Gaceta Sanitaria最新文献

{"title":"Evaluación del rendimiento y compensación en centros sanitarios de gestión directa. Parte 2: el Sistema Nacional de Salud. Informe SESPAS 2024","authors":"José Ramón Repullo Labrador,&nbsp;José Manuel Freire Campo","doi":"10.1016/j.gaceta.2024.102368","DOIUrl":"10.1016/j.gaceta.2024.102368","url":null,"abstract":"<div><p>In Spain, the compensation model for statutory health personnel is complex, heterogeneous, and more oriented to rewarding complementary functions and activities, than to paying for the actual performance in the position of employee. The various attempts to incorporate incentives have been distorted by a civil service egalitarianist culture, and weak systemic governance. External attractors (private practice, etc.) for healthcare professionals are becoming more important and neutralize many intramural incentives. There are few prospects of relevant or general changes, since the main actors involved are reforms-averse; but some environmental factors can lead to incremental improvements in employment contracts, in the information available to improve benchmarking, and in the creation of islands of good clinical governance and management. The economic scenario, increasingly concerned about inflationary trends and sustainability risks, may have a revitalizing effect of some governance and management reforms.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102368"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000153/pdfft?md5=e791befa34e19af8d289eb1e48b80a8d&pid=1-s2.0-S0213911124000153-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Parkinson's mortality in Mexico 2000–2020","authors":"Myrna L. Yeverino Gutiérrez ,&nbsp;María del Rosario González González ,&nbsp;Omar González Santiago","doi":"10.1016/j.gaceta.2024.102361","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102361","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the recent trends in Parkinson's disease mortality in Mexico during 2000-2020.</p></div><div><h3>Method</h3><p>The adjusted mortality rate per 100,000 inhabitants was calculated using the direct method and the world standard population. Trend analysis was performed with the Joinpoint software.</p></div><div><h3>Results</h3><p>The average mortality rate was 1.26/100,000 inhabitants (SD: 0.09), and males showed higher mortality than females (M/F ratio<!--> <!-->=<!--> <!-->1.60). Older individuals ≥<!--> <!-->70 years old showed higher mortality rates than the rest of the age groups. During the period of study, a significant increase in mortality was observed from 2000 to 2005, while from 2005 to 2020 no significant trend was observed in all the studied groups.</p></div><div><h3>Conclusions</h3><p>In Mexico, males and older individuals showed the highest mortality rates. The socioeconomic regions with high levels of wellness showed the highest mortality rates levels. Parkinson's mortality rate has remained constant since 2005 in Mexico.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102361"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000086/pdfft?md5=dbe04255b0c93ee3b589d837cb041d71&pid=1-s2.0-S0213911124000086-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139992412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Se cumple la ley de control del tabaquismo en las terrazas de hostelería?","authors":"M. José López ,&nbsp;Marcela Fu ,&nbsp;Esteve Fernández ,&nbsp;Elisabet Henderson ,&nbsp;Xavier Continente","doi":"10.1016/j.gaceta.2024.102422","DOIUrl":"10.1016/j.gaceta.2024.102422","url":null,"abstract":"<div><h3>Objetivo</h3><p>Describir el consumo de tabaco y el cumplimiento de la normativa en las terrazas de hostelería de Barcelona.</p></div><div><h3>Método</h3><p>Estudio transversal en una muestra de 120 terrazas de hostelería de Barcelona. Se realizaron observaciones de 30 minutos mediante una ficha de registro estandarizada. Las variables de estudio fueron personas fumando, número de cigarrillos fumados, presencia de colillas, nivel socioeconómico del barrio, momento de la observación, normativa de consumo, número de sillas y número de personas.</p></div><div><h3>Resultados</h3><p>En el 97,5% de las terrazas había personas fumando en el momento de la observación, sin diferencias según el nivel socioeconómico del barrio o la normativa de consumo de tabaco en la terraza. La ley se incumplía en el 100% de las terrazas en las que estaba prohibido fumar.</p></div><div><h3>Conclusiones</h3><p>El incumplimiento generalizado de la actual ley pone de manifiesto la necesidad de implementar la prohibición de fumar sin excepciones en las terrazas de hostelería.</p></div><div><h3>Objective</h3><p>To describe tobacco consumption and the compliance with the law on hospitality terraces in Barcelona.</p></div><div><h3>Method</h3><p>Cross-sectional study by observation in a sample of 120 hospitality terraces in Barcelona. 30-minute observations were made using a standardized record sheet. The study variables were number of people smoking, number of cigarettes smoked, cigarette butts, socioeconomic status of the neighborhood, time of observation, consumption regulation, number of chairs and number of persons.</p></div><div><h3>Results</h3><p>There were people smoking at the time of the observation in 97.5% of the terraces, with no differences according to socioeconomic level of the neighborhood or the regulation of the terrace. There was no compliance with the law in 100% of the terraces where smoking was banned.</p></div><div><h3>Conclusions</h3><p>The widespread non-compliance with the current law indicates the need to implement a smoking ban without exceptions on hospitality terraces.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102422"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000748/pdfft?md5=855c9bf1a60acdc9328f9ff24e9145a6&pid=1-s2.0-S0213911124000748-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142242879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Los retos de la gobernanza de los recursos humanos de la sanidad pública. Informe SESPAS 2024","authors":"Javier Hernández Pascual","doi":"10.1016/j.gaceta.2024.102377","DOIUrl":"10.1016/j.gaceta.2024.102377","url":null,"abstract":"<div><p>Recurrent imbalances between supply, demand and personnel needs are one of the main challenges facing the National Health System (NHS). This situation has its origin both in supply factors and in the conditioning factors of the demand for human resources in the public health sector. The demographic structure of the NHS health professionals is generating an increasing number of outflows of doctors and nurses. On the other hand, the complex institutional architecture of the public health system produces dysfunctions in the structure of demand and in the form of recruitment. This paper argues for the need to articulate a strategic response that addresses the improvement of the governance of the human resources of the NHS and the reform of the instruments of coordination and harmonization of actions at the three levels of government of public healthcare.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102377"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000244/pdfft?md5=1e70c471989272847cae605b00317ee5&pid=1-s2.0-S0213911124000244-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential rates of induced abortion in Spain: educational attainment and age among native and immigrant women","authors":"Miguel Requena ,&nbsp;Mikolaj Stanek","doi":"10.1016/j.gaceta.2024.102419","DOIUrl":"10.1016/j.gaceta.2024.102419","url":null,"abstract":"<div><h3>Objective</h3><p>Analyzing the variations in induced abortion (IA) rates across different subpopulations in Spain based on country of origin, while considering educational and age composition.</p></div><div><h3>Method</h3><p>Using 2021 Voluntary Termination of Pregnancy register and 2021 Spanish Census microdata, we calculated crude IA rates and age-specific abortion rates. We used age-standardized IA rates (ASIAR) to account for the confounding effect of age composition. We compared seven subpopulations residing in Spain, taking into account simple ages and educational levels aggregated into four categories.</p></div><div><h3>Results</h3><p>Immigrant women, especially those from Sub-Saharan and Latin American countries, consistently had higher IA rates compared to native Spanish women. According to age-specific IA rates, university-educated women had considerably fewer abortions than women with other education levels at any age. Age-standardized rates stratified by migratory origin revealed that native Spanish women with primary education or less had higher IA rates than their immigrant counterparts. There was a clear non-linear, association between educational level and IA rates among immigrants. The highest propensity for IA was found among secondary school graduates, while university graduates had the lowest IA rate.</p></div><div><h3>Conclusions</h3><p>The study demonstrated that variability in sociodemographic characteristics had an impact on IA rates. Young women with middle educational attainment and immigrant background had a higher likelihood of undergoing IA in Spain. The relationship between educational level and IA rates was complex, with variations observed among different groups and changes over time.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102419"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000712/pdfft?md5=3ed209b019af3d76eff4314c9dd420f6&pid=1-s2.0-S0213911124000712-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recensión bibliográfica","authors":"José Pulido Manzanero","doi":"10.1016/j.gaceta.2024.102396","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102396","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102396"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000438/pdfft?md5=e0b471ece746b2676a4e79a0aa4730b8&pid=1-s2.0-S0213911124000438-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140918824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La protección de la salud de jóvenes y adolescentes exige una subida urgente de los precios del tabaco","authors":"Josep M. Suelves ,&nbsp;Ángel López-Nicolás ,&nbsp;Eduardo Satué de Velasco ,&nbsp;Anna García-Altés","doi":"10.1016/j.gaceta.2024.102405","DOIUrl":"10.1016/j.gaceta.2024.102405","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102405"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000566/pdfft?md5=125def502e75d7dcfe61962dcebb533b&pid=1-s2.0-S0213911124000566-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluación piloto del programa «Transformem els patis» en escuelas de primaria de Barcelona","authors":"Jesús Periañez ,&nbsp;Xavier Continente ,&nbsp;Marta Sanz-Mas ,&nbsp;Gemma Drou ,&nbsp;Albert Espelt ,&nbsp;Emma Cortés ,&nbsp;María José López","doi":"10.1016/j.gaceta.2024.102429","DOIUrl":"10.1016/j.gaceta.2024.102429","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the “Transformem els patis” (Let's transform the schoolyards) program in Barcelona in terms of schoolyard use, social interaction, physical activity, and diverse forms of play with a gender perspective.</div></div><div><h3>Method</h3><div>A cross-sectional pilot evaluation study with mixed methodology involving eight primary schools (four in intervention group and four in control group). For the quantitative analysis, 16 systematic observations were performed in the schoolyards of both groups. The group size, group composition according to sex, physical activity, the carried-out activity and play structures or material use, and environmental variables were analyzed. For the qualitative analysis, three structured group interviews were held with teachers and the monitoring team of the intervention group. A thematic content analysis with a phenomenological perspective was conducted, exploring changes related to the physical schoolyard transformation, its educational use, and interactions among children, and the overall assessment of the schoolyard transformation.</div></div><div><h3>Results</h3><div>192 groups of schoolchildren were observed in the intervention group and 203 in the control group. The transformed schoolyards had more natural elements, play structures, places to sit and non-cemented flooring. Compared to the non-transformed schoolyards, both in the boys’ and girls’ groups, a higher proportion of active play was registered, as well as a higher proportion of non-sport games and imaginative games among boys and a lower proportion of girls watched the schoolyard.</div></div><div><h3>Conclusions</h3><div>Transformed the schoolyards are more inclusive, naturalized, playable, and equitable, with a greater diversity of elements and play structures.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102429"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Qué sabemos y qué deberíamos saber sobre los desequilibrios de médicos en España? Diagnóstico y propuestas. Informe SESPAS 2024","authors":"Beatriz González López-Valcárcel,&nbsp;Patricia Barber Pérez","doi":"10.1016/j.gaceta.2024.102366","DOIUrl":"10.1016/j.gaceta.2024.102366","url":null,"abstract":"<div><p>This article characterizes the main features of the supply, demand, and labor markets for physicians in Spain, with an international and territorial perspective. It also presents some of the results of the simulation model for specialist physicians with a 2035 horizon and proposes strategic and short-term lines of action in the planning, regulation, and management of health professionals in Spain, with a focus on specialist physicians. In Spain there are high rates of physicians and medical graduates, but low rates of nurses, compared to other developed countries. Approximately 30% of practicing physicians (not considering residents) practice only in the private network. In the last two decades, competition from the private sector for health professionals has intensified, competing with the public network, which is subject to an excessively rigid regulatory framework. There is currently a shortage of physicians in some specialties, particularly in family medicine, which urgently needs specific incentives to stimulate vocations. Numbers consider only part of the story. The imbalances in the educational and labor markets are not resolved by creating vacancies, but by reforming the regulatory framework, the incentive systems, and the slack in public management to compete with the private sector in attracting and retaining talent.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102366"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021391112400013X/pdfft?md5=83c9ff5c3c6442f78ebad7c10fdc65b9&pid=1-s2.0-S021391112400013X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sinhogarismo como determinante de la salud y su impacto en la calidad de vida","authors":"Mercedes Botija ,&nbsp;Ana Isabel Vázquez-Cañete ,&nbsp;Laura Esteban-Romaní","doi":"10.1016/j.gaceta.2024.102388","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102388","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the health status of the homeless population who spend the night on the streets and in shelters (extreme residential exclusion), with reference to their quality of life, self-perceived health, comorbidity and access to health resources.</p></div><div><h3>Method</h3><p>A cross-sectional descriptive study was carried out on a sample of 263 homeless people in the city of Valencia by means of a nocturnal count and using the EQ-5D-3L Health Related Quality of Life questionnaire and questions from the European Quality of Life Survey for Spain.</p></div><div><h3>Results</h3><p>Of the people who participated in the study, 129 of them slept outdoors, 49% (62.79% men, 19.37% women and 17.84% unidentified), while 134 slept in hostels, i.e. 51% (67.16% men and 32.84% women) with an estimated average age of 41.53 years and 55% had been living on the street for less than 12 months. People staying overnight on the streets presented worse quality of life and more than a quarter of the sample lacked a health card.</p></div><div><h3>Conclusions</h3><p>There is a relationship between homelessness and poor health conditions in terms of quality of life, perceived health, comorbidity and accessibility to health to resources. The inverse care law is evidenced.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102388"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000359/pdfft?md5=c76692aeb04e9d9f2c0683680afdd6b0&pid=1-s2.0-S0213911124000359-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140546213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}