Trends and area variations in Potentially Preventable Admissions for COPD in Spain (2002-2013): a significant decline and convergence between areas
Por:
Librero J, Ibañez-Beroiz B, Peiró S, Ridao-López M, Rodríguez-Bernal CL, Gómez-Romero FJ, Bernal-Delgado E and Spanish Atlas of Medical Practice Variation Research Group
Publicada:
9 ago 2016
Categoría:
Health policy
Resumen:
Background: Potentially Preventable Hospitalizations (PPH) are hospital admissions for conditions which are preventable with timely and appropriate outpatient care being Chronic Obstructive Pulmonary Disease (COPD) admissions one of the most relevant PPH. We estimate the population age-sex standardized relative risk of admission for COPD-PPH by year and area of residence in the Spanish National Health System (sNHS) during the period 2002-2013.
Methods: The study was conducted in the 203 Hospital Service Areas of the sNHS, using the 2002 to 2013 hospital admissions for a COPD-PPH condition of patients aged 20 and over. We use conventional small area variation statistics and a Bayesian hierarchical approach to model the different risk structures of dependence in both space and time.
Results: COPD-PPH admissions declined from 24.5 to 15.5 per 10,000 persons-year (Men: from 40.6 to 25.1; Women: from 9.1 to 6.4). The relative risk declined from 1.19 (19 % above 2002-2013 average) in 2002 to 0.77 (30 % below average) in 2013. Both the starting point and the slope were different for the different regions. Variation among admission rates between extreme areas dropped from 6.7 times higher in 2002 to 4.6 times higher in 2013.
Conclusions: COPD-PPH conditions in Spain have undergone a strong decline and a reduction in geographical variation in the last 12 years, suggesting a general improvement in health policies and health care over time. Variability among areas still remains, with a substantial room for improvement.
Filiaciones:
:
Centro Superior de Investigación en Salud Pública (CSISP-FISABIO), Catalunya Av. 21, 46020, Valencia, Spain.
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Valencia, Spain.
Ibañez-Beroiz B:
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Valencia, Spain
NavarraBiomed - Fundación Miguel Servet, Pamplona, Spain
:
Centro Superior de Investigación en Salud Pública (CSISP-FISABIO), Catalunya Av. 21, 46020, Valencia, Spain
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Valencia, Spain
:
Centro Superior de Investigación en Salud Pública (CSISP-FISABIO), Catalunya Av. 21, 46020, Valencia, Spain
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Valencia, Spain
Instituto Aragonés de Ciencias de la Salud. IIS Aragón, Zaragoza, Spain
:
Centro Superior de Investigación en Salud Pública (CSISP-FISABIO), Catalunya Av. 21, 46020, Valencia, Spain
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Valencia, Spain
:
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Valencia, Spain
Instituto Aragonés de Ciencias de la Salud. IIS Aragón, Zaragoza, Spain
Bernal-Delgado E:
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Valencia, Spain
Instituto Aragonés de Ciencias de la Salud. IIS Aragón, Zaragoza, Spain
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