Gaceta SanitariaPub Date : 2024-01-01DOI: 10.1016/j.gaceta.2024.102397
Wenqi Fu , Jufang Shi , Chaojie Liu , Wanqing Chen , Guoxiang Liu , Jie He
{"title":"Health insurance and inequalities in catastrophic health spending in cancer patients. A cross-sectional study in China","authors":"Wenqi Fu , Jufang Shi , Chaojie Liu , Wanqing Chen , Guoxiang Liu , Jie He","doi":"10.1016/j.gaceta.2024.102397","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102397","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the role of social health insurance programs in reducing inequality in the incidence and intensity of catastrophic health expenditure (CHE) of cancer patients in China.</p></div><div><h3>Method</h3><p>A convenient sample of 2534 cancer patients treated in nine hospitals in 2015 and 2016 were followed up through face-to-face interviews in March-December 2018. The incidence and intensity (mean positive overshoot) of CHE (≥ 40% household consumption) were calculated.</p></div><div><h3>Results</h3><p>About 72% of cancer patients experienced CHE events after insurance compensation, with the catastrophic mean positive overshoot amounting to 28.27% (SD: 15.83%) of the household consumption. Overall, social insurance contributed to a small percentage of drop in CHE events. Income-related inequality in CHE persisted before and after insurance compensation. Richer patients benefit more than poorer ones.</p></div><div><h3>Conclusions</h3><p>Cancer treatment is associated with high incidence of CHE events in China. The alleviating effect of social health insurance on CHE events is limited.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102397"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021391112400044X/pdfft?md5=ea69f9f4e1fa7648ab7dd9b6879e1259&pid=1-s2.0-S021391112400044X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141068703","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}
Gaceta SanitariaPub Date : 2024-01-01DOI: 10.1016/j.gaceta.2024.102403
Asier Calvo Álvarez de Arkaia , Carmen Belén Benedé Azagra , Mikel Gandarias Jaio , Adrián Cardo Miota , Mariano Hernán García
{"title":"¿Qué necesitamos para «hacer comunitaria»? Veinticinco medidas prácticas para gerencias y equipos de atención primaria","authors":"Asier Calvo Álvarez de Arkaia , Carmen Belén Benedé Azagra , Mikel Gandarias Jaio , Adrián Cardo Miota , Mariano Hernán García","doi":"10.1016/j.gaceta.2024.102403","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102403","url":null,"abstract":"<div><h3>Objective</h3><p>Identify and clarify what practical organizational measures would promote the development of level 2 (community-oriented group health education) and level 3 (community action) community activities in Primary Health Care (PHC) from the perspective of medical professionals with training and experience in this area.</p></div><div><h3>Method</h3><p>Exploratory, descriptive and cross-sectional study carried out using qualitative methodology using two techniques: 3 focus groups (24 participants) and 12 open questionnaires (12 participants).</p></div><div><h3>Results</h3><p>25 measures are defined to promote the development of these activities that are the responsibility of management and Primary Care Teams (PCT). The most notable proposals are: enhance training in community health, incorporate community activity into the work agendas of professionals, political prioritization and support from management, ensure the job stability of the teams, strengthen the recognition of activities community, resize the patient population of professionals, strengthen multidisciplinary work, cohesion and an autonomous and flexible organization in the PCT, and have the support of the coordinations-directions of the PCT.</p></div><div><h3>Conclusions</h3><p>Three proposals have been considered fundamental to promote the development of level 2 and level 3 community activities in PHC: 1) promote training in community health; 2) incorporate community activity into the work agendas of professionals; 3) political prioritization and support from management for the development of these two levels of work in PHC. Six other proposals have been recognized as being of special importance.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102403"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000542/pdfft?md5=3671b95a53ee783b812db2026ed3f0a9&pid=1-s2.0-S0213911124000542-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141290536","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}
Gaceta SanitariaPub Date : 2024-01-01DOI: 10.1016/j.gaceta.2024.102433
Nerea Mourino , Ana Teijeiro , Carla Guerra-Tort , Julia Rey-Brandariz , Cristina Candal-Pedreira , Lucía Martín-Gisbert , Marta Mascareñas-García , Guadalupe García , Leonor Varela-Lema , Mónica Pérez-Ríos
{"title":"Consumption of hypnosedatives in Spain: characterization and time trends, 2005-2022","authors":"Nerea Mourino , Ana Teijeiro , Carla Guerra-Tort , Julia Rey-Brandariz , Cristina Candal-Pedreira , Lucía Martín-Gisbert , Marta Mascareñas-García , Guadalupe García , Leonor Varela-Lema , Mónica Pérez-Ríos","doi":"10.1016/j.gaceta.2024.102433","DOIUrl":"10.1016/j.gaceta.2024.102433","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the evolution of hypnosedative use in the Spanish population aged 15 to 64 (2005-2022), identifying regional variations and changes in users profile.</div></div><div><h3>Method</h3><div>We used data from the Survey on the Use of Alcohol and other Drugs in Spain. Past 30-day use was analyzed by sex, age and autonomous community between 2005 and 2022. A multivariate logistic regression was used to identify characteristics of consumption; the temporal trend of prevalence and adjusted odds ratio were evaluated using joinpoint regression models.</div></div><div><h3>Results</h3><div>Between 2005 and 2022, the prevalence of hypnosedative use in Spain increased (from 3.7% to 9.7%) with an annual percentage change of 4.7%. The maximum increase was observed among women aged 55 to 64, reaching a prevalence of 21.4% in 2022. Use increased in all autonomous communities, with Cantabria, La Rioja and Andalusia standing out. The likelihood of using hypnosedatives was higher among women, the oldest age groups, those with basic or intermediate education, those unemployed or economically inactive, those not living with a partner or family, Spanish citizens, and tobacco or cannabis users.</div></div><div><h3>Conclusions</h3><div>An upward trend in the use of hypnosedatives in Spain has been observed since 2005, with variations according to sex, age, and autonomous community. It is crucial to update regional addiction plans, promote preventive strategies and foster collaboration between health authorities, medical professionals and the population to address mental health inequalities and ensure adequate care and responsible prescribing.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102433"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702932","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}
Gaceta SanitariaPub Date : 2024-01-01DOI: 10.1016/j.gaceta.2024.102414
José Ivo Montaño-Caicedo
{"title":"Niveles para la orientación comunitaria de la atención primaria en Colombia","authors":"José Ivo Montaño-Caicedo","doi":"10.1016/j.gaceta.2024.102414","DOIUrl":"10.1016/j.gaceta.2024.102414","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102414"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000669/pdfft?md5=38c40b9490c50fdaf768206d235e06df&pid=1-s2.0-S0213911124000669-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141732397","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}
Gaceta SanitariaPub Date : 2024-01-01DOI: 10.1016/j.gaceta.2024.102355
Eva Estévanez Jiménez , Maite Cruz Piqueras
{"title":"Aborto en Melilla: barreras de océano y frontera","authors":"Eva Estévanez Jiménez , Maite Cruz Piqueras","doi":"10.1016/j.gaceta.2024.102355","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102355","url":null,"abstract":"<div><h3>Objective</h3><p>To provide insights into the challenges faced by women seeking abortion services in Melilla, Spain. It seeks to describe the journey these women undertake and to identify and analyze the barriers they encounter in accessing abortion care.</p></div><div><h3>Method</h3><p>A qualitative research approach was employed, involving a series of eight semi-structured interviews during 2022. Three interviews were conducted with national experts in the field of abortion, while five interviews were conducted with healthcare professionals from the Melilla Health Area who are directly involved in providing abortion services and supporting women throughout the process. The study was guided by a theoretical framework that focuses on barriers to abortion access and sexual and reproductive rights. The collected data was analyzed using content analysis and categorized based on key dimensions of the study.</p></div><div><h3>Results</h3><p>The study identified several significant barriers to abortion care access in Melilla. These include conscientious objection among healthcare providers, the geographical remoteness of Melilla, the legal challenges faced by Moroccan women due to their irregular status, and the requirement of parental consent for minors aged 16 and 17. Consequently, women seeking abortion services are forced to travel to mainland Spain, continue with undesired pregnancies, or resort to unsafe clandestine abortions in Morocco, thereby endangering their lives in the worst cases.</p></div><div><h3>Conclusions</h3><p>The barriers to abortion access identified in this study represent a violation of women's reproductive rights in Melilla. Urgent action is required to review the current process, ensuring that access is improved and the right to safe abortion is guaranteed for all women residing in Melilla.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102355"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000025/pdfft?md5=51bfe659080b31405fb4ca03b370b8c4&pid=1-s2.0-S0213911124000025-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139674791","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}
Gaceta SanitariaPub Date : 2024-01-01DOI: 10.1016/j.gaceta.2024.102363
Guillem López-Casasnovas
{"title":"The lack of data and the conceptual mistakes in assessing public-private partnerships as a form of healthcare privatization","authors":"Guillem López-Casasnovas","doi":"10.1016/j.gaceta.2024.102363","DOIUrl":"10.1016/j.gaceta.2024.102363","url":null,"abstract":"","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102363"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000104/pdfft?md5=8fa323df8f3aea7a9823e972446746ac&pid=1-s2.0-S0213911124000104-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708851","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}
Gaceta SanitariaPub Date : 2024-01-01DOI: 10.1016/j.gaceta.2024.102395
Francisca María García-Padilla, Miriam Sánchez-Alcón, Elena Sosa-Cordobés, Ángela María Ortega-Galán, Almudena Garrido-Fernández
{"title":"Attitude towards health promotion in university students. Construction and validation of a scale","authors":"Francisca María García-Padilla, Miriam Sánchez-Alcón, Elena Sosa-Cordobés, Ángela María Ortega-Galán, Almudena Garrido-Fernández","doi":"10.1016/j.gaceta.2024.102395","DOIUrl":"https://doi.org/10.1016/j.gaceta.2024.102395","url":null,"abstract":"<div><h3>Objective</h3><p>To construct and validate a questionnaire about the attitude of university students toward health promotion.</p></div><div><h3>Method</h3><p>A cross-sectional study. A questionnaire of 14 questions was designed and administered to 1486 first-year undergraduates. The principal axes factoring method with oblique rotation was applied and a confirmatory factor analysis was carried out. Reliability was calculated through internal consistency with Cronbach's alpha and item-total correlation for the global scale and its subscales.</p></div><div><h3>Results</h3><p>A 14-item scale was constructed, with two dimensions. Its Cronbach's alpha was 0.872, and 0.852, and 0.718 for its subscales. The adjustment values of the confirmatory factor analysis were adequate.</p></div><div><h3>Conclusions</h3><p>The attitude towards health promotion scale has shown to have adequate psychometric properties. It is an instrument that will help to detect referents and health assets for future interventions.</p></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102395"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213911124000426/pdfft?md5=9e485d925a9021bfe5d9cd705c98225f&pid=1-s2.0-S0213911124000426-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141083377","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}
Gaceta SanitariaPub Date : 2024-01-01DOI: 10.1016/j.gaceta.2024.102426
Consuelo García Carbó , Viola Cassetti , Manel Monfort Lázaro
{"title":"Proyecto Alifara: experiencia de un análisis de salud participativo en comunidades rurales de la Comunidad Valenciana","authors":"Consuelo García Carbó , Viola Cassetti , Manel Monfort Lázaro","doi":"10.1016/j.gaceta.2024.102426","DOIUrl":"10.1016/j.gaceta.2024.102426","url":null,"abstract":"<div><div>A description of the Alifara Project is provided a participatory process to promote community health. In 2020, a core working group was created in the rural region of Els Ports, in the north of the Valencian Community, Spain, with the participation of 39 people, including professionals and community members. The core group itself designed the first health needs assessment survey, based on the health determinants they considered relevant in their context, and 1180 responses were collected. The results were presented in each town through focus groups or world café to gather suggestions for health promoting activities to implement locally. Finally, the process set the basis for the creation of a local health council, to implement the new Community Health Care Plan of the Valencian Community. Community engagement and partnerships were the key to the success of the process, while the limited resources and lack of training in data analysis were the main challenges.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"38 ","pages":"Article 102426"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484105","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}