scholarly journals Evolution of public hospitals expenditure by healthcare area in the Spanish National Health System: the determinants to pay attention to

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Manuel Ridao-López ◽  
Micaela Comendeiro-Maaløe ◽  
Natalia Martínez-Lizaga ◽  
Enrique Bernal-Delgado
2020 ◽  
Vol 32 (9) ◽  
pp. 599-608
Author(s):  
Daniel Angel García ◽  
Ismael Martínez Nicolás ◽  
José Andrés García Marín ◽  
Victoriano Soria Aledo

Abstract Objective To develop risk-adjusted models for two quality indicators addressing surgical site infection (SSI) in clean and colorectal surgery, to be used for benchmarking and quality improvement in the Spanish National Health System. Study design A literature review was undertaken to identify candidate adjustment variables. The candidate variables were revised by clinical experts to confirm their clinical relevance to SSI; experts also offered additional candidate variables that were not identified in the literature review. Two risk-adjustment models were developed using multiple logistic regression thus allowing calculation of the adjusted indicator rates. Data source The two SSI indicators, with their corresponding risk-adjustment models, were calculated from administrative databases obtained from nine public hospitals. A dataset was obtained from a 10-year period (2006–2015), and it included data from 21 571 clean surgery patients and 6325 colorectal surgery patients. Analysis methods Risk-adjustment regression models were constructed using Spanish National Health System data. Models were analysed so as to prevent overfitting, then tested for calibration and discrimination and finally bootstrapped. Results Ten adjustment variables were identified for clean surgery SSI, and 23 for colorectal surgery SSI. The final adjustment models showed fair calibration (Hosmer–Lemeshow: clean surgery χ2 = 6.56, P = 0.58; colorectal surgery χ2 = 6.69, P = 0.57) and discrimination (area under receiver operating characteristic [ROC] curve: clean surgery 0.72, 95% confidence interval [CI] 0.67–0.77; colorectal surgery 0.62, 95% CI 0.60–0.65). Conclusions The proposed risk-adjustment models can be used to explain patient-based differences among healthcare providers. They can be used to adjust the two proposed SSI indicators.


Author(s):  
Mª Isabel Ortega-Díaz ◽  
Ricardo Ocaña-Riola ◽  
Carmen Pérez-Romero ◽  
José Jesús Martín-Martín

Objective: To evaluate the relationship between the ownership structure of hospitals and the possibility of their being positioned on the frontier of technical efficiency in the economic crisis period 2010–2012, adjusting for hospital variables and regional characteristics in the areas where the Spanish National Health System (SNHS) hospitals are located. Methods: 230 National Health System hospitals were studied over the two-year period 2010–2012 according to their ownership structure—public hospitals, private hospitals and public–private partnership (PPP)—data envelopment analysis orientated to inputs was used to measure the overall technical efficiency, pure efficiency and efficiency of scale. A generalised linear mixed model (GLMM) with binomial distribution and logit link function was used to analyse the hospital and regional variables associated with positioning on the frontier. Results: There are substantial differences between the average pure technical efficiency of public, private and PPP hospitals, as well as a greater number of PPP models being positioned on the efficiency frontier (91.67% in 2012). The odds of being positioned on the frontier are 41.7 times higher in PPP models than in public hospitals. The average annual household income per region is related to the greater odds of hospitals being positioned on the frontier of efficiency. Conclusions: During the most acute period of recession in the Spanish economy, PPP formulas favoured hospital efficiency, by increasing the odds of being positioned on the frontier of efficiency when compared to private and public hospitals. The position on the frontier of efficiency of a hospital is related to the wealth of its region.


2019 ◽  
Vol 53 (5) ◽  
pp. 641-647
Author(s):  
Ferran Capdevila ◽  
Ruth Vera ◽  
Patricia Ochoa ◽  
Arkaitz Galbete ◽  
Eduardo Sanchez-Iriso

Author(s):  
Juan Manuel Carmona-Torres ◽  
Beatriz Recio-Andrade ◽  
María Aurora Rodríguez-Borrego

Abstract OBJECTIVE To determine the prevalence of intimate partner violence among health care professionals who work in the Spanish National Health System, according to the autonomous communities of Spain. METHOD This was a descriptive cross-sectional multicenter study conducted with male and female health professionals (doctors, nurses, and nursing aides) in the different autonomous communities that are part of the Spanish National Health System. The following instruments were employed: among women, an intimate partner violence screening questionnaire; and among men, a questionnaire that screened for violence in the family environment. RESULTS A total of 1,039 health professionals participated in the study. Of these, 26% had suffered some type of abuse. Among the men, this prevalence was 2.7%, while among the women, it was 33.8%. There were differences in the prevalence of intimate partner violence among different autonomous communities, with the highest percentages in the Canary Islands. In terms of profession, 19.5% of the doctors had been exposed to intimate partner violence, while this percentage was 31% and 48.6% for nurses and nursing professionals, respectively. CONCLUSION The results indicate the presence of intimate partner violence among healthcare personnel in most of the autonomous communities of Spain. The data demonstrate the need to implement action plans, both to support victims and to mitigate the problem.


2018 ◽  
Vol 7 (1) ◽  
pp. 16-30 ◽  
Author(s):  
Dimitrios G. Katehakis

The purpose of this work is to expose challenges related to the implementation of quality electronic medical record (EMR) systems in public hospitals in Greece, a country where the national health system (NHS) has already acquired electronic medical records (EMRs). The level of EMR implementation, together with organizational maturity at a hospital level, are explored. What is discovered is that there are different adoption levels, not recorded in a systematic manner. The majority of physicians are either reluctant to implement EMRs or do not know options available to them. Implications include not continuous flow of events, cut off of critical information, lower quality of health services, patients not empowered to carry with them clinically significant information, unnecessary repetition of medical procedures and higher costs. It is concluded that focus should be paid on enabling the use of quality, interoperable and secure EMRs to better support medical decision, in an effort to improve the health of the population and to better control costs.


2013 ◽  
Vol 16 (8) ◽  
pp. 686-695
Author(s):  
C. Caballero ◽  
E. Jantus-Lewintre ◽  
A. Carrato ◽  
J. García-Foncillas ◽  
P. Gascón ◽  
...  

2010 ◽  
Vol 5 (2) ◽  
pp. 170-171
Author(s):  
J.M. Garcia-Almeida ◽  
J. DelRio-Mata ◽  
J. Garcia-Aleman ◽  
C. Conejo-Gómez ◽  
A. Martínez-Reina ◽  
...  

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