RECALMIN. Patient care in the internal medicine units of the Spanish national health system

RECALMIN. La atención al paciente en las unidades de Medicina Interna del Sistema Nacional de Salud

RECALMIN. Four years of growth of the internal medicine units of the Spanish National Health System (2013–2016)

ObjectivesTo compare the structure, resources and activity of the internal medicine units (IMUs) of the Spanish National Health System (SNHS) in 2013 and 2016. To analyse the differences between IMUs in 2016 by hospital size. Material and methodsWe conducted a comparison of 2 descriptive cross-sectional studies of IMUs in general acute care hospitals of the Spanish National Health System, with data referring to 2013 and 2016. The variables were collected via an ad hoc questionnaire (RECALMIN survey). ResultsBetween 2013 and 2016, the demand for care increased dramatically (with an annual average of 11% in hospital discharges and 16% in first consultations), and comorbidity slightly increased (2%). During this period, the mean productivity of IMUs increased 16.7% (0.6±0.3 vs. 0.7±0.3; P=.09), and the mean stay decreased 10% (9±2.2 vs. 8.1±2.1 days; P=.001). Progress in implementing good practices and systematic care for complex chronic patients was scarce. Both surveys found variability among IMUs and marked differences among IMUs of hospitals of different sizes. ConclusionsIMUs responded to the increased burden of care they supported during 2013-2016 by improving their efficiency and productivity; however, advances in implementing good practices, including care for chronic complex patients, were scare. The significant variability in the indicators of structure, activity and management models found in 2013 remained in 2016.

RECALSEEN 2024. Resources and quality in the endocrinology and nutrition units of the National Health System of Spain.

RECALMIN V. Evolution in the activity of internal medicine units of the National Health System (2007-2022).

PMH10 - Budgetary Impact Analysis of Reimbursement Varenicline in the Smoking Cessation Treatment of Patients with Major Depression in Spain

RECALSEEN. Subgroup: Patient care in the clinical nutrition units of the Spanish National Health System

To reach a situation diagnosis on the status of patient management at digestive care units (DCUs) in Spain. A cross-sectional descriptive study across DCUs in general acute care hospitals within the Spanish National Health System (data referred to 2015). The study variables were collected with a questionnaire including items on structure, services portfolio, activity, education, research, and good practice. Hospital discharge rates for digestive diseases were also assessed using the minimum basic data set (2005-2014). Two hundred and nine hospitals invited, 55 responders (26.3%). Average discharges from hospital were 1,139 ± 653 per DCU/year, and 100 ± 66 per year per dedicated gastroenterologist. In 2014, admission rate to DCUs per 1,000 population and year was 280, with a mean stay of 7.4 days. The analysis of the MBDS for 2005-2014 reveals a progressive increase in the number of discharges (37% more in 2014 versus 2005), with a 28% decrease in hospital gross mortality rate (3.7% in 2014) and a slightly reduced (14%) mean stay (7.6 days in 2014). Considerable variability may be seen in structure, activity, and results indicators. Mortality and readmission rates, as well as mean stay, vary more than 100% amongst DCUs, and major dispersions also exist in frequentation and results amongst autonomous communities. The RECALAD 2015 survey unveiled relevant aspects related to DCUs organization, structure, and management. The notable variability encountered likely reflects relevant differences in efficiency and productivity, and thus points out there is ample room for improvement.

RECALMIN IV. Evolution in the activity of internal medicine units of the National Health System (2008–2021)

Gobernabilidad del Sistema Nacional de Salud: mejorando el balance entre los beneficios y los costes de la descentralización. Informe SESPAS 2008

RECALMIN IV. Evolución de la actividad de las unidades de medicina interna del Sistema Nacional de Salud (2008-2021)

Alternativas a la distribución de medicamentos y su retribución

In Spain, Inherited Retinal Dystrophies (IRD) gene diagnosis has been implemented from several decades ago (from 90's of last century), throughout the collaborative and multidisciplinary work of six teams located around the country (EsRetNet https://www.esretnet.org/, and others).Along this time, we have developed guidelines to extend and improve gene testing for IRD in Spain (Ministry of Health, 2019 (https://portal.guiasalud.es/gpc/distrofias-hereditarias-retina/), and different molecular approaches have been implemented to increase the rate of molecular characterization of the patients, rising next generation sequencing (NGS) for routine, in 2013.In January 2024, the pipeline for Gene testing in Spanish National Health System (NHS) was released, including ophthalmological genetic disorders (https://cgen.sanidad.gob.es/#/). This pipeline defines the conditions to be studied, using ICD 10 and ORPHA codification, the reasons to refer, and the molecular procedures to apply, among others.Moreover, during the last 4 years the Spanish Program: Impact genomics has provided WGS for more than 2,000 Rare Diseases patients, including some with IRD, to explore the feasibility to implement WGS in NHS.In the Department of Clinical Genetics of Fundacion Jimenez Diaz, Madrid, we have integrated in these national programs, as well as have introduced through research projects, the use of long reads WGS for IRD characterization.As a result, we show the results of the cases studied in our centre. By March 2024, 6,025 unrelated affected IRD families had been recorded, 5,123 of them could be genetically studied, comprising around 8,000 cases. The families were distributed into 3 categories: Non syndromic Retinitis Pigmentosa (RP) (2,597 families; 60% characterized), Syndromic RP (651 families; 69% characterized), and NonRP (Macular Dystrophies, Cone Dystrophies, Cone Rod Dystrophies, etc) (1,875 families; 63% characterized)In our cohort, the largest in the world from one single centre, 192 different genes were found as responsible for IRD, and about of 2,000 different causative variants were identified, half of them present in only one family. Despite this huge genetic heterogeneity, one fourth of the characterised families showed involvement of only seven genes (ABCA4, USH2A, RPGR, CRB1, RS1, PRPH2, and BEST1). RPE65 gene biallelic pathogenic variants were present in 30 families (around 50 affected cases).This approach has allowed to implement not only the molecular characterization, but also to offer authorized treatment (Luxturna) for more than 30 Spanish cases in 6 centres and access to reproductive counselling and techniques, as PGT for severe IRD conditions.

Cost-minimisation analysis of chronic lymphocytic leukemia in Spain in the era of oral targeted therapies

A comparative performance analysis of a renowned public private partnership for health care provision in Spain between 2003 and 2015