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Hernández Guillamet G, Morancho Pallaruelo AN, Miró Mezquita L, Miralles R, Mas MÀ, Ulldemolins Papaseit MJ, Estrada Cuxart O, López Seguí F. Correction: Machine Learning Model for Predicting Mortality Risk in Patients With Complex Chronic Conditions: Retrospective Analysis. Online J Public Health Inform 2024; 16:e58453. [PMID: 38513230 PMCID: PMC10995781 DOI: 10.2196/58453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 03/23/2024] Open
Abstract
[This corrects the article DOI: 10.2196/52782.].
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Affiliation(s)
- Guillem Hernández Guillamet
- Research Group on Innovation, Health Economics and Digital TransformationInstitut Germans Trias i PujolBadalonaSpain
- Hospital Germans Trias i PujolInstitut Català de la SalutBadalonaSpain
| | | | - Laura Miró Mezquita
- Research Group on Innovation, Health Economics and Digital TransformationInstitut Germans Trias i PujolBadalonaSpain
- Hospital Germans Trias i PujolInstitut Català de la SalutBadalonaSpain
| | - Ramón Miralles
- Direcció Clínica Territorial de Cronicitat Metropolitana NordInstitut Català de la SalutBadalonaSpain
- Department of GeriatricsHospital Germans Trias i PujolBadalonaSpain
| | - Miquel Àngel Mas
- Direcció Clínica Territorial de Cronicitat Metropolitana NordInstitut Català de la SalutBadalonaSpain
- Department of GeriatricsHospital Germans Trias i PujolBadalonaSpain
| | - María José Ulldemolins Papaseit
- Direcció d’Atenció Primària Metropolitana NordInstitut Català de la SalutBadalonaSpain
- Servei d’Atenció Primària Barcelonès NordInstitut Català de la SalutBarcelonaSpain
| | - Oriol Estrada Cuxart
- Research Group on Innovation, Health Economics and Digital TransformationInstitut Germans Trias i PujolBadalonaSpain
- Hospital Germans Trias i PujolInstitut Català de la SalutBadalonaSpain
| | - Francesc López Seguí
- Hospital Germans Trias i PujolInstitut Català de la SalutBadalonaSpain
- Chair in ICT and Health, Centre for Health and Social Care Research (CESS)University of Vic - Central University of Catalonia (UVic-UCC)VicSpain
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Hernández Guillamet G, Morancho Pallaruelo AN, Miró Mezquita L, Miralles R, Mas MÀ, Ulldemolins Papaseit MJ, Estrada Cuxart O, López Seguí F. Machine Learning Model for Predicting Mortality Risk in Patients With Complex Chronic Conditions: Retrospective Analysis. Online J Public Health Inform 2023; 15:e52782. [PMID: 38223690 PMCID: PMC10784974 DOI: 10.2196/52782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/18/2023] [Indexed: 01/16/2024] Open
Abstract
Background The health care system is undergoing a shift toward a more patient-centered approach for individuals with chronic and complex conditions, which presents a series of challenges, such as predicting hospital needs and optimizing resources. At the same time, the exponential increase in health data availability has made it possible to apply advanced statistics and artificial intelligence techniques to develop decision-support systems and improve resource planning, diagnosis, and patient screening. These methods are key to automating the analysis of large volumes of medical data and reducing professional workloads. Objective This article aims to present a machine learning model and a case study in a cohort of patients with highly complex conditions. The object was to predict mortality within the following 4 years and early mortality over 6 months following diagnosis. The method used easily accessible variables and health care resource utilization information. Methods A classification algorithm was selected among 6 models implemented and evaluated using a stratified cross-validation strategy with k=10 and a 70/30 train-test split. The evaluation metrics used included accuracy, recall, precision, F1-score, and area under the receiver operating characteristic (AUROC) curve. Results The model predicted patient death with an 87% accuracy, recall of 87%, precision of 82%, F1-score of 84%, and area under the curve (AUC) of 0.88 using the best model, the Extreme Gradient Boosting (XGBoost) classifier. The results were worse when predicting premature deaths (following 6 months) with an 83% accuracy (recall=55%, precision=64% F1-score=57%, and AUC=0.88) using the Gradient Boosting (GRBoost) classifier. Conclusions This study showcases encouraging outcomes in forecasting mortality among patients with intricate and persistent health conditions. The employed variables are conveniently accessible, and the incorporation of health care resource utilization information of the patient, which has not been employed by current state-of-the-art approaches, displays promising predictive power. The proposed prediction model is designed to efficiently identify cases that need customized care and proactively anticipate the demand for critical resources by health care providers.
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Affiliation(s)
- Guillem Hernández Guillamet
- Research Group on Innovation, Health Economics and Digital Transformation Institut Germans Trias i Pujol Badalona Spain
- Hospital Germans Trias i Pujol Institut Català de la Salut Badalona Spain
| | | | - Laura Miró Mezquita
- Research Group on Innovation, Health Economics and Digital Transformation Institut Germans Trias i Pujol Badalona Spain
- Hospital Germans Trias i Pujol Institut Català de la Salut Badalona Spain
| | - Ramón Miralles
- Direcció Clínica Territorial de Cronicitat Metropolitana Nord Institut Català de la Salut Badalona Spain
- Department of Geriatrics Hospital Germans Trias i Pujol Badalona Spain
| | - Miquel Àngel Mas
- Direcció Clínica Territorial de Cronicitat Metropolitana Nord Institut Català de la Salut Badalona Spain
- Department of Geriatrics Hospital Germans Trias i Pujol Badalona Spain
| | - María José Ulldemolins Papaseit
- Direcció d'Atenció Primària Metropolitana Nord Institut Català de la Salut Badalona Spain
- Servei d'Atenció Primària Barcelonès Nord Institut Català de la Salut Barcelona Spain
| | - Oriol Estrada Cuxart
- Research Group on Innovation, Health Economics and Digital Transformation Institut Germans Trias i Pujol Badalona Spain
- Hospital Germans Trias i Pujol Institut Català de la Salut Badalona Spain
| | - Francesc López Seguí
- Hospital Germans Trias i Pujol Institut Català de la Salut Badalona Spain
- Chair in ICT and Health, Centre for Health and Social Care Research (CESS), University of Vic - Central University of Catalonia (UVic-UCC), Vic, Spain
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López Seguí F, Cos Codina J, Ricou Ríos L, Martínez Segura MI, Miró Mezquita L, Escrich Navarro R, Davins Riu M, Estrada Cuxart O, Anashkin Kachalin G, Moreno-Martínez D. Readiness for Change in the Implementation of a 3D Printing Initiative in a Catalan Tertiary Hospital Using the Normalization Process Theory: Survey Study. JMIR Hum Factors 2023; 10:e47390. [PMID: 37801353 PMCID: PMC10589830 DOI: 10.2196/47390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/13/2023] [Accepted: 08/12/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The high failure rate of innovation projects motivates us to understand the perceptions about resistances and barriers of the main stakeholders to improving success rates. OBJECTIVE This study aims to analyze the readiness for change in the implementation of a 3D printing project in a Catalan tertiary hospital prior to its implementation. METHODS We used a web-based, voluntary, and anonymous survey using the Normalization Measurement Development questionnaire (NoMAD) to gather views and perceptions from a selected group of health care professionals at Germans Trias i Pujol University Hospital. RESULTS In this study, 58 professionals, including heads of service (n=30, 51%), doctors (n=18, 31%), nurses (n=7, 12%), and support staff (n=3, 5%), responded to the questionnaire. All groups saw the value of the project and were willing to enroll and support it. Respondents reported the highest scores (out of 5) in cognitive participation (mean 4.45, SD 0.04), coherence (mean 3.72, SD 0.13), and reflective monitoring (mean 3.80, SD 0.25). The weakest score was in collective action (mean 3.52, SD 0.12). There were no statistically significant differences in scores among professions in the survey. CONCLUSIONS The 3D printing project implementation should pay attention to preparing, defining, sharing, and supporting the operational work involved in its use and implementation. It should also understand, assess, and communicate the ways in which the new set of practices can affect the users and others around them. We suggest that health officers and politicians consider this experience as a solid ground toward the development of a more efficient health innovation system and as a catalyst for transformation.
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Affiliation(s)
- Francesc López Seguí
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
- Chair in ICT and Health, Centre for Health and Social Care Research, University of Vic - Central University of Catalonia, Vic, Spain
| | - Joan Cos Codina
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Laura Ricou Ríos
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - María Isabel Martínez Segura
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - Laura Miró Mezquita
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - Raquel Escrich Navarro
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - Meritxell Davins Riu
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - Oriol Estrada Cuxart
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
| | - German Anashkin Kachalin
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
| | - Daniel Moreno-Martínez
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Badalona, Spain
- Hospital Germans Trias i Pujol, Institut Català de la Salut, Badalona, Spain
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Ricou Ríos L, Esposito Català C, Pons Calsapeu A, Adroher Mas C, Andrés Martínez I, Nuño Ruiz I, Castellà Creus M, Castellà Fàbregas L, García Quesada MJ, Estrada Cuxart O, Ara Del Rey J, López Seguí F. Implementation of a vascular access specialist team in a tertiary hospital: a cost-benefit analysis. Cost Eff Resour Alloc 2023; 21:67. [PMID: 37716948 PMCID: PMC10505311 DOI: 10.1186/s12962-023-00464-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/01/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND The use of peripherally inserted central catheters and midline catheters is growing due to their potential benefits. These devices can increase patient safety and satisfaction while reducing the use of resources. As a result, many hospitals are establishing vascular access specialist teams staffed by nurses who are trained in the insertion and maintenance of these catheters. The objective of the study is to evaluate previously to the implementation whether the benefits of introducing ultrasound-guided peripheral venous catheters, midline catheters and peripherally inserted central catheters compared to current practice by a vascular access specialist team outweigh their costs. METHODS Cost-benefit analysis from the perspective of the healthcare provider based on administrative data. The study estimates the reduction in resources used when changing the current practice for the use of ultrasound-guided midline and PICC catheters, as well as the additional resources required for their use. RESULTS The use of an ultrasound-guided device on peripherally inserted central carheter, results in a measurable resource reduction of approximately €31. When 3 peripheral venous catheters are replaced by an ultrasound-guided peripherally inserted central catheter, the saving is €63. Similarly, the use of an ultrasound-guided device on a midline catheter, results in a reduction of €16, while each ultrasound-guided midline catheter replacing 3 peripheral venous catheters results in a reduction of €96. CONCLUSION The benefits of using ultrasound-guided midline and PICC catheters compared to current practice by introducing a vascular access specialist team trained in the implantation of ultrasound-guided catheters, outweigh its cost mainly because of the decrease in hospital stay due to the lowered risk of phebitis. These results motivate the implementation of the service, adding to previous experience suggesting that it is also preferable from the point of view of patient safety and satisfaction.
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Affiliation(s)
- Laura Ricou Ríos
- Direcció d'Estratègia Assistencial, Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
- CRES - Centre de Recerca en Economia de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Barcelona, Spain
| | - Candela Esposito Català
- CRES - Centre de Recerca en Economia de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - Arnau Pons Calsapeu
- Direcció d'Estratègia Assistencial, Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
- CRES - Centre de Recerca en Economia de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - Cristina Adroher Mas
- CRES - Centre de Recerca en Economia de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - Isabel Andrés Martínez
- Hospital Universitari Germans Trias i Pujol, Institut Català de la Salut, Barcelona, Spain
| | - Isaac Nuño Ruiz
- Hospital Universitari Germans Trias i Pujol, Institut Català de la Salut, Barcelona, Spain
| | - Mònica Castellà Creus
- Hospital Universitari Germans Trias i Pujol, Institut Català de la Salut, Barcelona, Spain
- Direcció Infermera. Àrea de Qualitat. Gerència Metropolitana Nord, Hospital Germans Trias i Pujol, Institut Català de la Salut, Barcelona, Spain
- NURECARE-IGTP Nursing Research Group, Germans Trias i Pujol Research Institute, Badalona, Spain
| | - Laia Castellà Fàbregas
- Hospital Universitari Germans Trias i Pujol, Institut Català de la Salut, Barcelona, Spain
- NURECARE-IGTP Nursing Research Group, Germans Trias i Pujol Research Institute, Badalona, Spain
| | - Maria José García Quesada
- Hospital Universitari Germans Trias i Pujol, Institut Català de la Salut, Barcelona, Spain
- NURECARE-IGTP Nursing Research Group, Germans Trias i Pujol Research Institute, Badalona, Spain
| | - Oriol Estrada Cuxart
- Direcció d'Estratègia Assistencial, Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - Jordi Ara Del Rey
- Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - Francesc López Seguí
- Direcció d'Estratègia Assistencial, Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain.
- CRES - Centre de Recerca en Economia de la Salut, Universitat Pompeu Fabra, Barcelona, Spain.
- Research Group on Innovation, Health Economics and Digital Transformation, Institut Germans Trias i Pujol, Barcelona, Spain.
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López Seguí F, Oyón Lerga U, Laguna Marmol L, Coll P, Andreu A, Meulbroek M, López Casasnovas G, Estrada Cuxart O, Ara Rey J, Quiñones C, Pérez F, Fernandez J, Rivero À, Ricou Ríos L, Clotet B. Cost-effectiveness analysis of the daily HIV pre-exposure prophylaxis in men who have sex with men in Barcelona. PLoS One 2023; 18:e0277571. [PMID: 36649273 PMCID: PMC9844874 DOI: 10.1371/journal.pone.0277571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/28/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Pre-Exposure Prophylaxis (PrEP) for HIV prevention has been implemented in several countries. Previous literature has shown that its cost-effectiveness (and, under some specifications, cost-saving character) is dependent on the reduction in price due to generics, the time-horizon and its effectiveness. The intervention has never been studied in Catalonia after the approval of the PrEP, a territory with extensive implementation. METHODS Economic evaluation of the implementation of HIV pre-exposition prophylaxis using administrative data from Men who have Sex with Men (MSM) who receive the treatment (at the generic price) compared with non-implementation. A deterministic compartmental model and a social perspective with a micro-costing approach over the time horizon 2022-2062 are used. A baseline 86% effectiveness of PrEP is assumed. RESULTS Daily oral PrEP is found to be cost-saving: discounted savings in costs are attained after 16 years, and after 40 years they reach 81 million euros. In terms of health indicators, 10,322 additional discounted QALYs are generated by the intervention. Results are sensitive to sexual behavioral patterns among MSM, the price of PrEP (reduced if offered on-demand), its effectiveness and the discount rate. CONCLUSIONS The use and promotion of PrEP in Catalonia is predicted to result in substantial health and monetary benefits because of reductions in HIV infections. Short-term investments in the promotion of PrEP will result in important cost-savings in the long term.
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Affiliation(s)
- Francesc López Seguí
- Hospital Germans Trias i Pujol, Barcelona, Spain
- Centre de Recerca en Economia de la Salut, Barcelona, Spain
- Fundació Lluita Contra les Infeccions, Barcelona, Spain
- Research Group on Innovation, Health Economics and Digital Transformation (IGTP), Barcelona, Spain
- * E-mail:
| | | | | | - Pep Coll
- Fundació Lluita Contra les Infeccions, Barcelona, Spain
- AIDS Research Institute-IrsiCaixa, Barcelona, Spain
| | | | | | | | | | | | | | - Fèlix Pérez
- Projecte dels NOMS-Hispanosida, Barcelona, Spain
| | | | - Àngel Rivero
- Projecte dels NOMS-Hispanosida, Barcelona, Spain
| | - Laura Ricou Ríos
- Hospital Germans Trias i Pujol, Barcelona, Spain
- Centre de Recerca en Economia de la Salut, Barcelona, Spain
- Research Group on Innovation, Health Economics and Digital Transformation (IGTP), Barcelona, Spain
| | - Bonaventura Clotet
- Fundació Lluita Contra les Infeccions, Barcelona, Spain
- AIDS Research Institute-IrsiCaixa, Barcelona, Spain
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López Seguí F, Navarrete Duran JM, Tuldrà A, Sarquella M, Revollo B, Llibre JM, Ara del Rey J, Estrada Cuxart O, Paredes Deirós R, Hernández Guillamet G, Clotet Sala B, Vidal Alaball J, Such Faro P. Impact of Mass Workplace COVID-19 Rapid Testing on Health and Healthcare Resource Savings. Int J Environ Res Public Health 2021; 18:7129. [PMID: 34281065 PMCID: PMC8297152 DOI: 10.3390/ijerph18137129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 12/20/2022]
Abstract
Background: The epidemiological situation generated by COVID-19 has cast into sharp relief the delicate balance between public health priorities and the economy, with businesses obliged to toe the line between employee health and continued production. In an effort to detect as many cases as possible, isolate contacts, cut transmission chains, and limit the spread of the virus in the workplace, mass testing strategies have been implemented in both public health and industrial contexts to minimize the risk of disruption in activity. Objective: To evaluate the economic impact of the mass workplace testing strategy as carried out by a large automotive company in Catalonia in terms of health and healthcare resource savings. Methodology: Analysis of health costs and impacts based on the estimation of the mortality and morbidity avoided because of screening, and the resulting savings in healthcare costs. Results: The economic impact of the mass workplace testing strategies (using both PCR and RAT tests) was approximately €10.44 per test performed or €5575.49 per positive detected; 38% of this figure corresponds to savings derived from better use of health resources (hospital beds, ICU beds, and follow-up of infected cases), while the remaining 62% corresponds to improved health rates due to the avoided morbidity and mortality. In scenarios with higher positivity rates and a greater impact of the infection on health and the use of health resources, these results could be up to ten times higher (€130.24 per test performed or €69,565.59 per positive detected). Conclusion: In the context of COVID-19, preventive actions carried out by the private sector to safeguard industrial production also have concomitant public benefits in the form of savings in healthcare costs. Thus, governmental bodies need to recognize the value of implementing such strategies in private settings and facilitate them through, for example, subsidies.
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Affiliation(s)
- Francesc López Seguí
- Fight AIDS and Infectious Diseases Foundation, 08916 Badalona, Spain; (A.T.); (M.S.); (B.R.); (J.M.L.); (R.P.D.); (B.C.S.)
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (J.A.d.R.); (O.E.C.)
| | - Jose Maria Navarrete Duran
- Health Safety and Emergencies Unit SEAT CUPRA, the Companies of the Volkswagen Group in Spain, 08916 Badalona, Spain;
| | - Albert Tuldrà
- Fight AIDS and Infectious Diseases Foundation, 08916 Badalona, Spain; (A.T.); (M.S.); (B.R.); (J.M.L.); (R.P.D.); (B.C.S.)
| | - Maria Sarquella
- Fight AIDS and Infectious Diseases Foundation, 08916 Badalona, Spain; (A.T.); (M.S.); (B.R.); (J.M.L.); (R.P.D.); (B.C.S.)
| | - Boris Revollo
- Fight AIDS and Infectious Diseases Foundation, 08916 Badalona, Spain; (A.T.); (M.S.); (B.R.); (J.M.L.); (R.P.D.); (B.C.S.)
| | - Josep Maria Llibre
- Fight AIDS and Infectious Diseases Foundation, 08916 Badalona, Spain; (A.T.); (M.S.); (B.R.); (J.M.L.); (R.P.D.); (B.C.S.)
| | - Jordi Ara del Rey
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (J.A.d.R.); (O.E.C.)
| | - Oriol Estrada Cuxart
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (J.A.d.R.); (O.E.C.)
| | - Roger Paredes Deirós
- Fight AIDS and Infectious Diseases Foundation, 08916 Badalona, Spain; (A.T.); (M.S.); (B.R.); (J.M.L.); (R.P.D.); (B.C.S.)
| | - Guillem Hernández Guillamet
- Central Catalonia Primary Care Directorate, Catalan Institute of Health, Sant Fruitos de Bages, 08272 Barcelona, Spain; (G.H.G.); (J.V.A.)
| | - Bonaventura Clotet Sala
- Fight AIDS and Infectious Diseases Foundation, 08916 Badalona, Spain; (A.T.); (M.S.); (B.R.); (J.M.L.); (R.P.D.); (B.C.S.)
| | - Josep Vidal Alaball
- Central Catalonia Primary Care Directorate, Catalan Institute of Health, Sant Fruitos de Bages, 08272 Barcelona, Spain; (G.H.G.); (J.V.A.)
- Health Promotion in Rural Areas Research Group, Gerencia Territorial de la Catalunya Central, Institut Catala de la Salut, Sant Fruitos de Bages, 08272 Barcelona, Spain
- Unitat de Suport a la Recerca de la Catalunya Central, Fundacio Institut Universitari per a la Recerca a l’Atencio Primaria de Salut Jordi Gol i Gurina, Sant Fruitos de Bages, 08272 Barcelona, Spain
| | - Patricia Such Faro
- Health Safety and Emergencies Unit SEAT CUPRA, the Companies of the Volkswagen Group in Spain, 08916 Badalona, Spain;
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López Seguí F, Estrada Cuxart O, Mitjà i Villar O, Hernández Guillamet G, Prat Gil N, Maria Bonet J, Isnard Blanchar M, Moreno Millan N, Blanco I, Vilar Capella M, Català Sabaté M, Aran Solé A, Argimon Pallàs JM, Clotet B, Ara del Rey J. A Cost-Benefit Analysis of the COVID-19 Asymptomatic Mass Testing Strategy in the North Metropolitan Area of Barcelona. Int J Environ Res Public Health 2021; 18:7028. [PMID: 34209328 PMCID: PMC8297108 DOI: 10.3390/ijerph18137028] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND The epidemiological situation generated by COVID-19 has highlighted the importance of applying non-pharmacological measures in the management of the epidemic. Mass screening of the asymptomatic general population has been established as a priority strategy by carrying out diagnostic tests to detect possible cases, isolate contacts, cut transmission chains and thus limit the spread of the virus. OBJECTIVE To evaluate the economic impact of mass COVID-19 screenings of an asymptomatic population during the first and second wave of the epidemic in Catalonia, Spain. METHODOLOGY Cost-Benefit Analysis based on the estimated total costs of mass screening versus health gains and associated health costs avoided. RESULTS Excluding the value of monetized health, the Benefit-Cost ratio was estimated at 0.45, a low value that would seem to advise against mass screening policies. However, if monetized health is included, the ratio is close to 1.20, reversing the interpretation. In other words, the monetization of health is the critical element that tips the scales in favour of the desirability of screening. Results show that the interventions with the highest return are those that maximize the percentage of positives detected. CONCLUSION Efficient management of resources for the policy of mass screening in asymptomatic populations can generate high social returns. The positivity rate critically determines its desirability. Likewise, precocity in the detection of cases will cut more transmissions in the chain of contagion and increase the economic return of these interventions. Maximizing the value of resources depends on screening strategies being accompanied by contact-tracing and specific in their focus, targeting, for example, high-risk subpopulations with the highest rate of expected positives.
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Affiliation(s)
- Francesc López Seguí
- Directorate for Innovation and Interdisciplinary Cooperation, North Metropolitan Territorial Authority Catalan Institute of Health, 08916 Badalona, Spain;
- Fight AIDS and Infectious Diseases Foundation, 08916 Badalona, Spain;
- Centre de Recerca en Economía de la Salut, Pompeu Fabra University, 08005 Barcelona, Spain;
| | - Oriol Estrada Cuxart
- Directorate for Innovation and Interdisciplinary Cooperation, North Metropolitan Territorial Authority Catalan Institute of Health, 08916 Badalona, Spain;
| | | | | | - Núria Prat Gil
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Josep Maria Bonet
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Mar Isnard Blanchar
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Nemesio Moreno Millan
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Ignacio Blanco
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Marc Vilar Capella
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | - Martí Català Sabaté
- Comparative Medicine and Bioimage Centre of Catalonia (CMCiB), Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, 08916 Badalona, Spain;
| | - Anna Aran Solé
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
| | | | - Bonaventura Clotet
- IrsiCaixa—Institut de Recerca de La SIDA, Hospital Universitari Germans Trias I Pujol, 08916 Badalona, Spain;
| | - Jordi Ara del Rey
- North Metropolitan Primary Care Directorate, Catalan Institute of Health, 08916 Badalona, Spain; (N.P.G.); (J.M.B.); (M.I.B.); (N.M.M.); (I.B.); (M.V.C.); (A.A.S.); (J.A.d.R.)
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Ponce González MA, Mirón Rubio M, Mujal Martinez A, Estrada Cuxart O, Fiuza Perez D, Salas Reinoso L, Fernández Fabrellas E, Chiner Vives E. Effectiveness and safety of outpatient parenteral antimicrobial therapy in acute exacerbation of chronic obstructive pulmonary disease. Int J Clin Pract 2017; 71. [PMID: 28949430 DOI: 10.1111/ijcp.13022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 09/05/2017] [Indexed: 01/10/2023] Open
Abstract
AIM We analysed the effectiveness and safety of outpatient parenteral antibiotic therapy (OPAT) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in patients admitted to home hospitalisation units (HHU). METHODS Retrospective multicentre study of patients with AECOPD included in the Spanish OPAT Registry during 2 years period. RESULTS Twenty-seven hospitals included 562 episodes in 361 patients diagnosed COPD GOLD III-IV. The most frequently isolated pathogen was Pseudomonas aeruginosa (38%) and the most frequently used antibiotic was piperacillin-tazobactam (20%). The effectiveness of OPAT defined as the rate of improvement or recovery was 93.4%. The safety of OPAT defined as no adverse drug events and no infectious or catheter-related complications was 89.3%. Moreover, the risk of hospital readmission was not greater in patients with AECOPD aged >80 years. No differences in the effectiveness or safety were observed when OPAT was administered by patients and/or caregivers. CONCLUSION Patients with AECOPD who require parenteral antimicrobial therapy can be managed effectively and safely in HHU, avoiding hospital stays, readmissions and complications.
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Affiliation(s)
- Miguel A Ponce González
- Home Hospitalization Unit and Department of Respiratory Medicine, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | - Abel Mujal Martinez
- Home Hospitalization Unit, Parc Tauli Hospital Universitari, Sabadell, Spain
| | - Oriol Estrada Cuxart
- Department of Procesos Transversales y Alianzas, Institut Catala de la Salut, Barcelona, Spain
| | - Dolores Fiuza Perez
- Department of Hospital Admissions, Hospital de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain
| | - Liliana Salas Reinoso
- Home Hospitalization Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | - Eusebi Chiner Vives
- Department of Pneumology, Hospital Universitario San Juan de Alicante, Alicante, Spain
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Cuxart Mèlich A, Estrada Cuxart O. Hospitalización a domicilio: oportunidad para el cambio. Med Clin (Barc) 2012; 138:355-60. [DOI: 10.1016/j.medcli.2011.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 03/31/2011] [Accepted: 04/07/2011] [Indexed: 11/16/2022]
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Estrada Cuxart O, Cuxart Mèlich A, Bonet Papell G, Riera Riezu C. Tratamiento antibiótico por vía intravenosa domiciliario y hospitalización a domicilio. Med Clin (Barc) 2007; 128:798. [PMID: 17568511 DOI: 10.1157/13106334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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