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Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El objetivo del estudio es analizar las tendencias, impactos y desafíos globales de la inversión pública en salud. Se empleó el enfoque cualitativo, nivel descriptivo mediante una revisión sistemática en Scopus, SciELO y Redalyc. Se apoyó en la metodología PRISMA cuyos criterios de inclusión considerados fueron: trabajos publicados entre 2017 y 2023; estudios originales; artículos en inglés o español; disponibilidad de texto completo; documentos deben estar directamente relacionados con el objetivo planteado y; palabras clave como public investment, government expenditure, public spending, health, healthcare, medical public health. Se encontró 673 documentos, de los cuales, fueron eliminados 655 por no cumplir con los criterios de inclusión. Finalmente, solo 18 artículos fueron incluidos para ser examinados. En cuanto a los resultados, los 18 artículos fueron agrupados de acuerdo a su contenido: Tendencias, impactos y desafíos globales. Se encontró una creciente tendencia en la inversión pública en salud, elevada preocupación debido a la privatización de la salud e incremento en la escasez de los recursos públicos. Se concluye que, la tendencia actual de la inversión pública en la salud es positiva y ocasionó el incremento del gasto público. Además, la inversión en salud pública es necesaria para mejorar el bienestar de la población.

Introducción: Los modelos de ecuaciones estructurales constituyen una herramienta valiosa para orientar la toma de decisiones al permitir identificar las relaciones entre diferentes variables y explicar el comportamiento de aquellas más abstractas. Tal es el caso de la probabilidad de que una persona consulte en el sistema de salud, donde intervienen factores demográficos, sociales y psicológicos. El presente trabajo se propuso construir un modelo explicativo de la utilización de los servicios médicos ambulatorios en una población de clase media urbana con seguro de salud relacionando variables demográficas, sociales y de autopercepción de salud. Métodos: Se realizó a través de un modelo de ecuaciones estructurales con diseño longitudinal (cohorte prospectiva). Para ello se realizaron inicialmente dos cortes transversales en diferentes momentos, y luego se realizó el análisis longitudinal teniendo en cuenta la información obtenida en los dos cortes transversales. Resultados: La utilización de los servicios médicos ambulatorios fue explicada en el siguiente orden según su fuerza de asociación: CPS (coeficiente de 0,57), la utilización de los servicios en el periodo anterior (0,23), la salud percibida en el último período (- 0,15), y los problemas familiares del último período (0,08). Las demás variables no tuvieron una asociación estadísticamente significativa. Conclusiones: La realización de CPS es la variable con mayor capacidad explicativa de la variabilidad de la utilización de servicios ambulatorios de salud de personas de clase media urbana que tienen seguro de salud y niveles altos de estudios. Esto podría tener implicancias importantes a nivel de gestión para asegurar la sustentabilidad del sistema de salud a través de una organización racional de los recursos disponibles.

The objective of this research, taking into consideration life expectative (LE) as an indicator of economic development, is analyzing, through econometric methods, a production function that explains the variations in the LE primarily due to health public expenditure, whether as directed by social security institutions or under different health programs. The analysis is extended to exploring several explanations of the differences in LE due to COVID at the national level and by clusters of states according to their human development indexes. Results show the crucial role of the health public expenditure in avoiding a more significant fall in the LE in those states classified in the medium and lower levels of human development. [ABSTRACT FROM AUTHOR]

Copyright of Acta Neurológica Colombiana is the property of Colombian Association of Neurology / Asociacion Colombiana de Neurologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: el ataque cerebrovascular isquémico (ACVi) es la segunda causa de muerte en Colombia. Se estimó que los costos asociados al ACVi podrían alcanzar los COP 5000 millones durante el 2019. Objetivo: describir los costos médicos directos de los pacientes que sufren de ACVi en una institución en Bogotá durante el 2020. Metodología: estudio de corte transversal que analiza los costos médicos directos de la atención hospitalaria de adultos que sufrieron un ACVi durante el 2020. Se compararon los costos, la estancia y los desenlaces clínicos de pacientes que recibieron trombólisis frente aquellos que no la recibieron. Resultados: los costos directos relacionados con 132 pacientes con ACVi fueron COP 1.218.970.831 en el año 2020 en nuestra institución. El costo promedio por paciente fue COP 7.845.073. Entre los eventos hospitalarios, las imágenes diagnósticas y otros métodos diagnósticos representaron la mayor proporción de costos (40?%), entre los que se destacó la angiotomografía de cabeza y cuello. La severidad del ACV influyó significativamente en los costos totales (p?=?0,018), así como en los costos de los medicamentos (p?0,001), procedimientos (p?

Aim: There are social inequalities in access to health care that affect therapeutic effort. The aim of the present study was to determine whether there are differences in expenditure according to days of admission and tests performed by age, sex and population of origin in patients at the end of life., Methods: Cross-sectional descriptive study, with review of clinical histories of terminally ill patients admitted to a hospital, recruited on the basis of the administration of transfusions, who underwent numerous tests and interventions during their last admission before death. Sociodemographic and clinical variables were studied, as well as the cost of admission and tests., Results: The 140 patients were hospitalized for an average of 17.41 days (SD: 14.323), with an average cost of 8,264.19 euros (SD: 6,799.8788) per stay. They underwent 59 tests, which amounted to €532,209.68. Being male, of advanced age and of rural origin saw an increase in the number of days of admission. Older people and women received more tests. No relationship was found between days of hospitalization and expenditure with sociodemographic and clinical variables. There was a relationship between surgical interventions and sex (p 0.047); between age and receiving oncological treatments (p < 0), other techniques (p < 0), nuclear medicine tests (p 0.02) and electrocardiograms (p 0.052)., Conclusions: Many palliative patients die in hospitals receiving numerous tests that increase the number of days of hospitalization and costs. Advanced age determines hospital admissions, but not sex or population of origin., (Copyright © 2024. Published by Elsevier España S.L.U.)

Introduction: Measuring social value has always been a challenge for organizations that generate such value, including foundations, NGOs, social enterprises, and governmental entities. Often, the benefits of these initiatives are perceived as intangible or long-term, making them difficult to quantify. Assessing social value demonstrates the impact of investments and accountability to stakeholders.Healthcare organizations should be evaluated from a broad perspective, where the quality of healthcare services is an integral part of the social value with multiple beneficiaries.This study aims to determine the economic and social impact of Hospital Santa Marina on the Bizkaia (Basque Country) population in 2023, as well as to evaluate the evolution of the hospital's social value from 2018 to 2023., Materials and Methods: The study was conducted from the multifaceted perspective of social accounting (stakeholder theory), utilizing the Social Return on Investment (SROI) tool. The economic value of the hospital (both direct and indirect) and the hospital's specific social value were calculated based on areas identified by stakeholders. Subsequently, the hospital's integrated social value and socio-emotional value were determined., Results: The hospital contributed €34,696,178.20 to society in Direct and Indirect Market Social Value (SROI), and the Non-Market Social Value amounted to €119,758,230.71. This generated an integrated social value of the hospital of €154,454,408.91, which, considering the satisfaction index for the year 2023 was 0.9805, leads to a socio-emotional value of €211,998,238.76., Conclusions: Hospital Santa Marina generates significant economic value for the society, beyond its direct contribution to the population's health. These findings underscore the importance of adopting a broader perspective on health and highlight the role of healthcare institutions as drivers of sustainable development., (Copyright © 2024 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Competing Interests: Declaración de conflicto de interesesNingún conflicto declarado.

Objective: Direct-acting antivirals for the treatment of hepatitis C virus (HCV) represented a paradigm shift. In 2017, sofosbuvir/velpatasvir (SOF/VEL-Epclusa®) was approved, which showed a high cure rate in all patient, contributing to HCV elimination. The analysis aimed to quantify the clinical and economic value of SOF/VEL in HCV chronic patients since its approval in Spain., Methods: An economic evaluation was elaborated adapting a Markov model that simulated the lifetime disease progression in of all HCV chronic patients treated with SOF/VEL (30,488 patients) since its launch (5-years), compared to previous therapies. Patients entered the model and were distributed between the fibrosis states (F0-to-F4) in treated and untreated. All patients (100%) were treated with SOF/VEL regardless of their fibrosis, and 49% with previous therapies in ≥F2. The average sustained viral response (SVR) rates 98.9% SOF/VEL versus 61.0% previous therapies. All parameters for the analysis were obtained from real-life data and literature. Only direct healthcare costs associated with disease management were included. The SOF/VEL value was measured as the number of hepatic complications avoided and their associated cost, and hepatic mortality compared to previous therapies. National Health System perspective and a 3% discount rate was applied., Results: SOF/VEL decreased the number of liver complications, avoiding 92% decompensated cirrhosis, 80% hepatocellular carcinomas, and 87% liver transplants, as well as 85% liver-related mortality. Their cost associated was reduced, amounting to savings of 197M€., Conclusion: SOF/VEL adds relevant value to the HCV treatment, reducing the clinical and economic disease burden and contributing to HCV elimination in Spain., (Copyright © 2024 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)