[Health services supply and the economic crisis: either we fund goods and services according to their value or we become bankrupt. SESPAS report 2014].

Abstract:

:Health policy has reacted to the financial crisis by overemphasising measures targeted at reducing unit costs, increasing barriers to access (waiting lists) or closing premises. It is too soon for scientific assessment of the impact of this reshaping of supply on equity, quality and safety, and on individual and population health. Nevertheless, the emergency measures taken to achieve fiscal stabilization have shifted the focus to resolving budget problems at the expenses of sounder and deeper initiatives aimed at deciding what must be funded and how. This article advocates a policy based on selective funding of services and benefits on the basis of their value. Other countries' experiences can serve as a useful guide, including robust methods to identify technologies (or their uses) of questionable value, prioritization criteria, and careful consideration of limitations associated with the elimination of a certain benefit, especially if it affects the founding values of the system. The necessary tools are available to the Spanish health system: the regulatory framework and technical bodies able to identify lower value care, support for decision-making, and timely evaluation of such decisions. Despite the numerous hurdles, maintaining the status quo is too expensive a choice, given the opportunity costs of effectiveness and safety losses, measured in terms of equity and the economic efficiency of the Spanish health system, which may ultimately translate into worsening of the population's health status.

journal_name

Gac Sanit

journal_title

Gaceta sanitaria

authors

Bernal-Delgado E,Campillo-Artero C,García-Armesto S

doi

10.1016/j.gaceta.2014.02.004

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

69-74

eissn

0213-9111

issn

1578-1283

pii

S0213-9111(14)00044-2

journal_volume

28 Suppl 1

pub_type

杂志文章
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    authors: Forga Llenas L,Goñi Iriarte MJ,Cambra Contin K,Ibáñez Beroiz B,Chueca Guendulain M,Berrade Zubiri S

    更新日期:2015-01-01 00:00:00

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    journal_title:Gaceta sanitaria

    pub_type: 杂志文章

    doi:10.1016/j.gaceta.2012.01.010

    authors: Campillo-Artero C,Bernal-Delgado E

    更新日期:2013-03-01 00:00:00

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    authors: Ruiz-Muñoz D,Pérez G

    更新日期:2013-01-01 00:00:00

  • [How to assess and reduce social inequalities in cancer screening programmes].

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    更新日期:2018-10-01 00:00:00

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    authors: Rodríguez Alvarez E,Lanborena Elordui N,Senhaji M,Pereda Riguera C

    更新日期:2008-09-01 00:00:00

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    authors: Sanfrutos Velázquez N

    更新日期:1991-09-01 00:00:00

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    pub_type: 杂志文章,多中心研究

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    更新日期:2003-11-01 00:00:00

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    journal_title:Gaceta sanitaria

    pub_type: 杂志文章

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    authors: Zambrana-García JL,Rivas-Ruiz F,en nombre del Grupo para el Análisis de la Calidad del Informe de Alta Hospitalaria en los Hospitales de Alta Resolución de Andalucía.

    更新日期:2013-09-01 00:00:00

  • Understanding Urban Health Inequalities: Methods and Design of the Heart Health Hoods Qualitative Project.

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    pub_type: 杂志文章

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    authors: Rivera Navarro J,Franco Tejero M,Conde Espejo P,Sandín Vázquez M,Gutiérrez Sastre M,Cebrecos A,Sainz Muñoz A,Gittelsohn J

    更新日期:2019-01-01 00:00:00

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    journal_title:Gaceta sanitaria

    pub_type: 杂志文章

    doi:10.1157/13106808

    authors: Vives-Cases C,Alvarez-Dardet C,Carrasco-Portiño M,Torrubiano-Domínguez J

    更新日期:2007-05-01 00:00:00

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    journal_title:Gaceta sanitaria

    pub_type: 杂志文章,评审

    doi:10.1157/13091148

    authors: García-Altés A,Zonco L,Borrell C,Plasència A,Barcelona Group on the Performance of Health Care Services.

    更新日期:2006-07-01 00:00:00

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    pub_type: 杂志文章,多中心研究

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    更新日期:2010-11-01 00:00:00

  • [Survival by cervical cancer stage and factors collected by the Cancer Registry in Mallorca (Spain)].

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    authors: Amengual J,Montaño J,Franch P,Ramos M

    更新日期:2020-01-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1016/j.gaceta.2011.09.017

    authors: López-Liria R,Padilla-Gógora D,Catalán-Matamoros DJ,Rocamora-Pérez P,Martínez-Cortés Mdel C,Rodríguez-Martín CR

    更新日期:2012-05-01 00:00:00

  • [Listening to the voice of the patient: an imperative. 2008 SESPAS Report].

    abstract::To democratize health services, citizen participation should be free, informed and involve choice. To achieve this, a formal and public system of health services' evaluation is required. The present article aims to argue the need to promote the participation of patients and persons affected by disease to achieve great...

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    pub_type: 杂志文章

    doi:10.1016/s0213-9111(08)76092-8

    authors: Jovell AJ,Navarro Rubio MD

    更新日期:2008-04-01 00:00:00

  • [Intimate partner violence: social and health determinants and responses].

    abstract::The present study aims to review the problem of intimate partner violence, as well as its causes and consequences. It will also specifically analyze the role of health professionals. In opposition to the classical epidemiological view of risk factors, Heise proposes an ecological framework to study violence against wo...

    journal_title:Gaceta sanitaria

    pub_type: 杂志文章,评审

    doi:10.1157/13061990

    authors: Ruiz-Pérez I,Blanco-Prieto P,Vives-Cases C

    更新日期:2004-01-01 00:00:00

  • [Leisure time physical activity and its association with demographic variables and other behaviors related with health].

    abstract:OBJECTIVES:To describe leisure-time physical activity at the levels considered more beneficial for health and to analyze the association with sociodemographic variables and other health behaviors, among the population older than 14 years in Barcelona, Spain. METHODS:A sample of 4,171 adults answered the Health Intervi...

    journal_title:Gaceta sanitaria

    pub_type: 杂志文章

    doi:

    authors: Domínguez-Berjón MF,Borrell C,Nebot M,Plasència A

    更新日期:1998-05-01 00:00:00

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    abstract:OBJECTIVE:To identify predisposing, inhibitory and facilitating factors that may affect participation in colorectal cancer screening programs in the Roma population. METHOD:Qualitative and exploratory study by focus group technique. Three focus groups of men and three groups of women were carried out, with a total of ...

    journal_title:Gaceta sanitaria

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    doi:10.1016/j.gaceta.2017.08.007

    authors: Santiago-Portero MC,Gómez-García JM,Reig-Gómez H,Oltra-Durá T,Gascón-Cánovas JJ

    更新日期:2018-01-01 00:00:00

  • [Literacy programs for the promotion of mental health in the school setting. SESPAS Report 2020].

    abstract::The World Health Organization emphasizes the importance of developing programs of mental health promotion and prevention to ensure the wellbeing of young people. Mental health literacy in schools is an example of universal prevention intervention. The objective of this article is to conduct a systematic review of the ...

    journal_title:Gaceta sanitaria

    pub_type: 杂志文章,评审

    doi:10.1016/j.gaceta.2020.06.010

    authors: Casañas R,Mas-Expósito L,Teixidó M,Lalucat-Jo L

    更新日期:2020-01-01 00:00:00

  • [Cost of therapy for neurodegenerative diseases. Applying an activity-based costing system].

    abstract:OBJECTIVE:To apply the activity based costing (ABC) model to calculate the cost of therapy for neurodegenerative disorders in order to improve hospital management and allocate resources more efficiently. METHOD:We used the case study method in the Francolí long-term care day center. We applied all phases of an ABC sys...

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    doi:10.1016/j.gaceta.2012.12.003

    authors: Sánchez-Rebull MV,Terceño Gómez A,Travé Bautista A

    更新日期:2013-09-01 00:00:00

  • [Malnutrition and cognitive development if infants in rural marginalized areas in Mexico].

    abstract:OBJECTIVE:To analyze the relationship between nutritional status measured by anthropometry and the mental, psychomotor and language development of infants in marginalized rural areas of Mexico. METHOD:Cross-sectional study with 576 infants aged from 7 to 26 months in four rural locations. Variables consisted of measur...

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    authors: Carrasco Quintero Mdel R,Ortiz Hernández L,Roldán Amaro JA,Chávez Villasana A

    更新日期:2016-07-01 00:00:00

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    journal_title:Gaceta sanitaria

    pub_type: 杂志文章

    doi:10.1016/s0213-9111(02)71668-3

    authors: Calderón J,Capell C,Centrich F,Artazcoz L,González-Cabré M,Villalbí JR

    更新日期:2002-05-01 00:00:00

  • [Authorship and data reporting according to gender in four Spanish biomedical journals].

    abstract:AIMS:To describe authorship according to gender in the articles published in four Spanish scientific journals of general medicine and public health, and to analyse the type of presentation of the results in relation to the sex of the subjects of the study. METHODS:We examined 423 articles from four Spanish scientific ...

    journal_title:Gaceta sanitaria

    pub_type: 杂志文章

    doi:10.1016/s0213-9111(01)71555-5

    authors: Schiaffino A,García M,Fernández E,Grupo Género y Salud Pública de SESPAS.

    更新日期:2001-05-01 00:00:00

  • [Internet and sexual risk in men who have sex with men].

    abstract:OBJECTIVE:1) To compare sociodemographic characteristics, Internet use to seek sexual partners, and sexual behavior in two samples of men who have sex with men: one sample that was surveyed on-line and another that was interviewed in gay venues. 2) To determine the variables associated with unprotected anal intercourse...

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    pub_type: 杂志文章

    doi:10.1016/j.gaceta.2008.11.004

    authors: Fernández-Dávila P,Zaragoza Lorca K

    更新日期:2009-09-01 00:00:00

  • [Indicators for the management of public health services].

    abstract:OBJECTIVES:To define a set of indicators for the management of the various services of an agency responsible for comprehensive public health in a defined area and population. METHODS:We analyzed the agency's activity and held discussions with those responsible for the distinct services to define indicators whose estim...

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    pub_type: 杂志文章

    doi:10.1016/j.gaceta.2010.03.004

    authors: Villalbí JR,Casas C,Bartoll X,Artazcoz L,Ballestín M,Borrell C,Camprubí E,Durán J,García R,Rodríguez P,Salamero M

    更新日期:2010-09-01 00:00:00

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    abstract::R-ALERGO is a project developed by researchers from the Universitat Politècnica de València and the Hospital Universitario La Fe (Valencia, Spain). The main objective of the project is to create a mobile application identifying, within the city of Valencia, the most favorable routes for allergic individuals. The appli...

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    pub_type: 杂志文章

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    authors: Temes Cordovez RR,Moya Fuero A,Martí Garrido J,Perales Chordá C,Díaz Palacios M,Hernández Fernández de Rojas D

    更新日期:2016-03-01 00:00:00

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    abstract::This article argues for the need to implement community healthcare promotion initiatives in medical practice. Some of the community initiatives introduced in primary care, as well as scientific evidence and associated implementation factors are described. The need for effective coordination between primary care and pu...

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    pub_type: 杂志文章

    doi:10.1016/j.gaceta.2016.05.012

    authors: Cabeza E,March S,Cabezas C,Segura A

    更新日期:2016-11-01 00:00:00

  • [Methods to smooth mortality indicators: application to analysis of inequalities in mortality in Spanish cities [the MEDEA Project]].

    abstract::Although there is some experience in the study of mortality inequalities in Spanish cities, there are large urban centers that have not yet been investigated using the census tract as the unit of territorial analysis. The coordinated project

    journal_title:Gaceta sanitaria

    pub_type: 杂志文章

    doi:10.1016/s0213-9111(08)75362-7

    authors: Barceló MA,Saez M,Cano-Serral G,Martínez-Beneito MA,Martínez JM,Borrell C,Ocaña-Riola R,Montoya I,Calvo M,López-Abente G,Rodríguez-Sanz M,Toro S,Alcalá JT,Saurina C,Sánchez-Villegas P,Figueiras A

    更新日期:2008-11-01 00:00:00

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    abstract:OBJECTIVE:Perceived health status questionnaires provide important information for health outcomes research. Reference measures are required to interpret the health-related quality of life questionnaires belonging to the short form (SF) health survey family. Previous studies have provided these reference measures for t...

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    authors: Monteagudo Piqueras O,Hernando Arizaleta L,Palomar Rodríguez JA

    更新日期:2009-11-01 00:00:00