Nolasco Andreu, Vicent-Castelló Eva M, Pereyra-Zamora Pamela, Caballero-Pérez Pablo, Moncho Joaquín
Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública, e Historia de la Ciencia, Universidad de Alicante, Alicante, España.
Formación para el Empleo, Ayuntamiento de Albal, Albal (Valencia), España.
Gac Sanit. 2019 Nov-Dec;33(6):504-510. doi: 10.1016/j.gaceta.2018.07.017. Epub 2018 Nov 22.
To describe the evolution of mortality risks for complications due to medical care or surgery between the periods prior to (2002-2007) and after (2008-2013) the beginning of the economic crisis for Spain and by autonomous region, and to analyse the relationship between the changes in the risks of death and the socioeconomic impact of the crisis and the variation in health spending.
Ecological study based on age-standardized mortality rates, synthetic index of vulnerability as a socioeconomic indicator and variation in health expenditure as an indicator of health expenditure. The relative risk of death between periods was estimated with Poisson regression models.
The number of deaths increased for Spain in the period studied. Although the relationship between the increase in public investment in health and the decrease in mortality due to this cause has not been clearly demonstrated, it was possible to determine that the autonomous regions with the lowest increase in health expenditure had rates higher than the rest throughout the period, and that the most vulnerable to the crisis and with the lowest increase in spending presented the greatest increase in the risk of death between the periods.
Given the increase in these deaths, due to avoidable failures of the system, it is necessary to continue investigating this cause of mortality.
描述西班牙经济危机开始之前（2002 - 2007年）和之后（2008 - 2013年）因医疗护理或手术导致的并发症死亡风险的演变情况，并按自治区进行分析，同时分析死亡风险变化与危机的社会经济影响以及卫生支出变化之间的关系。
基于年龄标准化死亡率、作为社会经济指标的综合脆弱性指数以及作为卫生支出指标的卫生支出变化进行生态研究。使用泊松回归模型估计不同时期之间的相对死亡风险。
在所研究的时期内，西班牙的死亡人数有所增加。尽管尚未明确证明卫生公共投资的增加与由此导致的死亡率下降之间的关系，但可以确定，卫生支出增幅最低的自治区在整个时期内的死亡率高于其他地区，而且最易受危机影响且支出增幅最低的地区在不同时期之间死亡风险的增幅最大。
鉴于由于系统可避免的失误导致这些死亡人数增加，有必要继续调查这种死亡原因。
