Biomedical subjects

Rosa Gispert

Publications and source records attributed to Rosa Gispert.

13 recordsLinked to original sources

PubMed2006

[Survival changes among AIDS cases in Catalonia, Spain (1981-2001)].

BACKGROUND AND OBJECTIVE: Our goal was to assess survival changes among AIDS patients in Catalonia. PATIENTS AND METHOD: We analyzed AIDS cases older than 13 years notified in the Catalonian AIDS Registry from January 1981 to December 2001. Sex, age, transmission category, AIDS-defining disease and diagnostic period were included. The survival cumulative risk was computed for each diagnostic period with Kaplan-Meier methods. RESULTS: During the study period 13,485 AIDS cases were reported. Median survival time was 0.9 years for 1981-1987, 1.7 for 1988-1993 and 2.4 years for 1994-August 1996. The survival time of 75% of patients diagnosed in September 1996-1997 and 1998-2001 was 1.57 and 2.02 years, respectively. Multivariate analyses showed a higher risk among intravenous drug users (hazard ratio = 1.25; 95% confidence interval, 1.17-1.33) than in homo/bisexual men. When we compared heterosexual and homo/bisexual groups, we found that the result was not significant (hazard ratio = 0.99; 95% confidence interval, 0.92-1.08). The analysis stratified by AIDS-defining disease showed a decrease in the risk of death in most illnesses. CONCLUSIONS: Our results confirm the increase in survival in AIDS cases related to highly active antirretroviral therapy (HAART).

Acquired Immunodeficiency Syndrome↗

PubMed2006

[Mortality of gastric cancer in Catalonia, Spain: geographical distribution and time trends from 1986 to 2000].

BACKGROUND AND OBJECTIVE: The aims of this study are to describe the time trends and the changes in the spatial distribution of stomach cancer mortality by gender, in Catalonia, Spain, in the period 1986-2000. MATERIAL AND METHOD: The mortality data comes from the Mortality Register for Catalonia at the Health Department and the population data from the Institute of Statistics for Catalonia. To analyze time trends, a Poisson regression model was adjusted for each gender. To analyze the geographical distribution, a Bayesian hierarchical model was used. RESULTS: During the period 1986-2000 the number of deaths from stomach cancer was 8,627 for males and 5,831 for females. During this period the estimated decrease in mortality was 3.13% for males and 3.91% for females. The spatial analysis showed the lowest mortality risk areas along the coast while the mortality risk increased toward the zones in the interior. This geographical pattern is very similar for both sexes but in the lasts years of the period it has been fading. CONCLUSIONS: The time trends and the geographical pattern of stomach cancer mortality in Catalonia is similar for both sexes and it is consistent with the trends observed in other developed countries. This suggests a relationship with improved food habits and a better accessibility to health care in the areas of higher risk.

Catchment Area, Health↗

PubMed2006

[The efficiency of the health system in Spain].

OBJECTIVE: This article is an approach to assess the effectiveness of the health system in Spain using information from health care activities, the health status of the populations and the performance of health services, taken as a whole, and the standard patterns defined by geographical distribution and time trends. MATERIAL AND METHOD: The most recent available data and historical series of basic indicators of general and premature mortality, hospital performance and avoidable mortality are used. Data has been aggregated by autonomous region and comes from official mortality and hospital statistics. RESULTS: All the indicators show the improvement experienced in all of the regions during the period analyzed. This evolution however, has not been homogeneous and the regions with the highest improvement are not always those which were in the worst situation at the base line. The results indicate the general idea that health services are responding well to the threats against the populations health, while this cannot be said with respect to public health policies. CONCLUSIONS: The available data, as well as the indicators and the methods used are only useful to express a general idea about the health services effectiveness. It is necessary to evaluate to what extent non-efficacy treatments are still being used and effective treatments are being used inefficiently. To do that, different data and methodology, centred in specific cases or groups of diseases, is needed.

Aged↗

PubMed2005

[Probability of developing and dying of cancer in Catalonia during the period 1998-2001].

BACKGROUND AND OBJECTIVE: We intended to estimate the probability of developing and dying from cancer in Catalonia during the period 1998-2001. PATIENTS AND METHOD: We used a Bayesian model which incorporates data from the Tarragona and Girona Cancer Registries and from the Catalonia Mortality Registry. The probability of developing and dying from cancer has been calculated using a competitive risk-based methodology. RESULTS: Lifetime probability of developing cancer in Catalonia is almost 1 out of 2 (43.7%) for men and 1 out of 3 (32.1%) in women. The probability of dying from cancer is 29.1% for men and 17.9% in women. 67% of men and 56% of women diagnosed with cancer will die from this disease. One out of 14 men will develop a lung cancer during his life and 1 out of 11 women will develop breast cancer. CONCLUSIONS: The observed rising in the probability of developing cancer in Catalonia over the last ten years highlights even more than ever the importance of this health problem.

Adolescent↗

PubMed2004

An adaptation of Charlson comorbidity index predicted subsequent mortality in a health survey.

OBJECTIVE: The Catalan Health Interview Survey Follow-up Study analyzed survival differences according to comorbidity, using an adaptation of the Charlson's index. STUDY DESIGN AND SETTING: Vital status was ascertained by record linkage with death certificates 5 years after interview. Three thousand one hundred five men and 3,536 women aged 40-84 years old were included in the analysis. Proportional hazards models with age as time scale were used to calculate relative risk (RR) and 95% confidence interval adjusted for potential confounders. RESULTS: The adjusted RR of death in men was 1.02 (0.73-1.41) for a comorbidity index of 1-2; the RR was 1.51 (1-2.30) for an index of 3-4, and 2.64 (1.43-4.89) for an index of >4 composed to an index of 0. In women, for the same comorbidity index categorization, the RR of death were 0.83 (0.55-1.24), 1.71 (1.09-2.72) and 2.65 (1.47-4.77). CONCLUSION: This result confirms the relation between comorbidity and the risk of death based on a comorbidity index that takes into account severity and number of self-declared chronic diseases with mortality.

Adult↗

PubMed2004

Underreporting of fatal occupational injuries in Catalonia (Spain).

BACKGROUND: Thoroughness in a given health information system is one of its most important quality indicators. In Spain, in approximately 30% of serious occupational injuries, there is no information on the final outcome. AIM: To assess underreporting of fatal occupational injuries in Catalonia. METHODS: All serious occupational injuries (excluding commuting injuries) reported in Catalonia (Spain) between 1994 and 1998 (n = 7330) were linked with data from the Catalonian Mortality Register, 117 deaths being identified during the year following the injury date. In order to assess whether death could or could not have been related to the prior occupational injury, two experts examined these cases independently. RESULTS: The experts concluded (kappa = 0.98) that 69 (59%) of these deaths were probably related to occupational injuries; the vast majority (n = 65) occurred within 3 months of the injury. This represents an accumulated risk of dying of approximately 1% for the total of serious injuries, not varying with economic activity or job category. However, this risk varied depending on the form of accident, and the site and nature of the injury. CONCLUSIONS: Occupational injury cases, especially serious ones, should be followed up over at least 3 months. These results suggest the importance of carrying out active case-finding and of incorporating the death certificate as one of the documents to be systematically reviewed in order to complete the statistics.

Accidents, Occupational↗

PubMed2003

Sociodemographic and health-related correlates of psychiatric distress in a general population.

BACKGROUND: Measuring factors related to psychiatric distress in public health surveys helps to identify groups at risk for developing psychiatric morbidity. AIMS: The aim of this study was to determine which socio-demographic and health-related factors are associated with psychiatric distress in the general population. METHOD: Data were from the Catalan Health Interview Survey (CHIS), a cross-sectional survey of 15000 members of the general population of Catalonia, Spain. The association between scores on the General Health Questionnaire-12 and socio-demographic and healthrelated variables was analyzed using logistic regression. RESULTS: Several socio-demographic and health-related variables were significantly associated with increased psychiatric distress. The factor most consistently related to psychiatric distress was the presence of one or more chronic physical conditions. The number rather than the type of declared chronic conditions was the most important factor,with the odds ratios (OR) for presence of psychiatric distress ranging from 1.1 [95% confidence interval (CI) = 1.0-1.4] for one declared chronic condition to 5.6 (95% CI = 4.2-7.4) in persons with over five chronic conditions. Other significant related variables varied by age and gender. CONCLUSIONS: The number of declared chronic physical conditions appears to be a relevant correlate of the presence of psychiatric distress, independently of other factors, including the type of chronic condition.

Adolescent↗

PubMed2002

[Mortality due to dementias in Catalonia, Spain: an emergent health problem].

BACKGROUND: The aims of this study were to describe the trends of mortality from dementias according to gender and age in Catalonia (Spain) and to estimate their evolution from 1979 to 2003. MATERIAL AND METHOD: The dementia death data (ICD-9: 290-290.9 298.9, 294.9, 331.0, and 331.2) between 1979 and 1998 come from the Catalonian Mortality Register of the Department of Health as well as the official population census, lineal estimations and projections made by the Institute of Statistics of Catalonia. For the calculation of trend and mortality projections up to 2003, a Poisson regression model was adjusted for each gender, using the variables age, period and birth cohort. RESULTS: Dementia mortality rate moved from 2.14 per 100,000 inhabitants during 1979-1983 to 41.95 during 1994-1998. With regard to the period 1989-1998, the average percentage of the annual variation of mortality is estimated to be 7.5% for males and 9.6% for females. The increase is in part due to population aging and also to a cohort effect of people born before 1925. The expected annual mean number of dementia deaths during 1999-2003 is estimated at 4,594. CONCLUSIONS: Mortality from dementias in Catalonia has experienced a substantial increase over the last 20 years. Given the health and social impact of this group of diseases and the future perspectives, dementias should be considered as an emergent problem in public health.

Aged↗

PubMedDate not supplied

[Analysis of mortality time trend using generalized linear models].

In this work it is shown how generalized linear models allow one to describe different patterns of temporary evolution of mortality data, while at the same time allow for an easy interpretation. As a practical application, the evolution of the female breast cancer mortality in Catalonia from 1986 to 2000 is analyzed. Remarkably, the mortality from breast cancer first increases and then decreases for all age groups. Moreover, the year in which the cancer rate starts decreasing is more recent in the older age groups.

Breast Neoplasms↗

PubMedDate not supplied

[Geographical distribution and time trends in avoidable mortality in Catalonia, Spain (1986-2001)].

OBJECTIVES: To analyze time trends and geographical variation in avoidable mortality by health areas in Catalonia. MATERIAL AND METHODS: Avoidable mortality was analyzed according to the classification used by the Health Department of the Regional Government of Catalonia from 1986-2001 for health areas and causes were grouped as treatable and preventable. Standardized mortality rates were calculated by the direct and indirect method and the comparative mortality figures were calculated for the treatable and preventable groups and for the 46 health areas. The mean annual change adjusted for age was also calculated using a Poisson regression of avoidable and general mortality. RESULTS: The total number of avoidable deaths was 61,261 (7.3% of overall deaths). 10,623 cases (17.34%) were classified as treatable and 50,638 (82.65%) as preventable. The mean annual change for avoidable causes was -2.43% (95% CI, -2.60 to -2.26), higher than the -1.57% (95% CI, -1.61 to -1.52) change for general mortality. The rates were higher for preventable causes than for treatable causes, although mortality decreased in both groups. The health area of Segrià was notable for its significantly higher mortality from both treatable and preventable causes in both periods. Four health areas showed a significant increase in mortality from preventable causes but none showed an increase in mortality from treatable causes. CONCLUSIONS: In Catalonia, the decrease in avoidable mortality was greater than that in general mortality from 1986 to 2001. The geographical distribution shows wide dispersion but allows areas requiring preventive interventions to be identified.

Adolescent↗

PubMedDate not supplied

[Differences between public and private hospital care in Spain: the realities of health care or a numerical fallacy?].

OBJECTIVE: To give an example of the misleading interpretations of the concepts "public and private" when dealing with simple data from hospital resources and activities in Spain. MATERIAL AND METHODS: Data comes from the survey of hospitals (EESCRI) for the year 2002 in Catalonia. Using the figures corresponding to resources (number of centers and beds) and activities (discharges, stays, mean stay, occupancy, and rotation) comparisons are made among different variables (managing authority and funding source) reclassified, according to the concepts of public and private. RESULTS: The figures on resources and activities offer a very different portrait about the public or private nature of the care provided, according to the variables being used for classification. CONCLUSIONS: It is necessary to specify the concepts and variables to be used when analyzing the performance of health services and to improve the information sources in order to adapt them to the new management forms of the health services.

Delivery of Health Care↗

PubMedDate not supplied

[Avoidable mortality: a consensus list of causes to update the indicator in Spain].

OBJECTIVE: Mortality indicators could reflect the effect of health services interventions on the population's health, although there is no agreement about which indicator would be the most appropriate. The objective of this study was to obtain a consensus list of causes of avoidable mortality that could be used as a reference in Spain. METHODS: Based on existing publications and participants' knowledge, a process of consensus among medical practitioners, producers and users of health indicators was carried out. The degree of agreement on the different items was assessed. RESULTS: Agreement was reached on a final list of 34 causes of avoidable mortality as well as on the interventions that could avoid death. The level of consensus was high or intermediate in most categories (consensus was low in only 4 categories) and was high for the list and sublists (medical care or health policy interventions) as a whole. Agreement was higher on the avoidable causes of death than on the kind of interventions that can avoid it. Discrepancy was greater for the kind of medical interventions than for intersectorial policy measures. CONCLUSIONS: The reflection and discussion involved in reaching a consensus on the avoidable mortality list, as well as the dissemination of the criteria and the procedures followed, provide added value. The list will improve data comparisons and facilitate benchmarking among the various regional health systems. We recommend its use in the Spanish context.

Cause of Death↗

PubMedDate not supplied

[Geographical distribution and time trends of suicide mortality in Catalonia and Spain [1986-2002]].

OBJECTIVE: To analyze time trends in Catalonia (1986-2002) and Spain (1986-2001) in suicide mortality and its geographical variation by health areas in Catalonia. METHODS: Standard annual mortality rates were calculated by the direct method for Catalonia (1986-2002) and Spain (1986-2001) (standard population of Catalonia 1991). The adjusted annual percent change was analyzed by means of a Poisson regression by gender and by age group for Catalonia and Spain. For the geographical variation in Catalonia, standardized mortality ratio using the indirect method (SMR) were calculated by gender and for the 46 health areas for the entire period and the comparative mortality figures and its confidence intervals at 95% were analyzed grouping the years in period 1(1986-1994) and period 2 (1995-2002). RESULTS: Men's mortality in Catalonia was lower than in Spain and an increase (not significant) was observed in both places during the period; for women, the evolution and rates were similar, with a small decrease (significant) for Catalonia and Spain. Differences in patterns and trends for age and sex were observed, showing a decrease in the elderly groups for both sexes and an increase for the young for Spain and Catalonia. In terms of geographic distribution, the health sectors of the Central, Northeast and South Catalonia zones show higher than average mortality. CONCLUSIONS: The time trends of mortality by suicide in Catalonia shows different patterns according to age and gender. A progressive homogenization in the territorial distribution by health areas was observed.

Adolescent↗