Costs In Spain Research Articles

The burden of hospital malnutrition in Spain: methods and development of the PREDyCES® study.

It is well known that hospital malnutrition is a highly prevalent condition associated to increase morbidity and mortality as well as related healthcare costs. Although previous studies have already measured the prevalence and/or costs of hospital nutrition in our country, their local focus (at regional or even hospital level) make that the true prevalence and economic impact of hospital malnutrition for the National Health System remain unknown in Spain. The PREDyCES® (Prevalence of hospital malnutrition and associated costs in Spain) study was aimed to assess the prevalence of hospital malnutrition in Spain and to estimate related costs. Some aspects made this study unique: a) It was the first study in a representative sample of hospitals of Spain; b) different measures to assess hospital malnutrition (NRS2002, MNA as well as anthropometric and biochemical markers) where used both at admission and discharge and, c) the economic consequences of malnutrition where estimated using the perspective of the Spanish National Health System.

The use of cost-generation curves for the analysis of wind electricity costs in Spain

The cost of the electricity generated from onshore wind is assessed through a method based on an estimation of the geographical distribution of the technical potential and a cost structure for the estimation of the local unit cost. Generation-cost curves are then employed to portray the evolution of the specific generating cost with the increase of the generated energy, until the limit of the technical potential is reached. The study also relates the energy cost to the land occupancy, the installed power and the capacity factor, and includes an assessment of the interplay between land usage and the cost of wind electricity. An analysis is presented to determine the uncertainty in the costs of the several model parameters. The method is applied to Spain, and allows to establish that, for an electricity-generation level of 300 TW h/y (roughly equal to the overall demand in Spain in 2008), the specific marginal cost is around 8.5 c€/kW h.

Probabilistic cost-minimisation analysis of darbepoetin alpha versus epoetin alpha in treating anaemia secondary to chronic renal failure. Assessment in Spanish clinical practice

IntroductionThe direct transfer of the results of pharmaco-economic studies between countries may not be suitable if the proper adaptations are not made to take into account differences in treatment patterns, resource use, and costs from country to country. ObjectiveTo estimate the cost in Spain of treating anaemia secondary to chronic renal failure with darbepoetin alpha or epoetin alpha from a review and analysis of available current information. In addition, the role of the route of administration as a main driver of the cost will be analysed. MethodPopulation: patients with chronic renal failure induced anaemia. Data: Medline and Embase search of studies directly comparing erythropoiesis stimulating agents. Analysis: Cost minimization analysis from the perspective of a hospital pharmacy department. The main outcome chosen was the difference between the average cost per patient undergoing a 30-day treatment with epoetin alpha versus darbepoetin alpha. Resultsa) Haemodialysis: changing from epoetin alpha to darbepoetin alpha is associated with a cost reduction of 8.67%; 95% CI, −1.34 to 17.92 (€uro17.48; 95% CI, −2.70 to 36.13); probabilistic analysis showed that the use of darbepoetin alpha could be associated with a costsaving probability of 94.9%. The IV administration yielded a decrease in costs of about 16.00%; 95% CI, −2.38 to 36.77 (€uro41.78, 95% CI: −6.21 to 96.04); b) Pre-dialysis: darbepoetin alpha is associated with a cost reduction of about 11%–32%. ConclusionsThe use of darbepoetin alpha for the treatment of chronic renal failure induced anaemia (haemodialysis and pre-dialysis) shows higher cost efficiency than epoetin alpha in Spain; these differences increase with IV administration.

Neuropathic pain ups resource use, costs in Spain

Neuropathic pain ups resource use, costs in Spain

The Effects of Reducing Firing Costs in Spain: A Lost Opportunity?

Abstract In the mid 80's, many European countries liberalized the use of fixed-term (temporary) contracts in order to lower firm's non-wage labor costs, instead of reducing firing costs associated with indefinite duration (permanent) contracts. This policy generated segmented labor markets. The Spanish case is the most striking, with a share of temporary employment of 33% by the mid 90's. Since then, several reforms have been suggested and in this paper I quantify some of their effects. First, I build a model of job creation and destruction of the search and matching type that is able to generate the main properties of a segmented labor market like the Spanish one. Then, I use his model to quantify the effects of removing procedural wages, and further reductions in firing costs associated with permanent contracts. The main results are: (i) a small increase in permanent job destruction, (ii) a significant reduction in temporary job destruction, mainly driven by the increase in job conversions from temporary contracts into permanent ones, and (iii) a significant reduction in labor market segmentation measured as the reduction in the wage gap of temporary versus permanent workers.

Inappropriate treatment for COPD leads to high direct costs in Spain

Inappropriate treatment for COPD leads to high direct costs in Spain

A pharmacoeconomic evaluation of the effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes in Spain

To determine the 16-week health economic outcomes of short-term, intensive lipid-lowering therapy with atorvastatin in patients with acute coronary syndrome (ACS) using unit costs from Spain. The total expected cost per patient and the cost per inpatient event avoided were compared for patients on atorvastatin 80 mg daily versus placebo. The analysis was based on clinical outcome data from the MIRACL study. Clinical outcomes measured in this analysis included: death, cardiac arrest, nonfatal myocardial infarction (MI), fatal MI, angina pectoris, stroke, congestive heart failure (CHF), and surgical or percutaneous coronary revascularizations. Unit costs for outcomes were values using 2001 Diagnosis Related Group (DRG) costs in Spain. The cost of a follow-up visit was added to the cost of each outcome in both groups. In the atorvastatin group, monitoring costs were also added. All direct medical costs were taken from the perspective of the Spanish National Health System during a 16-week period. The hospital cost in the atorvastatin group was <euro> 1,921 per patient, compared to <euro> 1,853 in the placebo group. The incremental cost per patient in the atorvastatin group was <euro> 67.47, corresponding to a cost per inpatient event avoided of <euro> 1,760. The cost of atorvastatin for 16 weeks was <euro> 128. Forty-seven percent of this cost of atorvastatin was offset by the cost savings obtained through the reduction of number of events in the atorvastatin group. In Spain, the intensive short-term use of atorvastatin in patients with ACS has a favorable cost-effectiveness. The direct cost of the drug was largely offset by the associated reduction in costs for treating fewer cardiovascular events.

Economic and Social Profitability of Water Use for Irrigation in Andalucia

The paucity of economic data on the use of water for irrigation has been a recurring issue in practically all of the social and technical forums of the last few years in Spain, and it should be approached by the Administration in a more open, transparent way. With the aim of partially amending this deficit, in 1996 to 1997 a study was carried out by the Regional Ministry of Agriculture and Fishing of Andalucia, called the “Inventory and Characterisation of Irrigation in Andalucia,” which was updated in 2002. The cost of this type of study is perfectly assumable by any Administration; as a reference, our initial study cost us 300,000 ε, and the update 60,000 €. The original information has been disseminated on CD-ROM and on the Internet, and it can be purchased for 4.2 €. Irrigation in Andalucia has grown by 54,000 ha, of which 36,000 ha correspond to olive production. Currently, there are 893,000 ha under irrigation, generating 154,000 direct jobs and producing 4,500 million euros. Surface water costs in Spain are mainly paid for by the public sector. The average price for water paid by irrigators in Andalucia is 0.039 €/m3, although groundwater irrigation costs are approximately double this amount. The economic and social efficiency of water is a major consideration when planning and allocating resources. In Andalucia, there are areas with water productivities of 12 €/m3 and areas where 3,000 m3 generates one job per year.

Labour market outliers: Lessons from Portugal and Spain

Iberian labour markets Why Spain and portugal are OECD outliers Spain has the highest unemployment rate (22.2%) of any European Union country, Portugal one of the lowest (7.3%). Superficially, these countries share many labour market features: the toughest job security rules in the OECD, an apparently similar architecture of wage bargaining, and comparable generosity of their unemployment insurance systems, at least since 1989. We address the puzzle by examining Portuguese and Spanish labour market institutions, in particular job security, unemployment benefits and the system of wage bargaining. We then conduct empirical analysis of Spanish and Portuguese unemployment outflows and wage distributions, using micro data. We find differences in unemployment benefits (non-existent in Portugal until 1985, and less generous nowadays), differences in wage flexibility (wage floors by category established by collective agreements are set at a lower relative level in Portugal), and, in practice, higher firing costs in Spain. A key explanation of the difference in Portuguese and Spanish unemployment rates is the wage adjustment process. Generous benefit levels may have been necessary for the path Spanish unions took, but this was not the sole explanation of different wage setting in Spain and Portugal. — Olympia Bover, Pilar Garcia-Perea and Pedro Portugal

Climatización de edificios con muros en cortina

This paper analyses the problems involved in the airconditioning of buildings with walls. These problems are not easy, since it may be necessary, at a given time, to heat a part of the building and cool another part of it. The various systems of airconditioning are reviewed. These can be classified into those making use of large ducts; those employing small, moveable units with fans; individual units fitted in windows, including a cooling compressor; induction units with two or three pipes; and finally double duct high speed systems with mixing boxes. The various systems are compared, and some information is given on costs in Spain, as inferred from a recent competition in which the author has taken part.