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Objective: The aim of this study was to investigate the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in women with pelvic inflammatory disease (PID) and the usefulness and cost-effectiveness of a rapid molecular test for the diagnosis and clinical management of PID., Methods: This observational study included 75 patients with mild-to-moderate PID (n=33), severe PID (n=29) and non-specific lower abdominal pain (NSAP) (n=13). CT/NG infections were analyzed using a standard and a rapid test. A cost analysis was carried out., Results: Samples of 19 patients (25.3%) were CT/NG positive. Concordance between rapid and standard tests was 100%. No significant differences were observed in the incidence of CT/NG in mild-to-moderate compared to severe PID. Costs differed according only to disease severity., Conclusions: Rapid molecular tests could help with the diagnosis of PID in sexually active women in clinical settings in which a standard technique is not available., (Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To evaluate preventive interventions on alcohol consumption has been long recommended in Spain. The impact evaluation of structured programs and specific actions for the prevention and treatment of alcohol consumption (PAPTCA) would allow making better informed decisions on public health financing based on the efficiency criteria. To the best of our knowledge, there is no scientific document that illustrates the situation of the PAPTCAs' evaluation in Spain. This paper aims to classify and describe PAPTCAs in Spain, focused on their impact evaluation and information on financing for accountability to society., Methods: A systematic literature review of the PAPTCAs implemented in Spain, from 2000 till 2017, at regional (autonomous communities) and local level was carried out, and a descriptive analysis of the PAPTCA database obtained from the literature review was carried out., Results: 145 structured programs and 45 specific actions were identified. Only 25% of structured programs provided an impact evaluation, besides, only 15% presented some information about their financing. Regarding the specific actions, the numbers were less encouraging where 10% provided an impact evaluation while a similar figure of PAPTCAs showed financing information., Conclusions: There is a need to systematize the information of the PAPTCA that serves as an instrument to conduct impact evaluations in Spain. This should ease the scarce presence of evaluative culture in this area and promote the accountability of resources spent on public health to society.

Background: Given the economic burden of seasonal influenza for the healthcare system, we performed a systematic review aiming to update available evidence on the cost-effectiveness of vaccination of seasonal influenza in different age groups, including children., Methods: A systematic review of the literature on economic evaluations of seasonal influenza vaccination programs in children and adults was carried out. The following databases were searched (January 2013 - April 2018): Medline and PREMEDLINE, EMBASE, EconLit and databases of the Centre for Reviews and Dissemination (DARE, HTA, NHS EED)., Results: A total of 11 economic evaluations were included. Methodological quality of included studies was acceptable. Scientific evidence shows that seasonal influenza vaccination programs in school-age children can be a cost-effective alternative from national health system perspective and can be cost-saving from societal perspective in European countries. However, available evidence does not allow us to conclude that influenza vaccination programs in healthy adults under 65 years of age were a cost-effective alternative in our context, due to the high uncertainty and the lack of studies carried out in Spanish context., Conclusions: Vaccination programs for the prevention of seasonal influenza in school-age children (3-16 years) can be a cost-effective strategy.

To incorporate economic evaluation into decision-making, we need to know how much a health system is willing and able to invest in a quality-adjusted life year (QALY). In Spain, the figure of €30,000 per QALY as cost-effectiveness (CE) threshold has been widely cited. However, as in most health systems, no value has been formally adopted; mainly because of the arbitrariness, the lack of theoretical and scientific basis, and the controversy around its estimation and what the threshold should represent. Based on a systematic review of empirical studies on the estimation of the CE threshold undertaken by this research team, we conducted a critical appraisal of the state of the art, using a Delphi with the participation of 13 national experts. This paper contributes to assess the research progress on the CE threshold in Spain, to consider its utility in the decision making process supported by economic evaluation, and to propose further research to improve what has been achieved so far.