Natividad Guadalajara

Explaining primary healthcare pharmacy expenditure using classification of medications for chronic conditions

BACKGROUND The Valencian Autonomous Community (Spain) has implemented a scheme of purchasing services with the participation of public and private providers. Five districts are managed using public-private partnership. The financing model is capitation and inter-center invoice. The pharmaceutical benefits are not included in the per capita assignment. OBJECTIVES Modeling and explaining pharmacy expenditure using electronic prescriptions drug data. METHODS A database of electronic prescription corresponding to 625,246 patients between November 2008 and October 2009 was used to run four linear models that explain the pharmaceutical expenditures. We take as dependent variable the neperian log of total pharmacy annual cost per patient in the primary health setting. The independent variables used combined demographics with revised classification in 18 chronic conditions obtained from the anatomical therapeutic chemical classification index (ATC). RESULTS The retrospective model selected included: gender, pharmaceutical co-payment status and 8 dummy variables for the number of chronic conditions of each patient from 1 to 8 or more. The goodness-of-fit achieved is measured in R(2) of 57%. CONCLUSIONS These models must be considered in the current capitation system for pharmaceutical budgeting in a primary care setting established at regional level, as is the case in the Valencian Autonomous Community. The use of diagnostics and information regarding hospital encounters appears to be a complementary option for refining models of capitation of pharmaceutical and total health expenditure.

Modeling Spanish anxiolytic consumption: Economic, demographic and behavioral influences

Abstract Anxiolytics (AX) are the psychotropic drugs prescribed for the treatment of anxiety and insomnia for 2–4 weeks, for longer periods of consumption (>1 month) may lead to the development of tolerance or addiction. In fact, its prescription was 16% of the total pharmaceutical expenditure in Spain in 2007. This paper deals with the development of a mathematical model describing the dynamic of the addiction to AX for the case study of the Spanish region of Castellon. The reasons believed to cause the development of addicts to AX are the economic situation, the marriage termination and the social contact. The simulations performed to forecast the addicts rate for the period 2010–2014 showed an increase from 6% in 2010 to 14% in 2014 with a fluctuation of about 2% between the possible economic scenarios. Finally, the analysis of sensitivity of the rate of addicts to the fluctuation of the social contact parameters was performed, letting us estimate its impact on the pharmaceutical expenditure.

Application of Compromise Programming to a semi-detached housing development in order to balance economic and environmental criteria

European Energy Performance of Buildings Directives DE promote energy efficiency in buildings. Under these Directives, the European Union States must apply minimum requirements regarding the energy performance of buildings and ensure the certification of their energy performance. The Directives set only the basic principles and requirements, leaving a significant amount of room for the Member States to establish their specific mechanisms, numeric requirements and ways to implement them, taking into account local conditions. With respect to the Spanish case, the search for buildings that are more energy efficient results in a conflict between users’ economic objectives and societys environmental objectives. In this paper, Compromise Programming is applied to help in the decision-making process. An appropriate distribution of types of dwellings, according to their energy performance and to the climatic zone considered in Spain, will be suggested. Results provide a compromise solution between both objectives.

Using the building energy rating software for mathematically modelling operation costs in a simulated home

The building industry is becoming very important in sustainable development. The recently developed policies in European Union directives on energy and their transposition to Spanish regulations make the Energy Performance Certification process for buildings mandatory. Two software tools have been developed in Spain to carry out this process: Lider and Calener. These software tools have been used in this paper to simulate energy performance in new semidetached houses after taking into account the thermal envelope of the building and facilities. This has been done in different climatic zones in Spain and for all the possible energy ratings. Based on the energy rating and construction cost variables, it has been possible to obtain mathematical models that explain the behaviour of global costs of buildings based on energy ratings and climatic zones. Depreciation costs, maintenance costs, energy consumption and CO2 emissions during the service life of a house have also been modelled.

The impact of Internet on the artist reputation

This work analyzes the relationship between the digital information provided by the search engine Google on the Internet and the volume of sales or revenues in the art market in order to quantify the variable artists reputation. In particular, the usefulness of digital media information is analyzed to interpret past sales in the art market or, conversely, to estimate future sales in the short term. Finally, we study the ability of digital information to explain the volume of activity (number of lots sold) or what is the same the degree of liquidity of the secondary market of artworks.