Jose Luis Navarro-Espigares

University of Granada | UGR · Departamento de Economía Internacional y de España

Background Polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) are persistent organic pollutants (POPs) that had been banned or restricted in many countries, including Spain. However, their ubiquity still poses environmental and human health threats. Objective To longitudinally explore public healthcare costs associated with long...

Background: Despite restrictions on their production and use, most of the population is still exposed to Persistent Organic Pollutants (POPs), including organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs). These chemicals are thought to contribute to the aetiology of highly prevalent chronic conditions, such as cardiovascular dis...

For years we have been fighting to activate the strategic plan for primary prevention of ADPKD in Andalusia and Spain: our studies show that in addition to being good for our patients, it is an efficient model and contributes to making the public health system more sustainable; it seems that we are closer

In Andalusia, Spain, a pioneering plan of primary prevention of the ADPKD is being developed. In order for children to be born without this hereditary disease, it is necessary to provide information and access to affected couples of reproductive age to techniques of assisted human reproduction such as the pre-implantation genetic test. The registry...

Spain is one of the European countries with more municipalities adhering to the Local Agenda 21 (LA21). Environmental spending exerts a great influence on implementing LA21. But some authors raise doubts about the firm commitment of local governments to LA21 objectives. Thus, the main objective of this paper is to verify whether political commitmen...

Introducción: La poliquistosis renal autosómica dominante (PQRAD) es la enfermedad renal hereditaria que con mayor frecuencia ocasiona fallo renal. No existe tratamiento curativo, por lo que la diálisis o el trasplante son las alternativas terapéuticas utilizadas. El objetivo de este trabajo consiste en comparar el coste económico de una estrategia...

Objetivos: El objetivo de este trabajo es calcular el coste individualizado real de la asistencia sanitaria a pacientes oncológicos. Métodos: Estudio descriptivo a partir de registros administrativos. La población de estudio son pacientes oncológicos fallecidos en la provincia de Granada durante los años 2009-2012. Fuentes de datos: Registro de Cán...

The objective of this paper is to compare Norwegian and Spanish municipalities regarding their commitment to environmental expenses and citizen participation within Local Agenda 21. Models estimated using the difference in differences methodology present positive and statistically significant impact of LA21 on municipal expenses in environmental pr...

This work addresses the healthcare systems sustainability objective from the perspective of reducing the demand for health services. Cooperation across industry sectors is a crucial issue in achieving healthier populations that demand less health care. This research work poses the question: how are greeninvestments affecting health and healthcare s...

As the United Nations is currently discussing the post-2015 agenda, this paper provides an updated quantification of the environmental impact index and its evolution during the last 50 years. An updated and global environmental impact index estimate, based on the theoretical model of consumption equations initiated in the 1970s by Paul Ehrlich and...

To analyze the cost-effectiveness of IVF-ICSI cycles with elective single-embryo transfer (eSET), plus elective single frozen embryo transfer (eSFET) if pregnancy is not achieved, compared with double-embryo transfer (DET). Cost-effectiveness analysis. Public hospital. A population of 121 women (<38 years old), undergoing their first or second IVF...

Objective: To assess differences in care given to patients with ST-segment elevation myocardial infarction (STEMI) in different hospitals with and without a cardiac catheterization laboratory. Methods: Retrospective cohort study of 11122 patients with STEMI attended in public hospitals in Andalusia, Spain. Data for patients treated from 2005 to 200...

Aunque los resultados no son concluyentes, podemos encontrar evidencia científica suficiente acerca del impacto positivo del desempeño social y medioambiental en el logro de los objetivos empresariales. Esta es una de las razones por las que consideramos acertada la introducción de la enseñanza de la Responsabilidad Social Corporativa en los progra...

In these times when The United Nations organization is discussing the post-2015 agenda, this paper provides an updated quantification of the environmental impact index and its evolution during the last fifty years. Based on the theoretical model of consumption equations initiated by Paul Ehrlich and John Holdren in the seventies, an updated and glo...

This study aims to estimate the incidence of adverse events (AEs) and avoidable AE in four hospital services before and after applying strategies for patient safety. Retrospective study of two cohorts (2006 and 2009). General Surgery, Internal Medicine, Intensive Care Unit and Oncology services. A sample of 365 patients (2006) and 232 in 2009 rando...

We have identified structural causes of workplace injuries and illnesses in Spain. At issue is to what extent these are also influential factors in the U.S. Two different econometric estimates were carried out in Spain using panel data techniques and logit econometric models. Similar models will be used to: a) analyze data for the entire U.S. fro...

Introduction: The growth of the service sector is a prevalent characteristic in advanced economies. Some recent publications point out the increasing relevance of injuries and occupational illnesses in the service sector in Europe. Objective: To analyze the evolution of fatal occupational injuries in the US at a state level. To also study the inequ...

Background: The elevated prevalence of osteoarthritis in Western countries, the high costs of hip and knee arthroplasty, and the wide variations in the clinical practice have generated considerable interest in comparing the associated costs before and after surgery. Objective: To determine the influence of a number of variables on the costs of t...

To evaluate the relevance of ongoing nociceptive joint inputs to the maintenance of widespread pain hypersensitivity in patients with hip osteoarthritis (OA) and to determine whether a reversal in the widespread pressure hypersensitivity together with an improvement in pain and function occurs after total hip replacement in these patients. Forty pa...

The objective of this study was to examine the contribution of patient weight and other preoperative variables to improvements in the general physical health of patients undergoing total hip arthroplasty (THA). Data were prospectively collected on 63 THA patients (28 males and 35 females). The primary outcome measure was the improvement in general...

The ability of regional economies to adjust their temporal dynamics to changing circumstances is a phenomenon recently included within the concept of resilience. This paper attempts to verify whether the relative weight of the service sector in the production structure of Spanish regions has a decisive influence on their reaction to the economic cr...

Introduction: The elevated prevalence of arthrosis in Western countries, the high costs of hip and knee arthroplasty, and the wide variations in clinical practice have generated considerable interest in comparing the associated costs before and after surgery. We undertook this study to determine the influence of a number of variables on the costs o...

In 1998, Spain led the ranking of occupational accidents in the European Union, accounting for 30% of the total. The highest incidence occurred among young people (16-19 years), and for workers with less than one year at their jobs. As a consequence of the European Union Directive on the prevention of occupational accidents, a new legal framework...

Illiteracy, a universal problem, limits the utilization of the most widely used short cognitive tests. Our objective was to assess and compare the effectiveness and cost for cognitive impairment (CI) and dementia (DEM) screening of three short cognitive tests applicable to illiterates. Phase III diagnostic test evaluation study was performed during...

Despite recent legislative progress, equality between men and women remains a challenge of major importance. From the hospital perspective, gender equality is a key element within corporate social responsibility policy. The aim of this study is to quantify the gender differences among professionals of the University Hospital Virgen de las Nieves (U...

According to the ILO, 2.3 million people die every year from occupational accidents and diseases, and 337 million are affected by non-fatal accidents in the workplace. Compensation systems for accidents are usually based on four components: bodily injury, moral damage, property damage, and lost income. At the international level, legal compensation...

The optimization of healthcare resources is a pivotal element in the clinical management strategy currently being developed by the Andalusian Healthcare Service. The incorporation of new technologies plays a key role in dynamically allocating health resources, particularly those technologies that concern the incorporation of new drugs. In this vein...

Phototest laminated sheet (version B). Laminated sheet with stimulus images in the version for English-speaking countries.

Phototest. Form with instructions for the application and correction of the Phototest.

To assess and compare the effectiveness and costs of Phototest, Mini Mental State Examination (MMSE), and Memory Impairment Screen (MIS) to screen for dementia (DEM) and cognitive impairment (CI). A phase III study was conducted over one year in consecutive patients with suspicion of CI or DEM at four Primary Care (PC) centers. After undergoing all...

In this paper, the authors are particularly interested in revealing the relationship between public–private partnership (PPP) investments and regional productivity. The main data sources are the database provided by the UK Her Majesty's Treasury on private finance initiative projects and the regional economic performance indicators published by the...

Objective: To determine the impact of a 1-month telephone care program after hospital discharge from a trauma surgery unit on health services utilization and patient anxiety and to perform a budgetary analysis. Methods: We carried out an experimental study in 604 patients who formed an experimental and a control group. The experimental group was...

The relationship between quality and efficiency in the health sector is influenced by various conditions. The objective of this paper is to analyse the evolution of efficiency and quality in the Andalusian Hospitals during the years 1997–2004 and to study the association between efficiency and quality indicators. Hospital performance is analysed us...

To determine the impact of a 1-month telephone care program after hospital discharge from a trauma surgery unit on health services utilization and patient anxiety and to perform a budgetary analysis. We carried out an experimental study in 604 patients who formed an experimental and a control group. The experimental group was offered telephone care...

The University Hospital of Jan (Spain) has 785 beds and a reference population of 292,633 inhabitants. During 2007, there were 25,459 admissions, with average hospital stays of 8.52 days. In this year, a prevention program of adverse events due to medication at the hospital was designed. Initially we determined the frequency of adverse events from...

Numerous investigations have shown that water quality affects social justice. Therefore, the quality of water should be the same in all territories of a country. Statistically significant differences in Spain have been verified regarding some variables that determine water quality. Regional differences of these variables could be regarded as a sour...

Background: Total hip arthroplasty (THA) is the primary late-stage treatment for many degenerative hip diseases, including osteoarthritis, avascular necrosis, and rheumatoid arthritis. In recent decades there has been growing interest in the development of minimally invasive techniques which have revolutionized hip surgery with the objectives of le...

Background: Total hip arthroplasty (THA) is one of the most successful orthopedic procedures of the past three decades. In general, it relieves pain, improves function and especially quality of life of patients with degenerative or inflammatory pathology of the hip. The introduction of minimally invasive techniques for total hip replacement has gen...

Corporate social responsibility (CSR) includes a threefold commitment, economic, social, and environmental. There is a close link between this concept and that of social justice, traditionally concerned about social equality, equal opportunities, welfare state, or income distribution. In Europe, where most healthcare systems incorporate a significa...

In Spain, 12,816 workers died in workplace accidents between 1999 and 2007. Although the trend during the period was decreasing, still, 1160 workers died in 2007. As a consequence of these high figures, workers' compensation becomes a key element in the social justice system. In this work, we address the issues relating to workers' compensation to...

The European Strategy for Environment and Health aims the adoption of environmental management policies in the Public Administration is an issue of great impact. This work presents the Environmental Management Plan of the Province Council of Jan. To develop the Environmental Management Plan of the Council it was necessary to form a multidisciplinar...

Great differences among Spanish regions have been observed in previous investigations regarding accidents at the workplace. Murcia, Navarre, the Balearic Islands, and the Basque Country were in the group of Communities with the highest risks of occupational injury in the period 1994-2004. A number of studies, such as the ones by ILO and WHO, have...

The objective of this work is to analyze organizational climate in a regional public hospital and its association with satisfaction, perceived health, and the health problems of workers. We designed a cross-sectional descriptive study developed in the General Hospital of Jan during the period January 2008 to April 2009 for employees with an active...

Mental health in young people is one of the problems associated with social exclusion. The project evaluated in this work was performed in the Juvenile Center of Berzosa de Lozoya, in the north of Madrid (Spain). This is a center for protected minors with mental health disorders managed by both a technical and a service team. The technical team c...

Mercury is a heavy metal and its presence in the human body is toxic at certain critical levels. It can cause acute, subacute, or chronic toxic effects to occur. The last form of toxicity is the most common in the workplace and is called hydrargyrism. The aim of this study is to determine the long-term effects on the health of a group of workers...

The aim of this article is to carry out an empirical analysis of certain factors related to dependence in Spain and additionally to study the intensity of the use of health resources by dependents. Age appears to be the main socio-demographic factor related to dependence, which confirms the need for measures to deal with the demographic changes tak...

La France connaît depuis le milieu des années 1970 un changement profond des tendances de localisation des activités et des secteurs. Le secteur des services aux entreprises joue un rôle moteur dans ces nouvelles dynamiques et confère de fait aux métropoles urbaines une place privilégiée. Globalement, les villes moyennes apparaissent relativement m...

The aim of this study was to analyse the influence of the type of service provided by assisted reproduction clinics. The activities, treatment patterns and results achieved by assisted reproduction centres in Spain were examined, comparing public and private clinics. A retrospective study was carried out using the Assisted Reproductive Technology R...

The Water Poverty Index (WPI) is an interdisciplinary measure that links household welfare with water availability and indicates how water scarcity impacts human populations. Water availability and income per capita may play determinant roles in worldwide life expectancy variations. In this paper we investigate whether the influence of water as a...

The Observatory (OMARS) is a pioneering initiative in the health sector, as defined under the current requirements of environmental development and continuous improvement. This observatory reflects the innovative character of the Andalusian Public Health System. OMARS emerged as a multi-stakeholder organization in which some Spanish public hospital...

The environmental commitment made by the Hospital Universitario Virgen de las Nieves has recently led to lower water consumption. This decline has caused the side effect of raising the concentration of certain contaminants in the water discharged, by reduction in the amount of solvent. Despite the processes of segregation and treatment of waste, th...

The total number of workplace deaths in the world increased by more than 2.2 million, according to ILO data. The World Health Organization (WHO) considers type of employment contract and working conditions to be the most important causes of workplace accidents. The National Institute for Occupational Safety and Health (NIOSH) in the U.S.A has reach...

Clinical Management Units (CMU) are organizational structures conceived to provide health care services to a reference population restricted to global budget and to quality and efficiency standards. The objective of this work is to describe the implementation process and results of an Internal Medicine CMU in a Spanish public hospital. A group of...

Subcutaneous fibrosis is one of the belated consequences after radiation in cancer patients and often represents a dose limiting factor. In many cases it produces a loss of mobility of the affected member, pain and edema. So far there is no standardized pharmacological intervention in that process. The objective of this work is to define a therapeu...

Public-Private Partnership (PPP) is expanding rapidly as an alternative for the provision of goods and services by governments around the world. Although PPP is usually only seen as a way to privatize public services, PPP implementation could deter excessive pressure from building up within public systems to move toward privatization. PPP is a type...

On the international level, compensation systems for accidents traditionally presented great heterogeneity. Legal compensation scales are being used to reduce arbitrariness and variability in the calculation of payments for personal injuries. However, this tool has not yet achieved international convergence for amounts of compensation. Compensati...

One of the most important organizations of Andaluca is The Servicio Andaluz de Salud (SAS) because it has a great volume of resources and a great number of workers. In 2005, it decided to assume the responsibility of incorporating the environmental commitment in his style of management. The above mentioned commitment implies advancing in the preven...

Crescimento económico espanhol levou a um aumento da degradação ambiental, com repercussão negativa na saúde pública. A deterioração é parcialmente refletido no baixo nível de tratamento de águas residuais. Embora a série de dados nacional sobre águas residuais tratadas mostra uma evolução favorável, a comparação por regiões revela a existência de...

Public-Private Partnership is expanding rapidly as an alternative for the provision of goods and services by governments. This paper analyses PPP phenomenon and focuses on relevance as regards healthcare ser- vices. Methodology is centred on literature review and a detailed descrip- tion of the Private Finance Initiative in the United Kingdom as a...

The Spanish border with Morocco in the Ceuta and Melilla territories has the greatest economic differential of all borders between countries in the world. The extreme wage inequality creates tremendous pressure on the labor market and situations of social dumping. The problem of cross-border workers in Ceuta and Melilla is affected by two circums...

Efficiency-based healthcare decision-making has been widely accepted for some time, with cost per quality-adjusted life year (QALY) as the main outcome measure. Nevertheless, for numerous medical procedures, little data are available on the cost per QALY gained. The aim of the present study was to calculate the cost per QALY gained with primary hip...

Dos recientes pronunciamientos de la Sala 4 ª de lo Social del Tribunal Supremo han puesto fin a la doctrina jurisprudencial por la que, para evitar el "enriquecimiento injusto" del trabajador accidentado, se exoneraba al empresario del deber de reparar los perjuicios causados en un accidente de trabajo o enfermedad profesional, por el incumplimien...

Access to assisted reproduction techniques (ARTs) is highly variable worldwide. The aim of this paper is to analyse the association between systems for ART coverage, patterns of clinical practice, and outcomes for these procedures. We performed a retrospective analysis of ART activity records in the USA and Europe, and concluded that the availabili...

The increase in the percentage of the elderly (the population 65 years or older) in developed countries is a cause for concern about the levels of health care services expenditures and the widening of long-term care services in these countries. The current debate includes the issue of establishing a system of protection for dependence as a new moda...

The recently developed Phototest is a simple, easy and very brief (<3 minutes) test with theoretical advantages over available dementia screening tests. Our objective was to evaluate its diagnostic accuracy under routine clinical conditions. A phase II cross-sectional validation study of diagnostic tests was performed in a sample of 308 patients re...

Background: There is known to be a statistically positive relationship between age, dependency, and per capita healthcare expenditure, although its impact on healthcare and long term care expenditure growth is not clear. Theories of compression and expansion of morbidity offer opposite approaches to this subject. Objectives: To quantify individual...

From the public health perspective, delinquency, economic growth, and immigration are three explicative factors of both population health and the volume of healthcare expenditure. This work attempts to quantify the relationship between these variables and the level of healthcare expenditure in Spain. With this aim we have used a panel data econom...

Introduction: The objective of this work was to analyze the influence of the organizational environment on health, labor satisfaction, and absenteeism of healthcare workers in a regional hospital. Methods: This is a descriptive cross-sectional study. The study was developed in a Spanish regional hospital during the period June to December, 2006....