Person: Sánchez Iriso, Eduardo
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Sánchez Iriso
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Eduardo
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Economía
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0000-0002-5320-8732
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2609
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Publication Open Access Costs and effectiveness of a syringe distribution and needle exchange programme for HIV prevention in a regional setting(2002) Cabasés Hita, Juan Manuel; Sánchez Iriso, Eduardo; Economía; EkonomiaObjective: To estimate the costs and effectiveness of a HIV prevention intervention consisting of distribution of an anti-Aids kit and needle exchange, in operation since 1993 in Navarra, Spain. Methods: Total costs of the programme, namely production, storage and distribution as well as management, are estimated getting a cost figure per sterile syringe distributed. Effectiveness, defined as the number of averted HIV infections among IDUs due to their injecting behaviour, is estimated as a function of the level of coverage of the programme, using a mathematical model. Results: The estimated number of averted HIV infections ranged from 7.59 (in 1995) to 1.23 (in 2000). Yearly incremental cost-effectiveness ratios (ICER) ranged from 8.331 (in 1994) to 44.287 (in 2000) euro per HIV infection averted. With estimated health care costs of treatment of an HIV infection of 99.371 euro, the programme has been cost saving along the whole period considered. One way sensitivity analysis for 5 uncertain parameters was performed. These were the number of active IDUs in the region, number of annual injections among IDUs with non sterile syringes, percentage of lost and unused syringes of the total provided, probability of HIV infection due to injecting behaviour, and life expectancy of HIV+ persons. The results confirm our findings. We conclude the programme has been cost saving from the health care system perspective.Publication Open Access Health related quality of life of patients with generalized anxiety disorder(2008) Cabasés Hita, Juan Manuel; Sánchez Iriso, Eduardo; Rovira i Forns, Joan; Economía; EkonomiaAims: To analyze the health-related quality of life of patients with Generalized Anxiety Disorder (GAD), with respect to the population at large and to a control group. The following goals are addressed: 1.- To determine what, if any, differences exist between the health status of patients diagnosed with GAD, the population in general and a group of control patients; 2.- To analyze the relation between the variables age, sex, and health status (as assessed by the patient’s GP) measured on the Hamilton anxiety scale, with the quality of life of the GAD patients and of the control group; 3.- To determine whether the variables age, sex, Hamilton scale values and index of quality of life influence the annual cost caused by the illness; 4.- To determine whether there are any differences in the evaluation of the same health status made by GAD patients and by the general population. This study forms part of a broader-ranging one (the ANCORA Study) set up to analyze Generalized Anxiety Disorder (GAD) and the costs and other burdens provoked by this illness in Spain. Material and Methods: Regression models were used to obtain the EQ-5D index of health state (EQindex) and to analyze the above-mentioned variables. The data on patients and on the costs of the illness are those registered in the ANCORA study. Results: The patients with GAD present a self-perceived level of health (EQ-5D) that is conspicuously below that corresponding to the general population, especially in three of the dimensions, namely usual activities, pain/discomfort and anxiety/depression. The mean value of the health index (EQindex) is ten points below that of the general population and that of the control group. Age was found to be negatively related to the health variables, as was a higher score on the Hamilton scale. For the group of patients with GAD, a worse perceived health state and a higher score on the Hamilton scale were associated with higher costs, although in the latter case the explicative power of the model is weak. Finally, the GAD patients assessed their health status more negatively than did the general population, with a visual analogue scale (VAS) result that was four points lower than that made by the general population.Publication Open Access Self perceived health status of schizophrenic patients in Spain: an analysis of geog raphical differences using bayesian approach(2005) Cabasés Hita, Juan Manuel; Sánchez Iriso, Eduardo; Vázquez Polo, Francisco J.; Negrín, Miguel A.; Domínguez Irastorza, Emilio José; Economía; EkonomiaObjectives. This paper explores the use of regression models for estimating health status of schizophrenic patients, from a Bayesian perspective. Our aims are: 1- To obtain a set of values of health states of the EQ-5D based on self-assessed health from a sample of schizophrenic patients. 2- To analyse the differences in the health status and in patients’ perceptions of their health status between four mental-health districts in Spain. Methods. We develop two linear models with dummy variables. The first model seeks to obtain an index of the health status of the patients using a VAS as a dependent variable and the different dimensions of EQ-5D as regressors. The second model allows to analyse the differences between the self-assessed health status in the different geographic areas and also the differences between the patients’ self-assessed health states, irrespective of their actual health state, in the different geographic areas. The analysis is done using Bayesian approach with Gibbs sampling (computer program WinBUGS 1.4). Data concerning self-assessed EQ-5D with VAS from four geographic areas of schizophrenic patients were obtained for the purposes of this analysis. Results. We obtained the health status index for this sample and analysed the differences for this index between the four geographic areas. Our study reveals variables that explain the differences in patients’ health status and differences in their health states assessment. We consider four possible scenarios.Publication Open Access Using bayesian techniques to build up an inconsistency free health status index(2004) Cabasés Hita, Juan Manuel; Sánchez Iriso, Eduardo; Economía; EkonomiaObjectives: 1-To obtain a set of values of health states of the EQ-5D based on self-related health VAS using linear and non- linear models Bayesian techniques. 2 - To analyse “logical consistency” in different models and to derive a model free from logical inconsistencies. 3 - To analyse and compare results of several models when using a priori sources of information. Methods: We apply the usual models and transformations of these, in order to attain logical consistency of the value set. Models proposed are: linear model (1); linear with dummy variables (2) and two models with a logistic structure with different distributions of the coefficients to be estimated (3 and 4). For two of these models new dummies are added in order to obtain logical consistency (2B and 4B). Results: We propose a modelling to guarantee consistency of values of the EQ-5D health states that may be applied to suitable samples at apparently low cost of fit. This model is nonlinear, has distribution Gamma in the coefficients and specific dummy variables. The introduction of priors may reduce the cost of forcing logical consistency.Publication Open Access Instrumentos económicos para la priorización de pacientes en lista de espera: los modelos de elección discreta(2006) Cabasés Hita, Juan Manuel; Sánchez Iriso, Eduardo; San Miguel Inza, Fernando; Economía; EkonomiaObjetivos. Analizar cuáles deben ser los criterios clínicos y sociales en base a los cuales deben ser priorizados los pacientes en listas de espera quirúrgicas programadas. Métodos Se estima un modelo de elección discreta (MED) utilizando una muestra representativa de la población general de Navarra. La muestra fue seleccionada mediante muestreo aleatorio simple por cuotas de edad y sexo, estratificada por áreas y municipios de residencia de la población mayor de 18 años. La información obtenida fue analizada mediante métodos bayesianos. Resultados. Los individuos ordenan a los pacientes según el tiempo de espera, la gravedad de la enfermedad y el coste de la intervención. Es decir, los pacientes que más tiempo llevan esperando, con enfermedades más graves y cuyos tratamientos son más costosos deberían ser intervenidos antes. Conclusiones. Los resultados indican que los tiempos de espera no deberían ser la única variable utilizada para la priorización de pacientes en las listas de espera. Un resultado interesante que deberá ser analizado en el futuro es la importancia otorgada al coste de la intervención. Los resultados reflejan también el potencial de los MED para crear mecanismos de priorización de pacientes en las listas de espera