Publications by authors named "Jose Repullo"

Article Synopsis
  • The study aims to evaluate the transparency and reproducibility of economic evaluations in healthcare interventions published in MEDLINE over different years (2012, 2019, 2022).
  • A random sample of 600 articles will be analyzed for their adherence to rigorous research practices using a standardized extraction form.
  • Results will be reported with risk ratios to highlight any changes in reporting standards over time, without requiring ethical approval for the study.
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Objective: To examine the endorsement of reporting guidelines for economic evaluation studies, such as the CHEERS (Consolidated Health Economic Evaluation Reporting Standards) statement, by Spanish biomedical journals.

Method: Cross-sectional analysis of the instructions to authors of Spanish biomedical journals included in the Journal Citation Reports 2017. Two authors examined and extracted the following information: mention of any reporting guideline, the CHEERS statement, the recommendations of the International Committee of Medical Journal Directors (ICMJE) and the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network.

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This analysis of the Spanish health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Overall health status continues to improve in Spain, and life expectancy is the highest in the European Union. Inequalities in self-reported health have also declined in the last decade, although long-standing disability and chronic conditions are increasing due to an ageing population.

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The 2008 economic crisis made the issue of good governance more present and visible, but the debate risks stalling in an academic and political discourse that barely exceeds the declarative. We acknowledge the existence of noteworthy documents from scientific medical societies and some institutional proposals that point towards promising changes. Viewing good governance as accountability, participation, transparency, intelligence and integrity, our objective is to identify the determinants of inaction and remove the barriers that prevent the adoption of rational and widely agreed-upon proposals.

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Portfolio methodology is widely applied to training, particularly in medical education and for medical trainees. Some Spanish Institutions (National University of Distance Learning and National School of Public Health) are using a seven dimension Portfolio in the field of Clinical Management, which could be used as conceptual framework and checklist for building up different documents for planning, programming and evaluating the new experiences of Clinical Units based on clinical management initiatives. This paper describe the Portfolio in short, takes into consideration its potential use, and concludes addressing the relevance of good governance and accountability for the medical professionalism.

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The economic and fiscal crisis of 2008 has erupted into the debate on the sustainability of health systems; some countries, such as Spain, have implemented strong policies of fiscal consolidation and austerity. The institutional framework and governance model of the national health system (NHS) after its devolution to regions in 2002 had significant weaknesses, which were not apparent in the rapid growth stage but which have been clearly visible since 2010. In this article, we describe the changes in government regulation from the national and NHS perspective: both general changes (clearly prompted by the economic authorities), and those more specifically addressed to healthcare.

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Background: Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-professionalism relationship; methodologically, we expand cross-country comparison towards the meso-level of organisations; and empirically, the focus is on processes and actors in a range of European hospitals.

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The good performance of publicly-produced health services is of vital importance, well beyond the health sector. Taking into account the great complexity of the health services in the public sector due both to their public and professional nature, we identify seven Gordian Knots as being responsible for the most frequent problems of publicly produced health services in Spain and Latin America. From the concept of good governance we take its character as a normative and ethical benchmark and its potential to renew and invigorate the government of the public sector.

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The Spanish National Health System (SNHS) is currently in a complex equilibrium which, even if acceptable in the short term, faces major sustainability and governance challenges; the so far inconclusive outcome of the SNHS decentralization process clearly underlines the importance of seeking new alternatives to effectively bring about the real benefits of decentralization, while taking advantage of the system's economies of scale and achieving its equity objectives. To this end, four lines of action are proposed in this paper: first, redefine the SNHS based on universal public coverage, as a civic right and equal for all; second, reframe the financing system and the role of the Cohesion Fund; third, review the role of central government and its Ministry of Health, and fourth, create of a SNHS Agency headed by a Commissioner, for providing an organizational framework and identity for the SNHS, and serving as the cooperative body of the seventeen Autonomous Communities' Health Services.

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[Not Available].

Rev Calid Asist

May 2008

Outsourcing and privatization of healthcare services are analyzed from Management and Economics perspectives, exploring form the Transaction Costs theory four types of outsourcing: centres, clinical services, diagnostic-therapeutic support services, and ancillary services. Potential effects of externalization are analysed, addressing the advantages and risks, and putting it into the context of the Spanish NHS. Some final remarks are made regarding policy and research agenda.

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[Not Available].

Rev Calid Asist

March 2008

Outsourcing and privatization of healthcare services are analyzed from management and economics perspectives, examining four types of outsourcing from the transaction costs theory: centres, clinical services, diagnostic-therapeutic support services, and ancillary services. Potential effects of outsourcing are analysed, addressing the advantages and risks, and putting it into the context of the Spanish NHS. Some final remarks are made regarding policy and research agenda.

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