Vicente Ortún-Rubio

University Pompeu Fabra | UPF · Department of Economy and Business

Background. In Spain’s “MIR” system of allocating residency training positions, medical school graduates are ranked according to their performance on a national exam and then sequentially choose from the remaining available training slots. We studied how changes in the MIR system might address the inadequate supply of practitioners of family and co...

Medical school graduates in Spain must take a uniform national exam (called "examen MIR") in order to enter postgraduate training in a specialty. Its results offer a unique opportunity to rank medical schools according to this exam. We measured differences in the MIR exam results among Spanish medical schools and assessed the stability of the MIR-b...

Cuando el componente sanitario del Estado de Bienestar en España, y particularmente su AP, parece estar enferma, y al igual que ocurre con un paciente, tanto o más que un diagnóstico se precisa un pronóstico. Este libro pretende contribuir a ambos.

Research in business dynamics has been advancing rapidly in the last years but the translation of the new knowledge to industrial policy design is slow. One striking aspect in the policy area is that although research and analysis do not identify the existence of an specific optimal rate of business creation and business exit, governments everywher...

Close Rigor académico, oficio periodístico Hay muchas voces reclamando suspender "temporalmente" las patentes de vacunas COVID. Estados Unidos (EEUU), la Unión Europea (UE) y Reino Unido (UK), lideran los territorios discordantes. Y, para estupefacción de todos, Biden, con un golpe de efecto, acaba de descolocar al mundo. El giro de EEUU responde a...

Resumen Se realiza una reflexión en torno a tres grandes palancas para reconstruir el sistema sanitario: la gobernanza, la integración asistencial y la digitalización. España tiene niveles preocupantes de calidad de la democracia y de confianza de la población en sus políticos, y se requieren grandes cambios en la Administración pública para conseg...

El marc vigent per a la contractació de les administracions públiques amb el sector privat sanitari ha experimentat im-portants canvis amb la recent Llei de contractes del sector públic de 2017 (LCSP). Tot i que les complexitats jurídiques aconsellen remetre a la literatura especialitzada (Domínguez 1 Els autors agraeixen el finançament del Ministe...

Tenim un bon sistema sanitari, però amb un pro-nòstic que s'ha anat agreujant. Tractarem, a continuació i de manera senzilla, sobre com evitar el desmantellament d'aquesta conquesta de la humanitat que és l'estat del benestar, esbossant alguna actu-ació de les que convindria executar per evitar la deriva cap a una "desamortització" del segle xxi: l...

Dossier on Health and Healthcare System, coordinated by V Ortún. Economic Journal of Catalonia, # 81, April 2020.

We have a good health system, but with an increasingly negative prognosis. Here we will discuss, in simple terms, how to prevent the human conquest -the welfare state- from crumbling, outlining some of the actions that need to be carried out to avoid drifting towards a 21st century version of the “confiscation”: the sale of public health (and unive...

The recent reform of public procurement in Spain. The experience of public-private collaboration in Spanish healthcare. How can the collaboration between the public and private sectors be improved?

Fifteen years ago, Gaceta Sanitaria published the article entitled "What is an efficient health technology in Spain?" The growing interest in setting the price of new technologies based on the value they provide to health systems and the experience accumulated by the countries in our environment make it opportune to review what constitutes an effic...

The prioritisation of tasks and programmes occurs in any field, public or prívate, collective or individual, and is always done, better or worse, explicitly or implicitly. The prioritization of interventions by the State is justified both to correct market failures and to favour a certain redistribution (the tandem efficiency-equity of public polic...

Se esquematiza la reciente evolución de la organización sanitaria en España analizando, e ilustrando con ejemplos, la innovación sanitaria. El énfasis del artículo se sitúa en la gestión sanitaria, tanto en la medida de su calidad como en la consideración del impacto de esta calidad en los resultados en salud. Se abordan las limitaciones de la gest...

Si el vino te perjudica los negocios, deja los negocios. A propósito de la desigualdad, la cobertura universal y la gestión sanitaria.

Se esquematiza la reciente evolución de la organización sanitaria en España analizando, e ilustrando con ejemplos, la innovación sanitaria. El énfasis del artículo se sitúa en la gestión sanitaria, tanto en la medida de su calidad como en la consideración del impacto de esta calidad en los resultados en salud. Se abordan las limitaciones de la gest...

Al lector le sonará Adam Smith y su afirmación (1776) de que la búsqueda del interés privado, en competencia y bajo una serie bastante exigente de requisitos técnicos e institucionales, conduce al interés público. Sus ideas fue-ron, dos siglos después, formalizadas y demostradas teóricamente por Arrow y Debreu (1959), posteriormente premios Nobel....

EL ESTADO DE BIENESTAR EN CATALUÑA/ESPAÑA Vicente Ortún (UPF) y María Callejón (UB) 30 abril 2018 Resumen de la ponencia: Una revisión sobre los aspectos disfuncionales de la modalidad de Estado de Bienestar (EB) en Cataluña/España. La efectividad de las políticas públicas resulta clave para la sostenibilidad del EB ya que únicamente con prestacion...

Aim: To explore the effect of hospital's characteristics in the proportion of obstetric interventions (OI) performed in singleton fullterm births (SFTB) in Catalonia (2010-2014), while incentives were employed to reduce C-sections. Methods: Data about SFTB assisted at 42 public hospitals were extracted from the dataset of hospital discharges. Ho...

In this book we pursue some answers to the following questions: What procedures are used to determine whether new technologies should be publicly funded? What is the role of each stakeholder in the prioritisation process? What type of evidence in necessary to decide priorities? When setting priorities, are trade-offs between the different objective...

PurposeTo assess the impact of the comprehensive orthogeriatric care model (OGM) on 2-year survival, length of stay (LOS), discharges to nursing homes, and antiosteoporotic treatment (AOT) in patients with hip fracture. Methods Retrospective cohort study. Hospitals were classified as OGM if the patient was cared for in a comprehensive orthogeriatri...

Pre-exposure prophylaxis (PrEP) effectiveness has been well established. This study aims to assess the cost-effectiveness of providing PrEP, estimate the number of eligible MSM, and its budget impact in Catalonia. Cost-effectiveness analysis compared costs of on daily basis and "on demand" PrEP to prevent one infection with lifetime costs of one HI...

Señor editor: En Latinoamérica, el incremento del producto interno bruto en relación con los nuevos escenarios epidemiológicos de cada país ocasionó un aumento y redistribución de los gastos en salud. Existen estudios económicos en salud en países desarrollados; sin embargo, éstos no son generalizables a la realidad latinoamericana2 debido no sólo...

Objectives: to describe the secular trend and seasonal variation in the incidence of hip fracture (HF) over 12 years (2003-2014) in Catalonia, the community with the highest incidence of HF in Spain. Methods: data about age, gender, type of fracture and month of hospitalisation among patients aged 65 years and older discharged with a diagnosis o...

This article provides a critical review about the challenges that taxes on sugary drinks as an instrument of health policy must face to reverse the trend of the current epidemics of obesity. We analyzed the experiences of the leading countries, particularly Mexico, and reflect on the counterweight exerted by the industry against obesity policies, a...

In Spain's 'MIR' system, medical school graduates are ranked by their performance on a national exam and then sequentially choose from the available residency training positions. We took advantage of a unique survey of participants in the 2012 annual MIR cycle to analyze preferences under two different choice scenarios: the residency program actual...

The historical relegation of women in society has had its expression in the subordinate and supporting role of midwifery in some countries. We know that midwifery-led care is associated with a reduction in the use of epidurals, fewer episiotomies or instrumental deliveries, and a decreased risk of fetal death before 24 weeks gestation. In order to...

Los autores del presente informe revelan sorprendentes similitudes entre los sistemas de atención a la maternidad descritos. El elemento común de la obra es el reconocimiento de que la caída de las tasas de mortalidad y morbilidad en las mujeres y los recién nacidos se ha visto acompañada por el augmento de la aplicación rutinaria de intervenciones...

Introducción. La selección en la formación sanitaria especializada de los médicos (MIR) se basa en la equidad interperso-nal que premia a los candidatos según su esfuerzo. El rendimiento académico, a través del baremo, refleja el 'esfuerzo de fondo', mientras que el examen MIR mide el 'esfuerzo sprint'. Este artículo discute los pros y los contras...

Sr. Director: Agradecemos la carta en relación con nuestro artículo, carta cuyo sentido general compartimos plenamente. También nosotros, con alguna facultad de medicina también joven y que no ha graduado todavía ninguna promoción entre las universidades de filiación de los autores, esperamos que una orientación hacia la medicina de familia en los...

Resumen Objetivo: Contrastar si hay diferencias significativas entre universidades en la proclividad a elegir medicina de familia y comunitaria (MFyC), dadas las restricciones impuestas por el número de elección. Contrastar la hipótesis de que las facultades que tienen la MFyC como asignatura obligatoria en el grado (3 de 27) presentan mayor predi...

In Spain, the Strategy for Assistance in Normal Childbirth (SANC) promoted a model of care, which respects the physiological birth process and discards unnecessary routine interventions, such as episiotomies. We evaluated the rate of episiotomy use and perineal trauma as indicators of how selective introduction of the SANC initiative has impacted c...

As a result of the growing number of interventions that are now performed in the context of maternity care, health authorities have begun to examine the possible repercussions for service provision and for maternal and neonatal health. In Spain the Strategy Paper on Normal Childbirth was published in 2008, and since then the authorities in Cataloni...

Scientific and technological advances have entailed an increased influence of medicine in the process of pregnancy, childbirth and post-partum with the institutionalisation this entails for childbirth care in the hospitals of most industrialised countries. Several organisational and childbirth care models are in place and differences can be observe...

In this article, we analyze the extent to which an individual's socioeconomic status is inherited and how equality of opportunity could be increased to improve social mobility. Poverty and deprivation can stop being dynastic-like if the social elevator works. In Spain, income inequality, measured by the Gini coefficient, rose from 0.31 in 2006 to 0...

Childbirth assistance in highly technological settings and existing variability in the interventions performed are cause for concern. In recent years, numerous recommendations have been made concerning the importance of the physiological process during birth. In Spain and Catalonia, work has been carried out to implement evidence-based practices fo...

Background: Childbirth assistance in highly technological settings and existing variability in the interventions performed are cause for concern. In recent years, numerous recommendations have been made concerning the importance of the physiological process during birth. In Spain and Catalonia, work has been carried out to implement evidence-based...

Objetivo: Contrastar si hay diferencias significativas entre universidades en la proclividad a elegir medicina de familia y comunitaria (MFyC), dadas las restricciones impuestas por el número de elección. Contrastar la hipótesis de que las facultades que tienen la MFyC como asignatura obligatoria en el grado (3 de 27) presentan mayor predilección p...

Scientific and technological advances have entailed an increased influence of medicine in the process of pregnancy, childbirth and post-partum with the institutionalisation this entails for childbirth care in the hospitals of most industrialised countries. Several organisational and childbirth care models are in place and differences can be observe...

To determine if there are significant differences between universities in the proclivity to choose Family and Community Medicine (FCM), given the constraints imposed by the number of choice. To test the hypothesis that the Schools of Medicine that have the FCM as a compulsory subject in the degree (3 of 27) had the highest preference for this speci...

Objective To assess the level of agreement in positive questions, and policy-value questions in Health Economics of the members of the Spanish Health Economics Association (AES). Methods A survey was made among the members of the AES (42 academic health economists, 196 health managers, and 34 practising physicians). The survey included 20 positive...

To investigate the determinants of specialty choice among graduating medical students in Spain, a country that entered into a severe, ongoing economic crisis in 2008. Since 2008, the percentage of Spanish medical school graduates electing Family and Community Medicine (FCM) has experienced a reversal after more than a decade of decline. A nationwid...

Objective To determine if there are significant differences between universities in the proclivity to choose Family and Community Medicine (FCM), given the constraints imposed by the number of choice. To test the hypothesis that the Schools of Medicine that have the FCM as a compulsory subject in the degree (3 of 27) had the highest preference for...