ABSTRACT
BACKGROUND: We carried out a descriptive analysis of the mortality in a Catalonian rural town (Canet d'Adri, 12 km from Girona) for the period 1872-1900. The knowledge of the main mortality causes, especially those non-transmissible, could be very illustrative. The objective was to show the distribution of the mortality by age and cause, and to compare mortality due to infections with mortality consequence of the rest of the causes. METHOD: Three aspects were analysed: the distribution of the deaths by age and sex; the temporal and seasonal evolution; and the distribution by cause-specific. RESULTS: 49.3% of the deaths corresponded to women and 50.7% to men. Younger than one-year old were the most important group, 35.6% of the total mortality, followed by older than 65, 23.7%. Respiratory diseases were responsible for 33.4% of deaths; infectious diseases 31.1%, circulatory diseases 13.4% and digestive diseases 2.6%. Amongst younger than 45 year old the main cause of mortality was infectious diseases, above all in women. Respiratory diseases were the main cause of mortality in women older than 45 and in men older than 65 year old. Deaths because circulatory diseases were a very important cause amongst men older than 65. CONCLUSIONS: Besides of the importance of the infectious diseases as the main cause of death, it is surprising the importance of circulatory diseases (the third cause of mortality).
Subject(s)
Cause of Death , Rural Population/statistics & numerical data , Adolescent , Adult , Age Distribution , Aged , Child , Child, Preschool , Female , History, 19th Century , Humans , Infant , Male , Middle Aged , Sex Distribution , Spain/epidemiologyABSTRACT
OBJECTIVES: To analyze the degree of utilization of generic drugs in Spain and Catalonia. To determine real savings and scope for further savings due to the use of generic drugs. DESIGN: Descriptive, crossover study. SETTING: Public health prescription in Spain and Catalonia in June of 1999 and in Catalonia from January to June of 1999. MEASUREMENTS AND MAIN RESULTS: In June of 1999, the market share of generic drugs in Spain was 1.15% in units and 0.91% in pesetas of the hole drug prescription. The most used were oral ranitidine, oral diclofenac and oral amoxicillin. Catalonia, in this period, has a greater relative utilization of generic drugs, specially in psychotherapeutic agents like alprazolam and fluoxetine. During the first semester of 1999 only in 9.9% of the occasions where generic drugs could be used, were they actually prescribed. Specifically, the drug most used in its generic form was oral diclofenac with 27.1% of the all possible prescriptions. The real savings generated by the generic drugs were 0.2% of the public pharmaceutical bill, and the theoretical capacity of savings with the current generic offer were 2.3%. CONCLUSIONS: There is a low but fast-rising utilization of generic drugs in Spain and Catalonia. Nevertheless the possibilities of savings are at the moment, in relative terms, small. A greater use of them and specially a diversification of the offer is necessary to achieve important relative savings in the overall pharmaceutical bill.
Subject(s)
Cost Savings , Drug Prescriptions , Drugs, Generic , Cross-Over Studies , Drugs, Generic/economics , Models, Theoretical , Public Health , SpainABSTRACT
Objetivo. Estudiar el grado de implantación de las especialidades EFG en España y Cataluña. Conocer el ahorro generado y teóricamente generable a partir de la oferta de EFG disponibles. Diseño. Estudio descriptivo, transversal. Emplazamiento. Prescripción por receta de la Seguridad Social en España y Cataluña en junio de 1999 y en enero-junio de 1999 para Cataluña. Mediciones y resultados principales. En junio de 1999, la participación de las EFG en España fue el 1,15 por ciento en envases y un 0,91 por ciento en importe sobre el total de la prescripción. Las EFG más prescritas fueron ranitidina oral, diclofenaco oral y amoxicilina oral. En ese período Cataluña presenta una utilización relativa de EFG mayor, especialmente en psicofármacos como alprazolam y fluoxetina. Durante el período enero-junio de 1999, de las prescripciones realizables como EFG en Cataluña tan sólo un 9,9 por ciento fue prescrito como tal. En concreto, el principio activo más prescrito como EFG fue el diclofenaco oral, con un 27,1 por ciento de las prescripciones. El ahorro generado por las EFG fue sólo de un 0,2 por ciento y la capacidad de ahorro teórica no utilizada (al no prescribir un EFG en lugar de una especialidad de marca) fue del 2,3 por ciento sobre el importe PVP del total de la prescripción. Conclusiones. La implantación de los genéricos en España y Cataluña es baja, pero está incrementándose con rapidez. Sin embargo, la capacidad de ahorro es actualmente todavía baja respecto al gasto total. Se precisa una mayor utilización y especialmente una mayor diversificación de la oferta EFG para conseguir un impacto relativo importante sobre la factura farmacéutica (AU)
Subject(s)
Drugs, Generic , Cost Savings , Drug Prescriptions , Spain , Cross-Over Studies , Models, Theoretical , Public HealthABSTRACT
OBJECTIVE: To identify factors influencing volume, quality and power of antibiotic prescription in primary care. DESIGN: Descriptive, crossover study. SETTING: Sanitary Region Coast of Ponent, 1992. PARTICIPANTS: They were studied 468 practitioners of primary care attention. 68 practitioners were excluded by various reasons. MEASUREMENTS AND MAIN RESULTS: The factors studied were: factors coming from the practitioner, the centre, and the assisted population. The following parameters were analysed: amount of prescribed antibiotics in DDDs, election level ("antibiotic power") and percentage of DDDs of low intrinsic value. It was used for the comparison of means, Student-Fisher t test and the confidence intervals of the difference. Also it was used the step-wise multiple regression analysis. Greater use of antibiotics. The variability can be explained through regression in a 45.7% in function of the doctors factors, not integrated in a team, older, doctor who works in a rural centre, of young population and of smaller revenue. Greater antibiotic power. It's explained in a 5.09% by the medical factors like man, that works in a not educational centre and of greater population revenue. Greater percentage of DDDs of low intrinsic value. It's greater in doctors not specialized in family care, permanent job, of greater age, men, not reformed professional and not of an educational centre. CONCLUSIONS: The volume of prescription of antibiotics and in minor extent its quality of prescription are in some part justified by variables coming from the practitioner, the centre and the assisted population. The antibiotic power mainly doesn't.
