Modelling efficiency in primary healthcare using the DEA methodology: an empirical analysis in a healthcare district.

Background: Primary healthcare management efficiency conditions the functioning of specialized care and has a direct impact on the outcomes of the health system and its sustainability. The objective of this research is to develop models to evaluate the efficiency, including health outcomes, of the primary healthcare centres (PHC) of the Clínico - La Malvarrosa Health District in Valencia.

Methods: To evaluate efficiency, Data Envelopment Analysis (DEA) was used with output orientation and variable returns to scale, with panel data from the years 2015 to 2019.

Incidence of anastomotic leakage using powered circular staplers versus manual circular staplers for left colorectal anastomosis: a cost-effectiveness analysis.

Background: Colorectal anastomotic leakage causes severe consequences for patients and healthcare system as it will lead to increased consumption of hospital resources and costs. Technological improvements in anastomotic devices could reduce the incidence of leakage and its economic impact. The aim of the present study was to assess if the use of a new powered circular stapler is cost-effective.

Cost of Type 2 Diabetes Patients with Chronic Kidney Disease Based on Real-World Data: An Observational Population-Based Study in Spain.

This study analyzed the prevalence, costs and economic impact of chronic kidney disease CKD in patients with T2D in a Spanish Health District using real-world data. Observational cross-sectional study in adult patients with T2D was through data extracted from the information systems of the Valencia Clínico-La Malvarrosa Health District in the year 2015. Patients were stratified with the KDIGO classification for CKD.

COVID-19, Fake News, and Vaccines: Should Regulation Be Implemented?

We analysed issues concerning the establishment of compulsory vaccination against COVID-19, as well as the role of misinformation as a disincentive-especially when published by health professionals-and citizen acceptance of measures in this regard. Data from different surveys revealed a high degree of hesitation rather than outright opposition to vaccines. The most frequent complaint related to the COVID-19 vaccination was the fear of side effects.

Cost-utility model of brivaracetam in the adjunctive treatment of patients with epilepsy in Spain.

Objective: This study aims to assess the cost utility of Brivaracetam compared with the third-generation anti-epileptic drugs used as standard care.

Methods: A cost utility analysis of Brivaracetam was carried out with other third-generation comparators. The treatment pathway of a hypothetical cohort over a period of 2 years was simulated using the Markov model.

Comparative analysis of direct and indirect costs of two minimally invasive techniques for the treatment of renal/ureteral calculi smaller than 2 cm.

Objective: To perform a comparative analysis of indirect and direct costs of two minimally invasive techniques (extracorporeal shock wave lithotripsy (ESWL) vs. ureteroscopy with holmium laser (URS/RIRS)) for the treatment of renal/ureteral calculi smaller than 2 cm.

Material And Methods: Prospective, comparative, non-randomized study of 84 patients treated for kidney stones smaller than 2 cm between January and December 2016.

Health-related quality of life in patients with systemic lupus erythematosus: a Spanish study based on patient reports.

Introduction And Objectives: Systemic lupus erythematosus (SLE) is a disease that significantly affects the quality of life and welfare of patients. SLE patients can be classified into multimorbidity levels using Clinical Risk Groups (CRGs) to help to incorporate predictive models of health needs. The goal of this study was to correlate CRGs with health-related quality of life (HR-QoL) and costs in SLE patients.

Predicting healthcare expenditure by multimorbidity groups.

Objectives: This article has two main purposes. Firstly, to model the integrated healthcare expenditure for the entire population of a health district in Spain, according to multimorbidity, using Clinical Risk Groups (CRG). Secondly, to show how the predictive model is applied to the allocation of health budgets.

Measurement of health-related quality by multimorbidity groups in primary health care.

Background: Increased life expectancy in Western societies does not necessarily mean better quality of life. To improve resources management, management systems have been set up in health systems to stratify patients according to morbidity, such as Clinical Risk Groups (CRG). The main objective of this study was to evaluate the effect of multimorbidity on health-related quality of life (HRQL) in primary care.

The trade-off between equity and efficiency in population health gain: Making it real.

Two fundamental goals of health systems are to maximise overall population health gain (referred to as efficiency) and to minimise unfair health inequalities (equity). Often there is a trade-off in maximising efficiency vis a vis equity and the relative weight given to one goal over the other is acknowledged to be essentially a value judgement. Health systems necessarily make those value judgements but in making them would benefit from relevant and accurate opportunity cost information.

Cost-effectiveness analysis of the human recombinant epidermal growth factor in the management of patients with diabetic foot ulcers.

: Diabetic foot ulcers are one of the most frequent complications of diabetes; such ulcers cause an increase in the costs of the health care of the diabetic patient and can even cause disability due to amputation in the patient. Although a proportion of patients achieve a spontaneous closure of ulcers, others require medical or surgical treatment. : To determine the cost-effectiveness of the intra- and perilesional application of recombinant human epidermal growth factor (rhEGF), as opposed to conventional therapy for the management of patients diagnosed with Wagner's 3 or 4 diabetic foot ulcer in Colombia.

[Impact of cardiovascular risk factors on the consumption of resources in Primary Care according to Clinical Risk Groups].

Objective: To analyze the prevalence of Cardiovascular Risk Factors (CVRF) in the context of a Basic Health Area and the impact they generate on morbidity and consumption of healthcare resources in the stratified population according to the Clinical System Risk Groups (CRG) in Primary Care, with the purpose of identifying the population with multimorbidity to apply preventive measures, as well as the one that generates the highest care burden and social needs.

Design: Observational, cross-sectional and population-based study for a basic health area during 2013.

Location: Department of Health 2 (Castellón), Comunidad Valenciana (CV).

[Direct hospitalization costs associated with chronic Hepatitis C in the Valencian Community in 2013].

Objective: Hospital costs associated with Chronic Hepatitis C (HCC) arise in the final stages of the disease. Its quantification is very helpful in order to estimate and check the burden of the disease and to make financial decisions for new antivirals. The highest costs are due to the decompensation of cirrosis.

Correction to: Budget Impact Analysis of Brivaracetam Adjunctive Therapy for Partial-Onset Epileptic Seizures in Valencia Community, Spain.

In the original publication, the abstract, conclusion was incorrectly published.

Budget Impact Analysis of Brivaracetam Adjunctive Therapy for Partial-Onset Epileptic Seizures in Valencia Community, Spain.

Background And Objective: More than 30% of patients with epilepsy have inadequate control of seizures with drug therapy. The goal of this study is to determine the budget impact (BI) of the introduction of brivaracetam to the portfolio of approved drugs in Spain as adjunctive therapy for the treatment of partial-onset epilepsy in patients over 16 years old with a 5-year time horizon in the Valencia Community, a Spanish region with a population of 5 million.

Methods: The BI model compares the pharmaceutical expenditure on antiepileptics in two scenarios: with and without brivaracetam.

Application of Lean Healthcare methodology in a urology department of a tertiary hospital as a tool for improving efficiency.

Objective: To describe the application of the Lean methodology as a method for continuously improving the efficiency of a urology department in a tertiary hospital.

Material And Methods: The implementation of the Lean Healthcare methodology in a urology department was conducted in 3 phases: 1) team training and improvement of feedback among the practitioners, 2) management by process and superspecialisation and 3) improvement of indicators (continuous improvement). The indicators were obtained from the Hospital's information systems.

Pharmaceutical cost and multimorbidity with type 2 diabetes mellitus using electronic health record data.

Background: The objective of the study is to estimate the frequency of multimorbidity in type 2 diabetes patients classified by health statuses in a European region and to determine the impact on pharmaceutical expenditure.

Methods: Cross-sectional study of the inhabitants of a southeastern European region with a population of 5,150,054, using data extracted from Electronic Health Records for 2012. 491,854 diabetic individuals were identified and selected through clinical codes, Clinical Risk Groups and diabetes treatment and/or blood glucose reagent strips.

[Impact of Morbidity on Health Care Costs of a Department of Health through Clinical Risk Groups. Valencian Community, Spain].

Background: Risk adjustment systems based on diagnosis stratify the population according to the observed morbidity. The aim of this study was to analyze the total health expenditure in a health area, relating to age, gender and morbidity observed in the population.

Methods: Observational cross-sectional study of population and area of health care costs in the Health District of Denia-Marina Salud (Alicante) in 2013.

A cost and performance comparison of Public Private Partnership and public hospitals in Spain.

Public-private partnership (PPP) initiatives are extending around the world, especially in Europe, as an innovation to traditional public health systems, with the intention of making them more efficient.There is a varied range of PPP models with different degrees of responsibility from simple public sector contracts with the private, up to the complete privatisation of the service. As such, we may say the involvement of the private sector embraces the development, financing and provision of public infrastructures and delivery services.

Methods to control the pharmaceutical cost impact of chronic conditions in the elderly.

Multimorbidity is the main cause of polypharmacy in elderly people, with the consequent increment in cost and use of inappropriate medication. To control cost, specific strategies have been implemented in healthcare services to reduce potentially inappropriate prescription. Many interventions are applied online during the prescription process using computerized decision support systems, for example, therapeutic algorithms and alerts.