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[Health care financing: is it enough and appropriate?].

INTRODUCTION: The object of this short paper is to present the results of Spanish public health care expenditures projections until 2013 according to the expected impact of the main demographic and technological health cost drivers. MATERIAL AND METHODS: Future annual health expenditures are estimated using a simple method based on the decomposition of the past main growth factors in two scenarios. The main cost drivers considered were the following: demography, which includes the increasing number of people and the impact of population ageing; the increase in the price of health care inputs above the general price level; and the impact of changes in medical practice related with expanding medical technology. RESULTS AND DISCUSSION: In 2013, public health care expenditure may be around 5.7% and 6% of gross domestic product (GDP); that is, at least, between 0.24 and 0.53 additional GDP points will be spent on public health care. The main factor responsible for the future expenditure increase will continue to be the increase in the average health service intensity, followed by demographic factors. In the base-case scenario, public expenditure increase until 2013 will be compatible with a real 2.5% annual increase in consumption of non-health goods and services. In order to finance the future costs, the Spanish population will have to devote to public health expenditure less than 7% of income increase until 2013. CONCLUSION AND PERSPECTIVES: Despite being important, the expected Spanish GDP growth until 2013 may be enough to finance the increase in public health expenditure as a result of the impact of demographic changes. Expanding medical technology is expected to continue being the main driver of future costs.

Age Distribution↗

Financial assistance for HIV-infected persons with haemophilia worldwide.

In many countries we could note the dramatic developments in regard to financial assistance of HIV-infected haemophiliacs and their families since we distributed the first overview on this to all World Federation of Hemophilia member countries. As a result of the untiring efforts of the National Haemophilia Societies, infected persons and their families receive essential assistance in 15 member countries. It is hoped that this development will sway more and more member countries to consider demands for financial support and provide them with the arguments to succeed.

Blood Coagulation Factors↗

The absent professor: why we don't teach research ethics and what to do about it.

Research ethics education in the biosciences has not historically been a priority for research universities despite the fact that funding agencies, government regulators, and the parties involved in the research enterprise agree that it ought to be. The confluence of a number of factors, including scrutiny and regulation due to increased public awareness of the impact of basic research on society, increased public and private funding, increased diversity and collaboration among researchers, the impressive success and speed of research advances, and high-profile cases of misconduct, have made it necessary to reexamine how the bioscience research community at all levels provides ethics education to its own. We discuss the need to and reasons for making ethics integral to the education of bioscientists, approaches to achieving this goal, challenges this goal presents, and responses to those challenges.

Biomedical Research↗

Problems in analyzing the comparative costs of private versus public psychiatric care.

The authors outline the difficulties in attempting to compare the costs of service in various mental health settings, especially private practice and community mental health centers. Contributing to the difficulties are the differences in the populations served, differences in treatment modalities employed, and the different economic incentives operating in each setting. The authors stress the need for research on cost effectiveness as the basis for valid comparisons of various care settings.

Community Mental Health Services↗

Halfway houses for the mentally ill and alcoholics: a 1973 survey.

A survey of halfway houses made in October 1973 identified 209 facilities primarily for psychiatric patients and 597 for alcoholics. The facilities for alcoholics average fewer employees than the psychiatric halfway houses, and proportionately more of them are recovered patients. The alcoholism facilities serve older clients, most of them males. Patients admitted to psychiatric halfway houses are more likely to enter from a hospital than from the community, and they have longer stays than the alcoholic patients. The largest percentage of both groups return to independent living; 15 per cent of the psychiatric patients are readmitted to hospitals.

Adolescent↗