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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.)

The cigarettes and tobacco consumption creates an externality that is more relevant in the detriment of the life quality and life expectancy experienced by the individual smoker, in relation to those who do not consume cigarettes or tobacco. The psychosocial cost not financially quantified far exceeds any expectation of economic benefit. This article deals with the socioeconomic impact of smoking in Cuba. The economic distribution induced by smoking leads to the persistence of such socioeconomic inequity, which worsens with the number of smokers and the intensity of cigarette and tobacco consumption. This phenomenon contradicts the socialist principle of distribution according to work, where non-smokers should not bear the consequences of smoking and smokers themselves should not be induced to persist in smoking. The subtlety of the social costs attributable to smoking and the impact of the benefits of domestic and foreign trade do not allow a full assessment of the main effects of smoking from the socioeconomic aspect.

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?

The health tourism sector is constantly evolving around the world, and Colombia is also joining this trend. In recent years, there has been a significant increase in the number of international tourists visiting Colombia and the southwestern region of the country for medical treatments and wellness therapies. In addition, this region has a rich cultural and natural offer, which makes it a very attractive tourist destination for visitors from all over the world. The region includes the provinces of Valle del Cauca, Cauca and Nariño. Objective: to identify the strategies developed in the health tourism sector in the southwest of Colombia in the years 2015 to 2019. Methodology: qualitative research approach of descriptive type, with interpretative-hermeneutic method, which allowed us to collect secondary data to answer our problem question. Result: Colombia has experienced a remarkable growth in the health tourism market in Latin America and has the second largest market in the region in terms of revenue. Conclusion: Tourism is considered as one of the economic sectors with a high capacity to boost the development and economic growth of a region, since it has been shown that in tourist places a greater agglomeration of companies and diverse economic activities are developed. [ABSTRACT FROM AUTHOR]

Objetivo. Estimar la carga de enfermedad y económica atribuible al consumo de bebidas azucaradas en El Salvador. Métodos. Se utilizó un modelo de riesgos comparativos para estimar los efectos en muertes, eventos de salud, años perdidos por muerte prematura y discapacidad (AVAD), y costos médicos directos atribuibles al consumo de bebidas azucaradas. Resultados. Un total de 520 muertes (8 cada 100 000 individuos), 214 082 eventos en salud (3 220 cada 100 000 individuos) y 16 643 AVAD podrían ser atribuibles al consumo de bebidas azucaradas en El Salvador, lo que representa $69,35 millones (dólar americano) en costos médicos directos para el año 2020. En particular, los eventos de diabetes tipo 2 (DBT2) atribuibles al consumo de bebidas azucaradas podrían llegar a representar más del 20% del total de casos de DBT2 para el país. Conclusión. Un elevado número de muertes, eventos y costos podrían atribuirse al consumo de bebidas azucaradas en El Salvador

Biomedicine constitutes an expert system that has garnered important attention regarding the epistemic injustices that it spawns. A considerable amount of literature has been produced, which analyzes both medical knowledge and practice, and the perpetration of epistemic injustices of different classes. This article tackles a particular case in this realm: Global Mental Health, a multilateral and interinstitutional enterprise whose main goal is to scale mental health attention, so it reaches vulnerable populations of all regions. The analysis targets the epistemic assumptions that underlie the expert knowledges which coalesced in the construction of this agenda, the concepts of health-sickness processes that they generate, and a discussion of why said concepts are epistemically unjust. [ABSTRACT FROM AUTHOR]

The cigarettes and tobacco consumption creates an externality that is more relevant in the detriment of the life quality and life expectancy experienced by the individual smoker, in relation to those who do not consume cigarettes or tobacco. The psychosocial cost not financially quantified far exceeds any expectation of economic benefit. This article deals with the socioeconomic impact of smoking in Cuba. The economic distribution induced by smoking leads to the persistence of such socioeconomic inequity, which worsens with the number of smokers and the intensity of cigarette and tobacco consumption. This phenomenon contradicts the socialist principle of distribution according to work, where non-smokers should not bear the consequences of smoking and smokers themselves should not be induced to persist in smoking. The subtlety of the social costs attributable to smoking and the impact of the benefits of domestic and foreign trade do not allow a full assessment of the main effects of smoking from the socioeconomic aspect. [ABSTRACT FROM AUTHOR]

Se determinaron los costos (directos e indirectos) de los servicios más demandados en el hospital Guillermo Luis Fernández Hernández Baquero que contribuya a la gestión del costo, el mismo se sustenta en el análisis de fundamentos teóricos y metodológicos para la determinación del costo. Para el desarrollo de la investigación se emplearon métodos teóricos como análisis y síntesis, inducción y deducción e histórico–lógico que junto al análisis documental y la observación directa, como métodos empíricos permitieron la obtención de los elementos que contribuyeron a la gestión del costo hospitalario. Con los resultados de la misma se pueden cuantificar los recursos sacrificados por servicios, demuestra el alto costo que tiene para el Estado asumir la responsabilidad de la atención sanitaria, siendo los costos directos mayores que los indirectos lo que implica la necesidad de un cambio en los procederes para el cálculo de los costos hospitalarios, al incorporar una visión de procesos asistenciales con la premisa de que la clave no radica solo en obtener un costo, sino que éste represente la realidad del servicio que presta la institución y proporcione la información necesaria para la gestión del costo.

Copyright of Saúde Coletiva is the property of MPM Comunicacao 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.)

Copyright of Roca: Revista Científico-Educacional de la Provincia de Granma is the property of Universidad de Granma, Departamento Editorial 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.)

Copyright of Saúde Coletiva is the property of MPM Comunicacao 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.)

Tras la pandemia por COVID-19, Perú se posicionó como el país a nivel mundial con mayor índice de mortalidad por cada 100,000 habitantes. Este hecho hizo evidente, entre otros factores, las limitaciones del sistema de salud, especialmente al interior del país. Por ello, bajo un enfoque de función de producción, se estimaron los índices de eficiencia para las 24 regiones en un periodo prepandemia, para evidenciar brechas ya existentes, tanto en insumos como en resultados de salud. Metodología: aplicación de un método paramétrico de fronteras estocásticas, modelo Battese y Coelli (1988), considerando como variable de resultado a las atenciones de salud e insumos como capital, trabajo y gasto público. Además se incorpora un país referencial (Estados Unidos) para dimensionar las brechas de eficiencia. Resultados: el índice de eficiencia de Estados Unidos es igual a 1, demostrando ser frontera; el promedio de eficiencia de las regiones del Perú es de 0.70; la región más eficiente Ayacucho (0.95) dado que logra mayor producción con menos recursos, mientras la menos eficiente Moquegua (0.23).

Las instituciones de salud utilizan diferentes disciplinas para ampliar la disponibilidad de su infraestructura, equipos biomédicos, equipos industriales y Tecnologías de Información y Comunicación y servicios de soporte. En este trabajo se realizó estudio bibliométrico con un enfoque mixto (cuantitativo y cualitativo) sobre las investigaciones más relevantes de disciplinas vinculadas al mantenimiento, gestión de edificios, gestión de inmuebles y gestión de activos en el sector de la salud en América Latina. El análisis cuantitativo ofreció información sobre producción por año, autor, institución, país, así como indicadores de productividad. En cambio, el análisis cualitativo con la ayuda de softwares especializados ofreció información sobre la reiteración de palabras en cuatro vertientes: clústeres, períodos de tiempo, concentración de coincidencia y temáticas por países. Los resultados muestran que tan solo tres países cuentan con el 90% de las publicaciones en el período 2000-2018, y la mayor parte (72%) de la producción científica ha recaído especialmente en universidades latinoamericanas, especialmente cuatro, que marcarán las tendencias de investigación de estas disciplinas en los próximos años en esta región. En conclusión, los autores de este trabajo han acotado al menos 11 tendencias investigativas de las cuatro disciplinas analizadas en América Latina. Estas tendencias tendrán una influencia significativa en la eficiencia de las instituciones de salud en las áreas financiera, eficiencia, sostenibilidad y en salud laboral.

Objective. To estimate the burden of disease and economic burden attributable to the consumption of sugar-sweetened beverages in El Salvador. Methods. A comparative risk model was used to estimate the effects on deaths, health events, disability- adjusted life years (DALYs), and direct medical costs attributable to the consumption of sugar-sweetened beverages. Results. A total of 520 deaths (8 per 100 000 individuals), 214 082 health events (3 220 per 100 000 individuals) and 16 643 DALYs could be attributable to the consumption of sugar-sweetened beverages in El Salvador, representing US$69.35 million in direct medical costs for the year 2020. In particular, type 2 diabetes (T2DM) events attributable to the consumption of sugar-sweetened beverages could represent more than 20% of total T2DM cases in the country. Conclusion. A high number of deaths, events, and costs could be attributed to the consumption of sugar-sweetened beverages in El Salvador. [ABSTRACT FROM AUTHOR]

In health systems, it is necessary to assess the costs for the production of services and the magnitude of the budget to operate, its formulation has been with the Historical Public Budget in Health, which can be complemented with the Zero-Base Budget, with reference medical technical costs. from the Economic Medical Certificate of the Groups Related to the Diagnosis and the Groups Related to Outpatient Care of the IMSS. The preparation of the certificate is for each scenario of treatment by hospital or outpatient diagnosis in four successive phases with groups of IMSS professionals. Each certificate contains information and costs of the production of services specified in: production functions, patient transit services; and production factors such as installed capacity, including personnel of all kinds, depreciation, general services, medicines, medical consumables, laboratory and office studies, and specific studies and procedures; with their respective unit cost. The Reference Technical Medical Cost provided by the Economic Medical Certificate with the necessary scaling allows estimating the budget for services, care units, institutions and health systems with medical, epidemiological, technical and economic information. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. 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.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca 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.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca 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.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca 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.)

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.)

Objetivo. Caracterizar el diseño de los impuestos selectivos al consumo de bebidas azucaradas en América Latina y el Caribe, y evaluar las oportunidades de aumentar su impacto en el consumo y la salud. Métodos. Se llevó a cabo una búsqueda y una evaluación exhaustivas de legislaciones vigentes a marzo del 2019, recopiladas mediante las herramientas de seguimiento ya existentes de la Organización Panamericana de la Salud y de la Organización Mundial de la Salud, fuentes secundarias, así como mediante una encuesta a ministerios de finanzas. El análisis se centró en el tipo de productos gravados y la estructura y la base de estos impuestos selectivos. Resultados. De los 33 países evaluados, en 21 se aplican impuestos selectivos al consumo de bebidas azucaradas. En siete países también se aplican impuestos selectivos sobre el agua embotellada y en al menos cuatro, se aplican tales impuestos sobre las bebidas lácteas azucaradas. Diez de estos impuestos selectivos al consumo son de tipo ad valorem con algunas bases imponibles fijadas en las primeras etapas de la cadena de valor, siete son de tipo específico y cuatro son de estructura combinada o mixta. En tres países se aplican impuestos selectivos al consumo en función de la concentración de azúcares del producto. Conclusiones. Si bien el número de países en que se aplican impuestos selectivos al consumo de bebidas azucaradas es prometedor, existe una gran heterogeneidad en su diseño en cuanto a la estructura, la base imponible y los productos gravados. Se podrían aprovechar aún más los impuestos selectivos existentes para tener un mayor impacto sobre el consumo de bebidas azucaradas y la salud si se incluyeran todas las categorías de bebidas azucaradas, excluyendo el agua embotellada, y si se recurriera más a impuestos específicos ajustados regularmente según la inflación y basados posiblemente en la concentración de azúcares del producto. Todos los países se beneficiarían si hubiera mayor orientación. Futuras investigaciones deberían tener como objetivo abordar esta brecha.

The economic value of increases in the length of life is estimated for a large set of countries using age-specific data on consumption, leisure earnings, and mortality. Estimates are sensitive to parameters on intertemporal substitution and minimum consumption, and to the interest rate. A scenario of improvement of 1/10000 survival probabilities across life results in Value of Statistical Life (VSL) gains at the beginning of life of around USD $500 for the wealthier countries, $200 for middle-income, and $30 for the poorest. Benchmark income elasticities are in general below 1, except for low-income countries at older ages. The income elasticity of VSL is calculated directly, and not, as in previous literature, calculated for less developed countries based on measurements for wealthier countries. [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao 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.)

Objetivo. Analizar las evaluaciones económicas en salud para el tratamiento de la obesidad en adultos publicadas en la literatura mundial entre 2009-2019. Métodos. Revisión sistemática aplicando las guías Cochrane, PRISMA y CHEERS para estudios de economía de la salud. Se garantizó la exhaustividad, reproducibilidad y calidad metodológica del protocolo de selección y extracción de la información. Se realizó síntesis cualitativa mediante frecuencia por tipo de evaluación económica. Resultados. Se tamizaron 4 493 artículos y sólo 95 cumplieron con los criterios del protocolo, la mayoría de Estados Unidos (n=38), principalmente con estudios de costo-utilidad (n=39) y descripción de costos (n=18). Se incluyeron personas con múltiples comorbilidades, la más frecuente de las cuales fue la diabetes. Las intervenciones más evaluadas fueron las quirúrgicas (n=53), y los desenlaces más frecuentes fueron la reducción de peso y los años de vida ajustados por calidad. La perspectiva de evaluación más frecuente fue la del tercer pagador (n=46) y el horizonte temporal más empleado fue el corto plazo para las intervenciones dirigidas a los estilos de vida y de largo plazo para las quirúrgicas. Conclusión. Los estudios microeconómicos para el tratamiento de la obesidad se han incrementado en los últimos años; sin embargo, persisten vacíos como la baja aplicación de intervenciones no quirúrgicas, evaluaciones parciales o de costo-efectividad y análisis desde la perspectiva social. Estos constituyen ejes importantes para las prácticas en salud basadas en evidencia y la toma de decisiones relacionando los beneficios en salud con los costos implicados.

Given the generalized financial infeasibility of the Health Promoting Entities (EPS), the aim was to provide elements of public policy in regulatory matters. Elements related to the permanence and stability of the EPS of the General System of Social Security in Health. The financial situation of the EPS in the years 2008 and 2019 was evaluated through an analysis of the income statement, the financial and capital structure. Likewise, regulatory failures that allow the existence of heterodox situations for the General System of Social Security in Health are shown. Some of them are vertical integration and significant financial leverage with suppliers, in which not paying interest along with practices of glosses and discounts for early payment, allow to have a low cost of debt. The General System of Social Security in Health has a high and progressive participation in which, finally, in the long term, the State assumes the risk by maintaining a financial structure with negative equity that, under current conditions, does not make insurance viable as a whole and affects performance. This situation warrants a review of the scope of the public sector in the health sector and, from this approach, the architecture of the General System of Social Security in Health because health and well-being opportunities for the population are lost. [ABSTRACT FROM AUTHOR]

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte 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.)

Copyright of Revista Salud UIS is the property of Universidad Industrial de Santander 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.)

This article explores the role of statistical modeling in the production of sound epidemiological objects in a context in which data are perceived as fragile and precarious. It analyzes the use of Markov chain modeling in the evaluation of cost-effectiveness of HPV vaccines in Colombia. Markov chain modeling has an important role in producing a "national" cohort of women in which it is possible to test the "virtual" effectiveness of HPV vaccines, transforming information that comes from international literature into national and local data. This modeling device plays a key role in the datafication of cervical cancer and HPV vaccination. The datafication of disease and populations allows connecting the calculative domains of epidemiology and economic valuation. Drawing on studies on data production, statistics and modeling I examine the role of statistics and data dynamics in the making of HPV vaccination as a public health matter. This paper offers a juxtaposition of two analytical domains entangled by the Markov chain. On the one hand, it presents an analysis of a set of technoscientific practices showing where and how a statistical enumerated entity that purports to represent cervical cancer becomes a socio-politically agential entity in the institutional life of the State. On the other, the paper discusses how social difference is left out the model. The exclusion of social difference from data production is coherent with the socio-political workings of Colombian healthcare and vaccination policy. [ABSTRACT FROM AUTHOR]

Resumen: Las lesiones por presión son un importante problema de salud con una gran repercusión epidemiológica y un gran impacto a nivel de salud y calidad de vida que genera importantes costes para las personas, instituciones y sistemas de salud. A pesar de la importancia económica del problema de las lesiones por presión, prácticamente no existe información sistematizada acerca de las diferentes dimensiones de su coste. Para cubrir esta falta de información se planteó la realización de una revisión integrativa acerca de la dimensión económica del problema de las lesiones por presión. Se han identificado y analizado 89 documentos con información económica acerca del problema de las lesiones por presión. La información se ha sistematizado basándose en los siguientes apartados: tiempo necesario para la cicatrización, impacto en las estancias hospitalarias, costes relacionados con la seguridad de los pacientes, impacto en los grupos relacionados de diagnóstico, coste total, coste por episodio, por tipo de tratamiento, de las complicaciones, de las demandas legales, de los años de vida ganados ajustados a calidad de vida, en pacientes lesionados medulares y con otras condiciones, y los costes de medidas preventivas.

The objective was to analyze the business intelligence applied to the health sector based on a universal database. Being of a descriptive type with a non-experimental field design, information was collected through 690 officials of the medical and dental branch, public and private of the city of Cuenca - Ecuador. 59.42% think that the archiving of the data is very necessary. Normally in public or private health centers this information has a physical storage, since they use paper forms for the compilation. The importance of creating a business intelligence solution, allowing there to be alternatives on how to modernize the administrative-technological-social part, thus generating faster, more agile processes that also allow effective responses from health experts.

La planeación estratégica del mercadeo es clave para la toma de decisiones a nivel organizacional, cuya implementación toma mayor relevancia en entidades del sector salud colombiano, que precisan hacer frente a una crisis estructural del sistema sanitario. Por ello, se realizó un estudio para analizar los retos en la planeación estratégica del mercadeo en instituciones prestadoras de servicios de salud en la ciudad de Medellín; conducido metodológicamente por un enfoque cualitativo, utilizando como técnica de análisis de la información herramientas de la Teoría Fundamentada. Así, se identificaron como retos para estas instituciones: la relación entre prestadores-aseguradores y el impacto en su capacidad financiera, la prestación de servicios de calidad y, finalmente, la gerencia estratégica de marketing. De allí se concluye que la incorporación del mercadeo en estas organizaciones se ha enfocado hacia el componente social, para mejorar las estrategias de promoción de la salud y prevención de la enfermedad. Strategic marketing planning is key to decision-making at the organizational level, the implementation of which takes greater relevance in Colombian health sector entities, who need to deal with a structural crisis of the health system. For this reason, a study was carried out to analyze the challenges in strategic marketing planning in Health Service Providers Institutions in the city of Medellin; meticulously driven by a qualitative approach, using as an information analysis technique tools of Founded Theory. Thus, they were identified as challenges for these institutions: the relationship between providers – insurers and the impact on their financial capacity, the provision of quality services, and finally, strategic marketing management. It concludes that the incorporation of marketing into these organizations has focused on the social component, to improve strategies for health promotion and disease prevention.

Competing Interests: Declaración de conflicto de interesesNingún conflicto declarado.

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Objective. To characterize the design of excise taxes on sugar-sweetened beverages (SSBs) in Latin America and the Caribbean and assess opportunities to increase their impact on SSB consumption and health. Methods. A comprehensive search and review of the legislation in effect as of March 2019, collected through existing Pan American Health Organization and World Health Organization monitoring tools, secondary sources, and surveying ministries of finance. The analysis focused on the type of products taxed, and the structure and base of these excise taxes. Results. Out of the 33 countries analyzed, 21 apply excise taxes on SSBs. Seven countries also apply excise taxes on bottled water and at least four include sugar-sweetened milk drinks. Ten of these excise taxes are ad valorem with some tax bases set early in the value chain, seven are amount-specific, and four have either a combined or mixed structure. Three countries apply excise taxes based on sugar concentration. Conclusions. While the number of countries applying excise taxes on SSBs is promising, there is great heterogeneity in design in terms of structure, tax base, and products taxed. Existing excise taxes could be further leveraged to improve their impact on SSB consumption and health by including all categories of SSBs, excluding bottled water, and relying more on amount-specific taxes regularly adjusted for inflation and possibly based on sugar concentration. All countries would benefit from additional guidance. Future research should aim to address this gap. [ABSTRACT FROM AUTHOR]

Objective: evaluating the health status and its dimensions in patients with Diabetes Mellitus treated in a teaching hospital in the light of the Commonsense Model. Method: a descriptive study with qualitative analysis of the data. Participated twenty patients hospitalized and in outpatient care. The data were submitted to content analysis and interpreted according to the concepts of the Commonsense Model. Results: the discourses were categorized according to the identity of the disease and its concepts; duration and time for diagnosis and symptoms; causes of the disease and its explanations; consequences and treatment; control and perceptions about prognosis. Final considerations: the concepts of health status and its dimensions related to Diabetes Mellitus interpreted in the light of the Commonsense Model described it as a disease with physical signs and potential for complication, even associated with death; however, they also revealed ignorance of the real causes and consequences of the disease. [ABSTRACT FROM AUTHOR]

Objective: to verify an association between income and eating habits of hypertensive people in Health Multicenter (Multicentro de Saúde in Portuguese) in the city of Salvador, Bahia. Method: cross-sectional study with 221 hypertensive patients. Sociodemographic and eating habits data were collected through interviews and a standardized instrument from July to December 2017. Bivariate analysis was performed using Pearson's Chi-square test. The level of statistical significance adopted was 5%. Results: predominance of consumption of vegetables (69.1%) and fruits (57.6%) less than five days/week, and use of salt substitute products (69.6%) by people with an income of less than one minimum wage; statistically significant associations were found (p=0.027, p=0.003, p=0.043, respectively). Conclusion: the association between income and eating habits of hypertensive people showed that those with income lower than a minimum wage consumed fruits and vegetables less frequently and used salt substitute products. [ABSTRACT FROM AUTHOR]

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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.)

Copyright of Revista Espacios is the property of Talleres de Impresos Oma 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.)

La crisis sanitaria mundial provocada por la pandemia de la enfermedad por coronavirus (COVID-19) ha puesto de manifiesto la importante relación que existe entre la economía y la salud. Esta relación se da en los planos microeconómico, macroeconómico e institucional, ya que los mercados de la salud tienden a sufrir fallas de mercado; el gasto sanitario tiende a aumentar como porcentaje del producto interno bruto (PIB), y su financiamiento tiene consecuencias en las finanzas públicas a largo plazo. En el caso de México, la creación de un sistema de salud público segmentado, como consecuencia del sistema de protección social que se viene aplicando en el país desde 1943 y que ha sido objeto de diversas reformas en los últimos años, ha contribuido a convertir el acceso a la salud en un importante factor de desigualdad, que repercute en la pobreza multidimensional de un segmento significativo de la población. [ABSTRACT FROM AUTHOR]

Copyright of Economic History Research / Investigaciones de Historia Económica is the property of Asociacion Espanola de Historia Economica 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.)