000056744 001__ 56744
000056744 005__ 20200221144333.0
000056744 0247_ $$2doi$$a10.1186/s12913-016-1624-y
000056744 0248_ $$2sideral$$a96174
000056744 037__ $$aART-2016-96174
000056744 041__ $$aeng
000056744 100__ $$aLibrero, J.
000056744 245__ $$aTrends and area variations in Potentially Preventable Admissions for COPD in Spain (2002-2013): A significant decline and convergence between areas
000056744 260__ $$c2016
000056744 5060_ $$aAccess copy available to the general public$$fUnrestricted
000056744 5203_ $$aBackground: 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.
000056744 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000056744 590__ $$a1.827$$b2016
000056744 591__ $$aHEALTH CARE SCIENCES & SERVICES$$b49 / 90 = 0.544$$c2016$$dQ3$$eT2
000056744 592__ $$a1.095$$b2016
000056744 593__ $$aHealth Policy$$c2016$$dQ1
000056744 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000056744 700__ $$aIbañez-Beroiz, B.
000056744 700__ $$aPeiró, S.
000056744 700__ $$aRidao-López, M.
000056744 700__ $$0(orcid)0000-0002-0961-3298$$aRodríguez-Bernal, C.L.
000056744 700__ $$aGómez-Romero, F.J.
000056744 700__ $$aBernal-Delgado, E.
000056744 773__ $$g16, 1 (2016),  -$$pBMC HEALTH SERV RES$$tBMC HEALTH SERVICES RESEARCH$$x1472-6963
000056744 8564_ $$s2195003$$uhttps://zaguan.unizar.es/record/56744/files/texto_completo.pdf$$yVersión publicada
000056744 8564_ $$s80463$$uhttps://zaguan.unizar.es/record/56744/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000056744 909CO $$ooai:zaguan.unizar.es:56744$$particulos$$pdriver
000056744 951__ $$a2020-02-21-13:46:10
000056744 980__ $$aARTICLE