. The aim of this study was to describe the organization, structure, functions, and activities of the nurses' breast disease clinic in Hospital Palmós (Gerona, Spain) between 2002-2005, as well as to promote this kind of clinic.