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

RECALSEEN. Subgrupo: la atención al paciente en las unidades de nutrición clínica del Sistema Nacional de Salud

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

RECALSEEN 2021. Resources and quality in the Endocrinology and Nutrition units of the National Health System of Spain

Background The Spanish National Health System (NHS) faces a significant shortage of specialists in Clinical Psychology with only 5.58 per 100,000 inhabitants. This study aimed to estimate the required number of specialists and residents in Clinical Psychology to provide adequate psychological treatments to the population in the Spanish public NHS. Methods A needs-based model was adapted to forecast the required total number of clinical psychologists and the annual increase in the positions of residents in Clinical Psychology (PIR). This model followed five steps: 1) obtaining Spanish prevalence rates for three broad mental disorder categories (depression, anxiety, and others) from the 2017 National Health Survey (ENSE); 2) multiplying the prevalence rates by the Spanish population; 3) defining the percentage of cases eligible for treatment under three predefined scenarios (protocolized, intermediate, and adjusted); 4) operationalizing the characteristics of the three treatment scenarios (session number and duration); and 5) calculating the total number of specialists and the annual increase required of residents in Clinical Psychology. Results Depending on the treatment scenario, the estimations show a need for Clinical Psychology specialists ranging from 1,665 to 13,527 for treating depressive disorders, 1,792 to 9,799 for anxiety disorders, and 2,074 to 8,294 clinical psychologists specifically for other mental disorders. On the other hand, depending on the treatment scenario and the timeframe to achieve the number of professionals estimated (within 3, 5, 8, or 10 years), for example, to achieve those estimations of professionals within three years, and according to the adjusted treatment scenario, the Spanish health system should offer approximately 481 PIR positions yearly during three years. Conclusions A significant increase in the number of PIR positions is necessary to meet the growing demand for psychological treatment in the Spanish NHS. Investing in a mental health workforce can lead to substantial health and economic benefits. This study provides valuable insights for workforce planning and highlights the importance of addressing the shortage of clinical psychologists in Spanish public NHS.

Patient care in the Endocrinology and Nutrition Units of the National Health System. The RECALSEEN study

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)

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

The use of certain strategies for the implementation of a specific recommendation yields better results in clinical practice. The aim of this study was to assess the effectiveness of an evidence-based model using clinical audits (GRIP model), for the implementation of recommendations in pain and urinary incontinence management as well as fall prevention, in the Spanish National Health System during the period 2015–2018. A quasi-experimental study has been conducted. The subjects were patients treated in hospitals, primary care units and nursing home centers. There were measures related to pain, fall prevention and urinary incontinence. Measurements were taken at baseline and at months 3, 6, 9, and 12. The sample consisted of 22,114 patients. The frequency of pain assessment increased from 59.9% in the first cycle to a mean of 71.6% in the last cycle, assessments of risk of falling increased from 56.8% to 87.8% in the last cycle; and finally, the frequency of assessments of urinary incontinence increased from a 43.4% in the first cycles to a mean of 62.2% in the last cycles. The implementation of specific evidence-based recommendations on pain, fall prevention, and urinary incontinence using a model based on clinical audits improved the frequency of assessments and their documentation.

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

Research in clinical nutrition and dietetics consists of "carrying out intellectual and experimental activities in a systematic way with the purpose of increasing knowledge on this topic." The biomedical research carried out in clinical nutrition and dietetics units (UNCyDs) must be clinical-translational, which is understood as the fastest way to ensure that new scientific knowledge is transferred not only to clinical research but also to clinical practice. When UNCyDs conduct research, regardless of type and extent, they achieve higher quality standards in the health care they provide to their users. Clinical practice and scientific research are activities that constitute a continuous, indissoluble action. For this reason, both those responsible for health management and nutrition units and all their members have an obligation to promote research. In this article, a brief historical review of the birth of clinical nutrition as a scientific discipline is made, the legislation that supports biomedical research is briefly mentioned, the main keys to promote research in UNCyD are proposed, and finally orientation is offered on the main funding for biomedical research programs, and how to transfer and disseminate results.

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

RECALSEEN 2021. La atención al paciente en las unidades de Endocrinología y Nutrición del Sistema Nacional de Salud