HEALTH SECTOR

Author: STOYANOVA ALEXANDRINA P..
Year: 2003.
University: BARCELONA [www.ub.es].
Place of defense: CIENCIAS ECONÓMICAS Y EMPRESARIALES.
Place of preparation: UNIVERSIDAD DE BARCELONA.

Author: STOYANOVA ALEXANDRINA P..
Year: 2003.
University: BARCELONA [www.ub.es].
Place of defense: FACULTAD DE CIENCIAS ECONÓMICAS Y EMPRESARIALES.
Place of preparation: UNIVERSIDAD DE BARCELONA.

Author: SANCHEZ IRISO EDUARDO.
Year: 2005.
University: PÚBLICA DE NAVARRA [www.unavarra.es].
Place of defense: DEPARTAMENTO DE ECONOMIA.
Place of preparation: FACULTAD DE CIENCIAS ECONOMICAS Y EMPRESARIALES.

Summary: Agencies economic evaluation of health technologies, such as the National Institute for Clinical Excellence (NICE) English and the World Health Organization (WHO) design their policies based on analysis coste-utilidad. Currently, the utility is measured in years of life adjusted for quality (QALYs, better known by its acronym English QALY). The calculation of QALYs requires an index that is capable of assessing the quality of life of individuals on the basis of their statements salud.Realizar measurement erroneous indices of quality of life, can have adverse consequences both in the assessment program health are in operation, as in the selection of programs to develop. Most of this thesis is part of the procedures for obtaining the indices of quality of life. It discusses their properties and proposing solutions to some of the problems identified by the relevant literature in the area.

Author: METZGER TORELLÓ XAVIER.
Year: 2005.
University: BARCELONA [www.ub.es].
Place of preparation: FACULTAD CIENCIAS ECONÓMICAS - UNIVERSIDAD DE BARCELONA.

Summary: Most of the indices of inequality biased constructive related to the theories of distributive justice. Here, the concentration index (CI) presents a particular vision of how it should be assessed to individuals rich versus the poor in its analysis of inequality associated with socioeconomic variables. Specifically, the index parameter value presents its version of inequality (V = 2). The thesis proposes a new methodology for all individuals in a population, which are relevant not only the socio-economic status of individuals, but also the health risk presented by each of them. The field study conducted (Barcelona, 2004), shows that individuals are adverse social and economic inequality in health for all scenarios analyzed health risk, and that is growing aversion to risk increases. Also, for most of the scenarios are signs that the IC is not --- for application in the field of health, and intends to use the concentration ratio with its generalized minimum value of V = 3.

Author: MORALES ASENCIO JOSE MIGUEL.
Year: 2005.
University: MÁLAGA [www.uma.es].
Place of defense: E.U. CIENCIAS DE LA SALUD.
Place of preparation: FACULTAD DE CIENCIAS ECONÓMICAS Y EMPRESARIALES - UNED.

Summary: INTRODUCTION The demographic, social, growing demand for care, shortening stays, increased capacity resolutiva Primary Care and the loss of family support network for the care, have turned, Home Care (AD) a service for the Strategic Health Systems. The responses have been mixed, highlighting the multiplicity of suppliers and resources, with great difficulty in accessing them by the most vulnerable populations. In Andalusia, in 2002, introduced a new model of organizing services AD; incorporating case management as a second level decision. MAIN OBJECTIVES describe the results obtained in patients cared for at home and their carers, in terms of functional capacity, utilization of resources and social and satisfaction by the comparison with the conventional model. SECONDARY determine attracting carers by the Health System, to verify potential impact on the institutionalization of patients, fear-term survival, quality of life, family and function overloading of carers, as well as analyze the profile them in Andalusia. MATERIALS AND METHODS Prospective study, quasi-experimental multicenter, with concurrent control group conducted from 2003 to 2005 in District Primary Health Care in Malaga, Almeria, Granada and Costa del Sol. SUBJECT OF STUDY Patients reinclusion in the services of AD (terminals, hospital discharges and immobilized), as well as their caregivers. Patients were assigned to the intervention group or control depending on whether perteneciesen or not health centers where the new model was already in place, respectively. The follow-up period was 6 months. The main outcome variables were: functionality (activities of daily living), cognitive function, use of health resources and satisfaction. RESULTS 647 subjects were selected, which were finally included 460 (intervention = 249, control = 211, carers 44.1%. Inmovilizados 35.9%, hospital discharges 14.8% and terminal patients 5.2%). The baseline of patients in the intervention group was manifestly worse, which responds to the appropriateness of the criteria set derivation. In immobilized differences in baseline functionality at the expense of the intervention group were not equalized to 6 months. In contrast, hospital discharges, a game situation functionality detriment lower in the intervention group were not equalized to 6 months. In contrast, hospital discharges, a game situation functionality lower in the intervention group (Barthel: 47.56 vs. 71.80, p = 0.0001), disappeared two months these differences (Bartherl: 65.56 vs. 76.09, p = 0113). In terminals, there was no difference between groups. It showed fewer home visits in the intervention group, obtaining greater social benefits of interventions by the social worker, physical therapy and less of the carer visits to the health center, as well as patient. By contrast, although not statistically significant, increased visits to emergency in the intervention group. Satisfaction is differentiated in favor of the intervention group in a significant way: 16.84 (95% CI, 16.28-17.41) VS 15.02 (IC92%: 14.10-15.94) (p = 0004) . The overload of carers to 6 months was lower in the intervention group (Zarit 52.53 vs. 66.14, p = 0.0001) there was no difference in mortality or institutionalization. CONCLUSIONS The new model of AD with solvency identifies those patients most vulnerable and positively affects the functionality of hospital discharges, the overload of carers and the use of health services, as well as satisfaction with fewer visits. By contrast, appears to have no impact on readmissions or with the functionality of the patients deteriorated.

Author: PRADAS VELASCO ROBERTO.
Year: 2006.
University: LA RIOJA [www.unirioja.es].
Place of defense: Facultad de Ciencias Empresariales.
Place of preparation: FACULTAD DE CIENCIAS EMPRESARIALES.

Summary: The health interventions at the workplace can have obvious consequences for the company and for society in general. This thesis is an analysis of the impact of vaccination antigripal of the employed population. The results are studied both health and economic nature as to substantially affect three actors: employer, employee and system sanitario.Se taken several perspectives for the analysis of the impact of the health intervention: immunization against influenzavirus of the employed population. So, from a business perspective explores the implications for the employer to the fact prevent cases of flu among its employees, basically avoid days off and those in which the employee is diminished productivity; from the perspective of the patient potential measured how it affects suffering from the flu to their quality of life and their economy, finally, from the perspective health will be discussed saving health resources? doctors surgeries and treatments? Associated with the introduction of health intervention. To evaluate the effectiveness of the intervention using a range of indicators fruit contrast with the cost savings incurred. In addition to the prospects mentioned, it takes a social adding the results obtenidos.Para to accommodate all of the factors involved it is necessary to use a mixed model that combines diverse nature of scientific instruments. Used tools and techniques of mathematical nature, such as infinitesimal calculus and regression minimocuadrática to consider the impact of epidemiological immunization program. Furthermore, the valuation of consumption of health care resources, financial and business use of labor has required the use of decision trees and concepts such as the elasticity of a variable. Moreover, the study of the quality of life associated with immunization has resulted in a specific field of work. There are four elements that distinguish this study of what has been done so far, both nationally and internationally: the mathematical modeling of the dynamic epidemiological evolution of the disease through differential equations; the extent of the change in quality of life health-related (HRQOL) employing subjects representing the collective target, the consideration of multiple perspectives? business, personal, health and social? , And the use of the concept of elasticity in the analysis of the results obtenidos.Mediante analysis of the results it is concluded that you can get the wave epidemic of influenza enters a downturn vaccination figures reaching close to half the expected incidence. In addition, intervention can help to improve labor productivity and the quality of life of the collective intervened, and the timely release of health resources. Factors valued in monetary terms, exceeding in value to the costs associated with health intervention.