Gaceta Sanitaria最新文献

英文中文

Control epidémico y certificado médico de defunción con recuento rápido de causas de muerte. Réplica [防疫和医学死亡证明，快速死因报告。]回复)。

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria

Pub Date : 2026-01-01 DOI: 10.1016/j.gaceta.2025.102557

Susana Monge , Sandra Campos , María Sastre , Diana Gómez-Barroso , Elena Vanessa Martínez , María José Sierra

引用次数: 0

Hospitalization and referral for mental illness among people under 30 in Euskadi: a retrospective population-based cohort Euskadi地区30岁以下人群的精神疾病住院和转诊：一项基于人群的回顾性队列研究

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria

Pub Date : 2026-01-01 DOI: 10.1016/j.gaceta.2025.102559

Lorea Mar-Barrutia , María Gascón , Silvia García de Garayo , Ana González-Pinto , Andrea García , Juan Pablo Chart-Pascual , Guillermo Cano-Escalera , Javier Mar

Objective

To explore the trends in hospitalisations and referrals to a psychiatrist among 0- to 30-year-olds with a pre-existing mental disorder between 2019 and 2022.

Method

We conducted an observational study of psychiatric hospitalisations and referrals from primary care to psychiatric services in the Basque Country population aged 0-30 years with a previously recorded mental disorder, from 2019 to 2022. Logistic regression models were used to assess the effects of calendar year (2019–2022), gender, age, psychiatric comorbidity and socioeconomic status.

Results

Of the 608,984 individuals in 2019, 97,962 had a mental health diagnosis. Of these individuals, 0.77% were admitted to a psychiatric ward, while 9.44% were referred to a psychiatrist. Overall, there was a decrease in hospitalisations among patients in 2020, with an odds ratio (OR) of 0.89 (confidence interval [CI]: 0.79-0.99), followed by increases in 2021 (OR: 1.22; CI: 1.10-1.36) and 2022 (OR: 1.29; CI: 1.16-1.43). The clusters with the greatest increases in hospitalisations were self-harm and anxiety. Total referrals to specialist services did not show significant changes. Patients with a low to middle socioeconomic status were more likely to decompensate. Psychiatric comorbidity was the main cause of decompensation, with an OR > 40.

Conclusions

The change in trend on mental health decompensation was more evident in hospital-based care than in community care. The high decompensation rate in people with psychiatric comorbidities indicates a deterioration in clinical course, suggesting the need for more intensive monitoring.

目的：探讨2019年至2022年期间，0至30岁既往存在精神障碍的人群住院和转诊的趋势。方法：我们对巴斯克地区0-30岁、既往有精神障碍记录的人群进行了一项观察性研究，包括精神科住院和从初级保健转介到精神科服务的情况，研究时间为2019 - 2022年。采用Logistic回归模型评估历年（2019-2022年）、性别、年龄、精神疾病合并症和社会经济地位的影响。结果：在2019年的608,984人中，有97,962人患有精神健康诊断。在这些人中，0.77%的人住进精神科病房，而9.44%的人被转介给精神科医生。总体而言，2020年患者住院率下降，优势比（OR）为0.89（置信区间[CI]: 0.79-0.99），其次是2021年（OR: 1.22; CI: 1.10-1.36）和2022年（OR: 1.29; CI: 1.16-1.43）的增加。住院人数增加最多的类别是自残和焦虑。转介到专家服务的总人数没有明显变化。社会经济地位中低的患者更容易失代偿。精神合并症是代偿失代偿的主要原因，OR为40。结论：以医院为基础的护理比社区护理的心理健康失代偿趋势变化更明显。精神合并症患者的高失代偿率表明临床病程恶化，提示需要更密切的监测。

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引用次数: 0

Healthcare inequity among people with dementia in Gipuzkoa: a retrospective cross-sectional population-based study Gipuzkoa痴呆症患者的医疗不公平：一项基于人群的回顾性横断面研究

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria

Pub Date : 2026-01-01 DOI: 10.1016/j.gaceta.2025.102563

Javier Mar , Marisa Merino , Myriam Soto-Gordoa , Oliver Ibarrondo , Lore Zumeta-Olaskoaga

Objective

To compare the use of healthcare resources among the Gipuzkoa population with and without dementia.

Method

A retrospective, cross-sectional cost study was conducted on the entire population over 60 years of age registered with the Basque Health Service. We measured the use of health services (hospital and primary care) and health needs as a function of the presence of dementia and neuropsychiatric symptoms, adjusting for age, sex and comorbidity. Generalised linear models from the Tweedie family distribution were fitted, taking into account the asymmetric distribution of costs.

Results

Of the 215,859 over-60-year-olds in Gipuzkoa registered, 7553 (3.5%) had dementia. The median (interquartile range) cost was €743 (241-1682) for the total population, broken down into €722 (241-1660) for individuals without dementia and €1090 (481-2140) for those with dementia. In the Tweedie models adjusted for need, the estimated costs were €496 for the group with only neuropsychiatric symptoms, compared to €358 for the group with both conditions.

Conclusions

When healthcare resource use is adjusted for need, people with dementia receive less care than those without. However, it is difficult to determine whether this is harmful, depriving people with dementia of necessary care (inverse care law), or beneficial, sparing them from unnecessary treatment (overuse).

目的比较吉普斯科阿地区痴呆患者和非痴呆患者的医疗资源利用情况。方法对巴斯克卫生局登记的60岁以上人口进行回顾性、横断面成本研究。我们测量了卫生服务的使用（医院和初级保健）和卫生需求作为痴呆和神经精神症状存在的功能，调整了年龄、性别和合并症。考虑到成本的不对称分布，拟合了Tweedie家族分布的广义线性模型。结果在Gipuzkoa登记的215,859名60岁以上老年人中，有7553人（3.5%）患有痴呆症。总人口的中位数（四分位数范围）成本为743欧元（241-1682），其中非痴呆症患者为722欧元（241-1660），痴呆症患者为1090欧元（481-2140）。在根据需要调整的Tweedie模型中，只有神经精神症状的一组的估计成本为496欧元，而两种情况都有的一组的估计成本为358欧元。结论当根据需要调整医疗资源使用时，痴呆患者得到的护理少于无痴呆患者。然而，很难确定这是有害的，剥夺了痴呆症患者必要的护理（逆护理定律），还是有益的，使他们免受不必要的治疗（过度使用）。

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引用次数: 0

Socioeconomic inequalities and life expectancy in Madrid metro line 5 马德里地铁5号线的社会经济不平等和预期寿命。

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria

Pub Date : 2026-01-01 DOI: 10.1016/j.gaceta.2025.102561

Eva de Santiago-Cortés , Julia Martínez-Alfonso , Nuria Jiménez-Olivas , Sara Santamaría-Rodríguez , Rosa González-Crespo , Amanda Sanz-Aguado , Manuel Díaz-Olalla

Objective

This study estimates life expectancy by sex and analyzes its relationship with social deprivation along the stations of Madrid Metro Line 5. It also applies a linear model to predict life expectancy in men and women.

Method

A descriptive and analytical study was conducted on the population living within 350 meters of each station (2015–2019). Socioeconomic status was assessed using a deprivation index. Pearson's correlation coefficient was applied to explore the relationship between life expectancy and deprivation by sex. Multiple linear regression models were then used to analyze the influence of index components.

Results

Socioeconomic inequalities were identified along the line. Average life expectancy was 82.29 years in men (95%CI: 80.05–84.54) and 86.95 in women (95%CI: 85.15–89.11). In men, it was inversely related to the deprivation index (r = –0.38; p < 0.005). In women, a model including electoral abstention (p < 0.005) and unemployment (p < 0.005) explained 23% of the variability.

Conclusions

Life expectancy varies along Madrid Metro Line 5. In men, it is associated with socioeconomic status, whereas in women electoral abstention and unemployment stand out. These findings reinforce the need for public health interventions aimed at reducing social inequalities.

目的：本研究估计了马德里地铁5号线沿线的性别预期寿命，并分析其与社会剥夺的关系。它还应用线性模型来预测男性和女性的预期寿命。方法：2015-2019年对各监测站周围350米范围内的人口进行描述性分析研究。使用剥夺指数评估社会经济地位。使用Pearson相关系数来探讨预期寿命与性别剥夺之间的关系。采用多元线性回归模型分析各指标成分的影响。结果：社会经济不平等在这条线上被识别出来。男性的平均预期寿命为82.29岁（95%CI: 80.05-84.54），女性为86.95岁（95%CI: 85.15-89.11）。在男性中，它与剥夺指数呈负相关（r=-0.38; p）。结论：马德里地铁5号线的预期寿命各不相同。在男性中，它与社会经济地位有关，而在女性中，选举弃权和失业尤为突出。这些发现加强了采取旨在减少社会不平等的公共卫生干预措施的必要性。

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引用次数: 0

Redes de entornos promotores de salud en España [西班牙健康促进机构网络]。

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria

Pub Date : 2026-01-01 DOI: 10.1016/j.gaceta.2025.102544

María Ramos-Monserrat , Almudena Personat-Labrador , Trinidad Planas-Juan , Ana Gil-Luciano , Jara Cubillo-Llanes , Elena Cabeza-Irigoyen

Objective

To describe the networks of health-promoting settings in Spain, with the aim of learning from the accumulated experience and thus contributing to their development.

Method

A document analysis of health-promoting settings in Spain using web searches and selected publications. A combination of terms and inclusion/exclusion criteria were used. The following information was collected from each network: geographic scope, name, website, settings included, objectives, number of members, whether it is a network of networks and/or integrated into a larger network. Subsequently, the Health Promotion Panel of the Public Health Commission was contacted to review the results.

Results

Sixty-seven networks were identified, of which 41 were included. All autonomous communities, except Illes Balears, Ceuta, and Melilla, have networks of health-promoting settings. The settings are varied: schools, health centers, municipalities, companies, universities, beaches, and parks. Four networks of networks and four networks integrated into a broader network were identified. Only five (12.2%) were created through legislation.

Conclusions

Networks of health-promoting settings are a widespread model in Spain, developed across diverse scopes and contexts.

目的：描述西班牙促进健康环境的网络，目的是学习积累的经验，从而促进其发展。方法：使用网络搜索和选定的出版物对西班牙的健康促进机构进行文献分析。使用术语和纳入/排除标准的组合。从每个网络中收集以下信息：地理范围，名称，网站，包括的设置，目标，成员数量，是否是网络的网络和/或集成到一个更大的网络中。随后，与公共卫生委员会的健康促进小组联系，审查结果。结果：确定了67个网络，其中包括41个。除Illes Balears、休达和Melilla外，所有自治区都有促进健康的环境网络。环境多种多样：学校、保健中心、市政当局、公司、大学、海滩和公园。确定了四个网络中的网络和四个集成到更广泛网络中的网络。只有5个（12.2%）是通过立法创建的。结论：促进健康的环境网络在西班牙是一种广泛的模式，在不同的范围和背景下发展起来。

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引用次数: 0

Estimación de la resistencia a la insulina mediante antropometría y glucosa en ayunas en población mexicana [用人体测量和空腹血糖估算墨西哥人群的胰岛素抵抗]。

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria

Pub Date : 2025-12-17 DOI: 10.1016/j.gaceta.2025.102551

María Guadalupe López-Velázquez, Nicolás Camacho-Calderón, Jorge Arturo Torres-Juárez, María del Rosario Moreno-Ramírez, Aida Guadalupe Díaz-Martel, David Salvador Díaz-Ortegón, Siddhartha Mondragón-Rodríguez, César Campos-Ramírez

Objective

To develop and internally validate a mathematical model to estimate insulin resistance (IR) using two variables: body mass index (BMI) and fasting glucose. This model is called “BMI-glucose index”.

Method

Cross-sectional study in a Mexican population. 112 participants were evaluated using standardized blood sampling methods and anthropometric measurements. A mathematical model was obtained using binomial logistic regression, internally validated, and its clinical utility was determined.

Results

The BMI-glucose index had an AUC of 0.872 (95%CI: 0.807-0.936; p < 0.001) and a cutoff point of 0.30, with a sensitivity of 93% and a specificity of 69%.

Conclusions

Our results show good preliminary diagnostic capacity, which should be confirmed in larger, longitudinal population studies for its possible application in primary healthcare as a screening method to detect individuals with IR.

目的：建立并内部验证使用两个变量：身体质量指数（BMI）和空腹血糖来估计胰岛素抵抗（IR）的数学模型。这个模型被称为“bmi -葡萄糖指数”。方法：在墨西哥人群中进行横断面研究。112名参与者使用标准化血液采样方法和人体测量测量进行评估。使用二项逻辑回归获得数学模型，内部验证，并确定其临床实用性。结果：bmi -葡萄糖指数的AUC为0.872 （95%CI: 0.807-0.936; p）结论：我们的研究结果显示了良好的初步诊断能力，应该在更大规模的纵向人群研究中得到证实，以便可能在初级卫生保健中作为检测IR个体的筛查方法。

{"title":"Estimación de la resistencia a la insulina mediante antropometría y glucosa en ayunas en población mexicana","authors":"María Guadalupe López-Velázquez, Nicolás Camacho-Calderón, Jorge Arturo Torres-Juárez, María del Rosario Moreno-Ramírez, Aida Guadalupe Díaz-Martel, David Salvador Díaz-Ortegón, Siddhartha Mondragón-Rodríguez, César Campos-Ramírez","doi":"10.1016/j.gaceta.2025.102551","DOIUrl":"10.1016/j.gaceta.2025.102551","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and internally validate a mathematical model to estimate insulin resistance (IR) using two variables: body mass index (BMI) and fasting glucose. This model is called “BMI-glucose index”.</div></div><div><h3>Method</h3><div>Cross-sectional study in a Mexican population. 112 participants were evaluated using standardized blood sampling methods and anthropometric measurements. A mathematical model was obtained using binomial logistic regression, internally validated, and its clinical utility was determined.</div></div><div><h3>Results</h3><div>The BMI-glucose index had an AUC of 0.872 (95%<span>C</span>I: 0.807-0.936; p <0.001) and a cutoff point of 0.30, with a sensitivity of 93% and a specificity of 69%.</div></div><div><h3>Conclusions</h3><div>Our results show good preliminary diagnostic capacity, which should be confirmed in larger, longitudinal population studies for its possible application in primary healthcare as a screening method to detect individuals with IR<strong>.</strong></div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102551"},"PeriodicalIF":1.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relación entre el índice de privación y los sucesos adversos en cáncer colorrectal y de mama en el País Vasco [社会剥夺指数与巴斯克地区结直肠癌和乳腺癌不良事件的关系]。

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria

Pub Date : 2025-12-17 DOI: 10.1016/j.gaceta.2025.102549

Nerea González-Hernández , María José Legarreta , Urko Aguirre , Susana García-Gutiérrez , Eduardo Millán Ortuondo , Nere Larrea , José María Quintana

Objective

To analyze the relationship between deprivation index and mortality, readmissions, and recurrences in two cohorts of cancer patients in the Basque Country.

Method

Analytical observational study in two cohorts, colorectal cancer and breast cancer. Patients with colorectal cancer were recruited from eight hospitals in the Basque Health Service - Osakidetza between June 2010 and December 2012. Patients with breast cancer were recruited from six hospitals in the Basque Health Service - Osakidetza between April 2013 and May 2015. Sociodemographic and clinical data were collected at the start of the study and 1, 2, 3, and 5 years after surgery in the first cohort, and at the start of the study and 2 years after diagnosis in the second cohort.

Results

In the bivariate analyses, the deprivation index showed no relationship with any of the three parameters studied in any of the follow-up periods in the colorectal cancer cohort. In the breast cancer cohort, a statistically significant association was found between the deprivation index and recurrence, which was higher in quintiles 1 and 5 (p = 0.001), and in the probability of readmission, which was higher in quintiles 1, 2, and 3 (p = 0.001). In the multivariate analyses, no differences were found according to the deprivation index in any of the outcomes studied in either of the two cohorts.

Conclusions

In this study, no significant differences were found in mortality, recurrence, or readmission according to the deprivation index.

目的：分析巴斯克地区两组癌症患者的剥夺指数与死亡率、再入院率和复发率的关系。方法：对结直肠癌和乳腺癌两组患者进行分析性观察研究。2010年6月至2012年12月期间，研究人员从巴斯克卫生服务中心——Osakidetza的八家医院招募结直肠癌患者。乳腺癌患者于2013年4月至2015年5月期间从巴斯克保健服务- Osakidetza的六家医院招募。在研究开始时和第一组手术后1、2、3、5年收集社会人口学和临床数据，在第二组研究开始时和诊断后2年收集数据。结果：在双变量分析中，在结直肠癌队列的任何随访期间，剥夺指数与研究的三个参数中的任何一个都没有关系。在乳腺癌队列中，剥夺指数与复发率之间存在统计学意义上的关联，在1和5分位数中复发率较高（p=0.001），在1、2和3分位数中再入院率较高（p=0.001）。在多变量分析中，根据剥夺指数，在两个队列中研究的任何结果都没有发现差异。结论：在本研究中，根据剥夺指数，在死亡率、复发率或再入院率方面没有发现显著差异。

{"title":"Relación entre el índice de privación y los sucesos adversos en cáncer colorrectal y de mama en el País Vasco","authors":"Nerea González-Hernández , María José Legarreta , Urko Aguirre , Susana García-Gutiérrez , Eduardo Millán Ortuondo , Nere Larrea , José María Quintana","doi":"10.1016/j.gaceta.2025.102549","DOIUrl":"10.1016/j.gaceta.2025.102549","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the relationship between deprivation index and mortality, readmissions, and recurrences in two cohorts of cancer patients in the Basque Country.</div></div><div><h3>Method</h3><div>Analytical observational study in two cohorts, colorectal cancer and breast cancer. Patients with colorectal cancer were recruited from eight hospitals in the Basque Health Service - Osakidetza between June 2010 and December 2012. Patients with breast cancer were recruited from six hospitals in the Basque Health Service - Osakidetza between April 2013 and May 2015. Sociodemographic and clinical data were collected at the start of the study and 1, 2, 3, and 5 years after surgery in the first cohort, and at the start of the study and 2 years after diagnosis in the second cohort.</div></div><div><h3>Results</h3><div>In the bivariate analyses, the deprivation index showed no relationship with any of the three parameters studied in any of the follow-up periods in the colorectal cancer cohort. In the breast cancer cohort, a statistically significant association was found between the deprivation index and recurrence, which was higher in quintiles 1 and 5 (p=0.001), and in the probability of readmission, which was higher in quintiles 1, 2, and 3 (p=0.001). In the multivariate analyses, no differences were found according to the deprivation index in any of the outcomes studied in either of the two cohorts.</div></div><div><h3>Conclusions</h3><div>In this study, no significant differences were found in mortality, recurrence, or readmission according to the deprivation index.</div></div>","PeriodicalId":12494,"journal":{"name":"Gaceta Sanitaria","volume":"40 ","pages":"Article 102549"},"PeriodicalIF":1.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Control epidémico y necesidad de un certificado médico de defunción con recuento rápido de causas de muerte 流行病控制和需要快速死亡原因医疗死亡证明

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria

Pub Date : 2025-12-17 DOI: 10.1016/j.gaceta.2025.102550

Lluís Cirera , Diego Salmerón , Alexandre Xifró , Rafael María Bañón , Eneko Barbería

引用次数: 0

Más allá del burnout: la fatiga estructural de la atención primaria [超越倦怠：初级保健的结构性疲劳]。

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria

Pub Date : 2025-12-17 DOI: 10.1016/j.gaceta.2025.102553

Beatriz González López-Valcárcel

引用次数: 0

614 - ANÁLISIS DEL EMPLEO JOVEN Y RELEVO GENERACIONAL EN INVESTIGACIÓN EN SALUD PÚBLICA Y EPIDEMIOLOGÍA 614 -公共卫生和流行病学调查中的青年和世代就业分析

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria

Pub Date : 2025-09-01 DOI: 10.1016/S0213-9111(25)00205-5

A. Marcos-Delgado, S. Rivera, V. Dávila, F. Arribas, E. Ojeda, I.A. Torres, B. Grau-Pujol, Z. Herrador

引用次数: 0

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