Biomedical subjects

E Marín Nieto

Publications and source records attributed to E Marín Nieto.

3 recordsLinked to original sources

PubMed2001

[Economic impact of the introduction of a minor surgery program in primary care].

OBJECTIVE: To value the economic impact of implantation (establishment) of a minor surgery programme within health area of primary care in Albacete (Spain). SETTING: Primary care (PC). DESIGN: Observational, cross-sectional and retrospective study. Interventions and measurements. It has been recorded some patients operated on subsidiary minor surgery pathologies in the three health centers of Albacete area that participated in pilot experience from 1 November 1997 to 30 October 1998. It has been calculated the fixed costs corresponding to sanitary staff and the repayment of chirurgical area daily. As well, it were calculated the costs corresponding to disposable and not disposable equipment. It were analysed costs in function of intervention and the total cost were compared with the cost it would have supposed if it would carried out in specialized private centers according to up to dated fees of 1998 insurance companies. MAIN RESULTS: During the study interval were operated on 185 patients with an average age of 64,5 years (SD +/- 21,4) with a slight predominance of women. All pathologies treated were benign, 39 cases were abscess, 38 were nail pathology, and 35 were foreign bodies removed.Cost were calculated on the basis of time of one year. Total cost of minor surgery programme were 1.234.440 Pts (7715 Euros) whereas if it would have carried out at specialized level it supposed between 2621450 Pts (15755.23 Euros) and 4440000 Pts (26684.94 Euros). CONCLUSION: In our study, the minor surgery programme in primary care diminish the cost in comparison with private specialized level, at the same time as reducing standby list in specialities like surgery or dermatology.

Cross-Sectional Studies↗

PubMed2000

Economic evaluation of colorectal cancer screening with fecal occult blood detection.

OBJECTIVE: To analyze the cost/benefit (CBA), cost/effectiveness (CEA) and cost/utility (CUA) of colorectal cancer (CC) screening through the detection of fecal occult blood (FOB). METHODS: A retrospective 10-year study was carried out in primary care hospitals to observe the evolution of CC in the study zone; subsequently, CC screening with FOB detection was done, and the entire population aged 50 to 75 years living in the Casas Ibáñez Health Zone was invited to take part. When the results had been evaluated, the screening program was evaluated in economic terms to determine CBA and to compare screening costs (option A) with the cost of allowing CC to develop without intervention (doing nothing), according to the previous retrospective study. The CEA calculated the cost of each cancer found in an asymptomatic stage, and the CUA calculated the cost of each year adjusted to quality of life (QUALY) for both options. RESULTS: The CBA showed that screening for CC with FOB detection (option A) produced a savings of 2,001,067 Spanish pesetas (USD15,310) in comparison with option B (doing nothing). The CEA showed that each cancer detected by screening at an asymptomatic stage cost 806,025 pesetas (USD6,167). The CUA showed that each QUALY for men in option A cost 1,051,185 pesetas (USD8,043), whereas for option B each QUALY would cost 4,220,315 pesetas (USD32,290). For women, each QUALY cost 564,795 pesetas (USD4,321.31) in option A and 2,413,834 pesetas (USD18,469) in option B. CONCLUSIONS: Our economic evaluation demonstrates that the cost/benefit, cost/effectiveness and cost/utility ratios for CC screening through FOB detection with the Hemoccult test are better than for the alternative of doing nothing.

Aged↗

PubMed1995

[Visual and auditory difficulties expressed by the aged].

OBJECTIVE: To determine the proportion of the elderly who have difficulties in their perceptive functions (seeing and hearing) and associated factors in the area of health self-perception and functional capacity. DESIGN: Observational and crossover, using an interview. SETTING: Community. PARTICIPANTS: 787 elderly people not in institutions; 93.8% reply rate. MEASUREMENTS AND MAIN RESULTS: Using a questionnaire, data were obtained on deficiencies in their sense organs and self-perceived health. Validated scales to determine functional capacity (physical, psychic and social) were used: Katz, Lawton and Brody indexes, Cognitive mini-test, DUKE-UNC questionnaire and Geriatric Depression scale. A serious difficulty or inability to read or watch television was expressed in 17.3% of cases (CI 95%; 14.8-20.0) and to follow a normal conversation in 10.5% (CI 95%; 8.4-12.6). The proportion of the elderly dependent on others to carry out their normal daily activities was 2.2 times greater among those who displayed severe visual problems (CI 95%; 1.7-2.9) and 1.8 times greater if they had hearing difficulties (C.I. 95%; 1.4-2.3). There was a linear tendency between greater visual or auditory problems and less social support (p = 0.01), greater dependency on others for basic daily activities (p < 0.001) and worse perceived health (p < 0.001). CONCLUSIONS: The elderly, especially the oldest among them, frequently display hearing and visual problems, which are related to low self-perception of health and greater functional incapacity.

Age Factors↗