Coordinators, presenters, commentators and lighting and sound technicians traveled to Seville to film one more edition of #LoDeEvaluaAES. On this occasion they did it within the framework of the XIII EvaluAES Workshop that was held on May 10, 2024 at the Faculty of Nursing, Physiotherapy and Podiatry of the University of Seville. The point is that the production team landed on the 9th in the capital of Seville to, with the help of Ana and Paula, coordinator of the group, the first, and both, members of the scientific committee organizing the Workshop, to follow a ritual of lightheartedness, tapas and beers that sought to break an ice that Seville never stopped forming, well, Seville, and the desire of the participants to return to verse in these events, which although with reduced and modest capacity in monies, with a lot of science and politics to contribute. To begin this new edition of the Workshop, he gave us a warm welcome, never better said in Seville, Gabriel Dominguez Maldonado, Dean of the Faculty of Nursing, Physiotherapy and Podiatry at the University of Seville. In this welcome, he was accompanied by Ana Magdalena Vargas Martínez (University of Seville) and Paula González (Pablo Olavide University), yes, the same ones who organized Thursday’s party, there they were putting a face to the group and the Workshop program. By then, all that was left was to start with the presentations.
Welcome to the XIII EvaluAES Workshop.
The first presentation was given by Juan Marcelo Virdis (University of Manchester), with his work titled Expulsion from private insurance and adoption of public insurance: evidence of almost universal health coverage for older people. The study addressed the crowding-out effect that public health insurance can have on the purchase of private health insurance using the Permanent Household Survey (EPH) of Argentina for the period 2016-2023. In Argentina, people over 70 years of age without social coverage and retirees can benefit from the medical, welfare and social services of the Comprehensive Medical Assistance Program (PAMI). This program depends on the Ministry of Health and guarantees medical coverage and free medicines to its members. Work benefits from the discontinuity that exists in the legal retirement age in Argentina, at which time individuals can benefit from the Comprehensive Medical Assistance Program (PAMI). A still point regression design approach is used (Regression design) to measure, at legal retirement age, the variation in individuals’ level of public health insurance coverage, as well as the slope and variation in private insurance coverage. The results reveal a significant displacement effect of private insurance compared to public insurance once the legal age is reached, although very weak. Additionally, some results broken down by income and educational level are presented. The commentator of this work was manuel serrano (European Commission, Joint Research Center (JRC)), who highlighted the interest of the research question and suggested complementing the analysis with a study of the variation in total health insurance coverage after the retired population accesses PAMI. Additionally, she offered several tips to improve the quality of work. Among them, she emphasized the need for a better justification of the identification strategies used, clarifying the process of the population’s access to the retirement pension and PAMI. He also recommended a more detailed explanation of the differences between registered and unregistered workers before retirement, in order to better understand who are actually “treated” by the policy.
Juan Marcelo Virdis (University of Manchester) presenting his work and Manuel Serrano (European Comission) as a commentator at the XIII EvaluaAES Workshop.
After a short pause, the presentation of the keynote speakerthe midwife Lucia Alcaraz Vidal (Catalan Institute of Health), with the work titled The planned place of labor and birth in low-risk women. Impact on maternal and neonatal outcomes. Lucía, coordinator of the Casa Laietània Birth Center-Germans Trias Hospital, including with the audience an evaluation of the center’s experience, implemented in 2021, on the health of the newborn and his mother. The Casa Laietània Birth Center offers a maternity care model focused on women and the family, which guarantees respectful and safe care throughout the entire pregnancy, childbirth and postpartum process for pregnant women with uncomplicated pregnancies. The analyzed sample included 512 women who gave birth in the birth center and 1,391 who gave birth in the hospital delivery room, all of them low risk. The former were, on average, older, had a higher cultural level and showed a lower body mass index. The results obtained were very positive for the Birth Center and translated into fewer cesarean sections, fewer instrumental births and fewer episiotomies, as well as greater adherence to exclusive breastfeeding, among other benefits. However, Lucía stressed the need to evaluate the results over 3 or 5 years, in addition to incorporating information on costs that allows carrying out an economic evaluation that helps health managers explore with sufficient evidence the efficiency of this type of birth.
Lucia Alcaraz Vidal (Catalan Institute of Health) presenting his work at the XIII EvaluAES Workshop.
After the necessary coffee break to recover energy and chat more informally among the attendees, we moved on to the presentation of Laia Maynou (University of Barcelona) who presented the work titled The effects of physical activity prescription on mental health: evidence from primary care, where the authors analyze the impact of Physical Activity Promotion Program through primary care medical professionals (PAFES) in mental health. The program is aimed at men and women over 45 and 55 years of age, respectively, who have at least two cardiovascular diseases or Type 2 Diabetes Mellitus. Unlike the group without PAFES who was given advice on physical activity, this group was included them in a three-day training program for six months. Taking data from the Catalonia Health Survey, it will be observed that PAFES helped improve the mental health of both groups, with a greater impact on the PAFES group. However, no changes were perceived in the majority of resource utilization; A decrease in medication consumption was only noted in the PAFES group. Likewise, it was observed that the policy had a greater impact on women, who started from a worse situation. Regarding the mechanisms, the authors found that the prescription of physical activity has a positive impact on its practice, but not on lifestyle. Emma Motrico (University of Seville), expresses the originality of the program for prescribing physical activity at the community level. Comment on the differences between the terms: physical activity and physical exercise. Randomized clinical studies have proven that moderate aerobic exercise is necessary to see results, the type of training provided with PAFES. Likewise, it suggests recommendations for the rest of the communities that are currently implementing this type of policies, including the appropriateness of defining different policies by gender or even age group.
Laia Maynou (University of Barcelona) presenting her work and Emma Motrico (Sevilla University) at the XIII EvaluaAES Workshop.
Juan David García-Corchero (University of Granada), led the following presentation titled The socioeconomic gradient in waiting times: evaluating the impact of provider choice in a universal health system, which dealt with the impact that the free choice of medical professionals has on waiting lists, focusing on finding out if this measure reduces socioeconomic inequalities. Based on data from Health Barometer of Spain, the authors used synthetic control estimation techniques to analyze possible levers and demand-side factors affecting the waiting time gradient, and differences in differences to explore heterogeneity between socioeconomic levels. The results show greater declines in the most disadvantaged groups. It is suggested that healthcare-driven accessibility has improved by the rise of public-private initiatives. In your comments, Myriam Soto Gordoa (Mondragon Unibertsitatea) congratulated the authors for the relevance of the topic and suggested better explaining the policy itself and analyzing its implementation. Likewise, he stressed that the proportion of patients with private insurance is also relevant in the Community of Madrid and it could happen that patients combine private and public services to streamline certain processes. An indicator that is included in this Health Barometer and that could be explored is the proportion of professionals with exclusive rights to work in public care.
Juan David García-Corchero (University of Granada) presenting her work and Myriam Soto-Gardoa (Mondragon Unibertsitatea) at the XIII EvaluaAES Workshop.
After recovering energy with the lunch that they had prepared for us, Borja García-Lorenzo (Biosystemk Institute), representation of the VOICE Communitypresented the work Bringing the value equation into play as a decision-making tool in value-based healthcare, in which the practical application of the Porter value equation for Value-Based Healthcare (ASBV) is studied. Borja addressed the ambiguity in defining the value of healthcare by proposing a method to estimate patient-centered outcomes (PCOs), while addressing the complexities of cost estimation, with the goal of using the value equation as a tool in value-based healthcare efficiency decision making. Clara Bermudez Tamayo (Andalusian School of Public Health), highlighted the innovative purpose of the work presented by Borja and brought up a debate on the importance of valuing previous works in the literature despite the fact that they addressed a quantitative approach, as well as the study area of patients diagnosed with breast cancer, an area with greater intensity of innovation.
Borja García-Lorenzo (Biosistemak Institute) presenting her work and Clara Bermúdez-Tamayo as commentator at the XIII EvaluAES Workshop.
To conclude this day enriched by synergies, this time we don’t forget the group photo! And in less than a month, and with great enthusiasm!, to continue with #LoDeEvaluAES, we will celebrate the EvaluAES table at the XLIII AES Conference in San Cristóbal de La Laguna. This year still has more and better in store for us!
Attendees to the XIII EvaluaAES Workshop.
Headquarters of the XIII EvaluaAES Workshop.
