[Human resource management in health. Consensual paths forward. SESPAS Report 2024].

Healthcare professionals deserve good management, and Spain, stagnant in its productivity, needs it. Good management is possible, as evidenced during the states of alarm in 2020. None of the lessons learned have been consolidated.

[Rebuilding the healthcare system: governance, organization and digitalization. SESPAS Report 2022].

Reflection on three major levers for rebuilding the healthcare system: governance, integration of health and social care and digitalization. Spain has worrying levels of quality of democracy and public confidence in its politicians, and major changes are required in public administration to achieve a better state. Healthcare suffers from a deficient institutional architecture that prevents adequate macrogovernance.

[What is an efficient health intervention in Spain in 2020?].

Fifteen years ago, Gaceta Sanitaria published the article entitled "What is an efficient health technology in Spain?" The growing interest in setting the price of new technologies based on the value they provide to health systems and the experience accumulated by the countries in our environment make it opportune to review what constitutes an efficient health intervention in Spain in 2020. Cost-effectiveness analysis continues to be the reference method to maximize social health outcomes with the available resources. The interpretation of its results requires establishing reference values that serve as a guide on what constitutes a reasonable value for the health care system.

Association of orthogeriatric services with long-term mortality in patients with hip fracture.

Purpose: To assess the impact of the comprehensive orthogeriatric care model (OGM) on 2-year survival, length of stay (LOS), discharges to nursing homes, and antiosteoporotic treatment (AOT) in patients with hip fracture.

Methods: Retrospective cohort study. Hospitals were classified as OGM if the patient was cared for in a comprehensive orthogeriatric unit.

Secular trend in the incidence of hip fracture in Catalonia, Spain, 2003-2014.

Objectives: to describe the secular trend and seasonal variation in the incidence of hip fracture (HF) over 12 years (2003-2014) in Catalonia, the community with the highest incidence of HF in Spain.

Methods: data about age, gender, type of fracture and month of hospitalisation among patients aged 65 years and older discharged with a diagnosis of HF were collected. Crude and age-standardised annual incidence rate were reckoned.

Tax on sugar sweetened beverages in Spain.

This article provides a critical review about the challenges that taxes on sugary drinks as an instrument of health policy must face to reverse the trend of the current epidemics of obesity. We analyzed the experiences of the leading countries, particularly Mexico, and reflect on the counterweight exerted by the industry against obesity policies, and on the power of lobbyists. Those tax policies for public health have to overcome the enormous strength of the industry, which is exerted in several-science and research, brand reputation, influence on regulators-levels.

Allocation of Residency Training Positions in Spain: Contextual Effects on Specialty Preferences.

In Spain's 'MIR' system, medical school graduates are ranked by their performance on a national exam and then sequentially choose from the available residency training positions. We took advantage of a unique survey of participants in the 2012 annual MIR cycle to analyze preferences under two different choice scenarios: the residency program actually chosen by each participant when it came her turn (the 'real') and the program that she would have chosen if all residency training programs had been available (the 'counterfactual'). Utilizing conditional logit models with random coefficients, we found significant differences in medical graduates' preferences between the two scenarios, particularly with respect to three specialty attributes: work hours/lifestyle, prestige among colleagues, and annual remuneration.

Cross-sectional study comparing public and private hospitals in Catalonia: is the practice of routine episiotomy changing?

Background: In Spain, the Strategy for Assistance in Normal Childbirth (SANC) promoted a model of care, which respects the physiological birth process and discards unnecessary routine interventions, such as episiotomies. We evaluated the rate of episiotomy use and perineal trauma as indicators of how selective introduction of the SANC initiative has impacted childbirth outcomes in hospitals of Catalonia.

Methods: Cross-sectional study of all singleton vaginal term deliveries without instrument registered in the Minimum Basic Data Set (MBDS) of Catalonia in 2007, 2010 and 2012.

[Vertical social mobility in Spain and ways to improve it. SESPAS report 2014].

In this article, we analyze the extent to which an individual's socioeconomic status is inherited and how equality of opportunity could be increased to improve social mobility. Poverty and deprivation can stop being dynastic-like if the social elevator works. In Spain, income inequality, measured by the Gini coefficient, rose from 0.

Obstetric interventions in two groups of hospitals in Catalonia: a cross-sectional study.

Background: Childbirth assistance in highly technological settings and existing variability in the interventions performed are cause for concern. In recent years, numerous recommendations have been made concerning the importance of the physiological process during birth. In Spain and Catalonia, work has been carried out to implement evidence-based practices for childbirth and to reduce unnecessary interventions.

[Important differences between faculties of medicine. Implications for family and community medicine].

Objective: To determine if there are significant differences between universities in the proclivity to choose Family and Community Medicine (FCM), given the constraints imposed by the number of choice. To test the hypothesis that the Schools of Medicine that have the FCM as a compulsory subject in the degree (3 of 27) had the highest preference for this specialty.

Design: Observational study on the data file of all the individuals taking the MIR examination between 2003 and 2011.

Specialty choice in times of economic crisis: a cross-sectional survey of Spanish medical students.

Objective: To investigate the determinants of specialty choice among graduating medical students in Spain, a country that entered into a severe, ongoing economic crisis in 2008.

Setting: Since 2008, the percentage of Spanish medical school graduates electing Family and Community Medicine (FCM) has experienced a reversal after more than a decade of decline.

Design: A nationwide cross-sectional survey conducted online in April 2011.