Mortalidad por complicaciones médicas y quirúrgicas, impacto de la crisis y gasto sanitario en España, 2002-2013 / Mortality due to medical and surgical complications, economic crisis and health spending in Spain, 2002-2013

Objetivo: Describir la evolución de los riesgos de mortalidad por complicaciones debidas a la atención médica o la cirugía entre los periodos anterior (2002-2007) y posterior (2008-2013) al inicio de la crisis económica, en España y por comunidades autónomas, y analizar la relación entre los cambios en los riesgos de muerte y el impacto socioeconómico de la crisis y la variación del gasto sanitario. Método: Estudio ecológico basado en tasas de mortalidad estandarizadas por edad, índice sintético de vulnerabilidad como indicador socioeconómico y variación del gasto sanitario como indicador del gasto en salud. Se estimó el riesgo relativo de muerte entre periodos con modelos de regresión de Poisson. Resultados: El número de muertes aumentó para España en el periodo estudiado. Aunque la relación entre el incremento en la inversión pública en salud y la disminución de la mortalidad por esta causa no ha quedado claramente demostrada, sí ha podido determinarse que aquellas comunidades autónomas con menor incremento del gasto sanitario presentaron mayores tasas que el resto a lo largo de todo el periodo, y que las más vulnerables a la crisis y con menor incremento del gasto presentaron un mayor incremento de riesgo de muerte entre periodos. Conclusión: Dado el incremento de las muertes debidas a fallos evitables del sistema, es necesario seguir investigando sobre esta causa de mortalidad

Objective: 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. Method: 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. Results: 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. Conclusions: Given the increase in these deaths, due to avoidable failures of the system, it is necessary to continue investigating this cause of mortality

[Mortality due to medical and surgical complications, economic crisis and health spending in Spain, 2002-2013]. / Mortalidad por complicaciones médicas y quirúrgicas, impacto de la crisis y gasto sanitario en España, 2002-2013.

OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSIONS: Given the increase in these deaths, due to avoidable failures of the system, it is necessary to continue investigating this cause of mortality.