JOSE MARIA ABELLAN PERPIÑAN - Academia.edu (original) (raw)
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Papers by JOSE MARIA ABELLAN PERPIÑAN
The patient, Jan 7, 2018
The aim of this study was to compare the Parkinson's Disease Questionnaire-8 (PDQ-8) with thr... more The aim of this study was to compare the Parkinson's Disease Questionnaire-8 (PDQ-8) with three multi-attribute utility (MAU) instruments (EQ-5D-3L, EQ-5D-5L, and 15D) and to develop mapping algorithms that could be used to transform PDQ-8 scores into MAU scores. A cross-sectional study was conducted. A final sample of 228 evaluable patients was included in the analyses. Sociodemographic and clinical data were also collected. Two EQ-5D questionnaires were scored using Spanish tariffs. Two models and three statistical techniques were used to estimate each model in the direct mapping framework for all three MAU instruments, including the most widely used ordinary least squares (OLS), the robust MM-estimator, and the generalized linear model (GLM). For both EQ-5D-3L and EQ-5D-5L, indirect response mapping based on an ordered logit model was also conducted. Three goodness-of-fit tests were employed to compare the models: the mean absolute error (MAE), the root-mean-square error (RMS...
Nutricion hospitalaria, 2015
generic, preference-based Health- Related Quality of Life instruments are receiving growing atten... more generic, preference-based Health- Related Quality of Life instruments are receiving growing attention in health-care decision-making process. In spite of this, to our knowledge, EQ-5D and SF-6D have never been compared in a Parkinson´s disease population sample. the aim of this paper was to assess the psychometric properties of both instruments in a Spanish PD population sample. a total sample of 133 patients were interviewed using EQ-5D-3L and SF-6D. The validity, level of agreement and sensitivity of both instruments were computed and then compared. The Spanish tariff has been used in both instruments. utilities of EQ-5D-3L and SF-6D have shown a strong correlation (r >0.50 and p.
Value in Health, 2015
To elicit willingness-to-accept (WTA) values for informal care based on the preferences of inform... more To elicit willingness-to-accept (WTA) values for informal care based on the preferences of informal carers and noncarers. Methods: Two surveys were conducted with a sample of carers (n ¼ 202) and a sample of noncarers (n ¼ 200). Individuals in both groups were asked three questions in which they had to state the minimum monetary compensation they would require (WTA) if they had to look after a person described in a hypothetical scenario for one extra hour per day. Furthermore, carers were asked for the compensation they would demand if they had to be in charge of their actual care recipient for one extra hour per day. Results: No significant differences were found between the distributions of carers' and noncarers' WTA values. Overall, respondents' valuations were sensitive to and consistent with their preferences over the tasks to be carried out in the extra hour of informal care. On average, carers required a lower monetary compensation for one extra hour taking care of their loved one (mean/median WTA values €5.2/€4.5) than if they had to devote that time to look after the hypothetical care recipient (mean/median WTA values €6.4/€5.5). More than half of the carers stated the same value under the two caring situations, which suggests that carers' WTA values were influenced by their own experience providing informal care. Conclusions: Our results show that it is feasible to derive a monetary valuation for informal care from the preferences of noncarers.
![Research paper thumbnail of [Privatization in healthcare management: an adverse effect of the economic crisis and a symptom of bad governance. SESPAS report 2014]](https://attachments.academia-assets.com/119170591/thumbnails/1.jpg)
](Gaceta sanitaria / S.E.S.P.A.S, 2014
It is often asserted that public management of healthcare facilities is inefficient. On the basis... more It is often asserted that public management of healthcare facilities is inefficient. On the basis of that unproven claim, it is argued that privatization schemes are needed. In this article we review the available evidence, in Spain and other countries, on the application of private management mechanisms to publicly funded systems similar to the Spanish national health system. The evidence suggests that private management of healthcare services is not necessarily better than public management, nor vice versa. Ownership-whether public or private-of health care centers does not determine their performance which, on the contrary, depends on other factors, such as the workplace culture or the practice of suitable monitoring by the public payer. Promoting competition among centers (irrespective of the specific legal form of the management arrangements), however, could indeed lead to improvements under some circumstances. Therefore, it is advisable to cease the narrow-minded debate on the...
Health Economics, 2011
This paper presents a new scoring algorithm for the SF-6D, one of the most popular preference-bas... more This paper presents a new scoring algorithm for the SF-6D, one of the most popular preference-based health status measures. Previous SF-6D value sets have a minimum (a floor), which is substantially higher than the lowest value generated by the EQ-5D model. Our algorithm expands the range of SF-6D utility scores in such a way that the floor is significantly lowered. We obtain the wider range because of the use of a lottery equivalent method through which preferences from a representative sample of Spanish general population are elicited.
Cost Effectiveness and Resource Allocation, 2020
Although the choice of the comparator is one of the aspects with a highest effect on the results ... more Although the choice of the comparator is one of the aspects with a highest effect on the results of cost-effectiveness analyses, it is one of the less debated issues in international methodological guidelines. The inclusion of an inappropriate comparator may introduce biases on the outcomes and the recommendations of an economic analysis. Although the rules for cost-effectiveness analyses of sets of mutually exclusive alternatives have been widely described in the literature, in practice, they are hardly ever applied. In addition, there are many cases where the efficiency of the standard of care has never been assessed; or where the standard of care has demonstrated to be cost-effective with respect to a non-efficient option. In all these cases the comparator may lie outside the efficiency frontier, so the result of the CEA may be biased. Through some hypothetical examples, the paper shows how the complementary use of an independent reference may help to identify potential inappropr...
Tanto el actual marco normativo como el escenario económico del Sistema Nacional de Salud debería... more Tanto el actual marco normativo como el escenario económico del Sistema Nacional de Salud deberían favorecer un marco institucional adecuado para dar respuesta al diseño de un sistema de financiación selectiva de los medicamentos, y de forma muy especial al alud de innovaciones, tanto las adoptadas como las que están en camino, que con unos costes muy elevados pueden aportar mejoras significativas, pero muchas veces con una elevada incertidumbre, en la esperanza de vida en la última etapa de la vida, como es el caso de las terapias oncológicas. Este informe huye de las prescripciones normativas y de tener ánimo de exhaustividad pero aporta sin complejos y con el apoyo del mejor conocimiento disponible la opinión de los expertos sobre aspectos concretos de este diseño institucional a los que la política sanitaria deberá dar una respuesta. El informe se estructura alrededor de tres puntos concretos, algunos con referencia normativa reciente, y que precisamente dan respuesta a varias d...
Gaceta sanitaria / S.E.S.P.A.S, 2008
The conflict between scarce resources and unlimited needs is perhaps more prominent in the health... more The conflict between scarce resources and unlimited needs is perhaps more prominent in the healthcare sector than in any other areas. Thus, setting priorities in health care emerges as an unavoidable task. The laudable aim of adopting any health technology that improves the population's health is impossible when confronted by budgetary constraints. Therefore, the outstanding health problems of a society and the most efficient health technologies in terms of their cost-effectiveness must be identified and patients must be prioritized, bearing in mind aspects of equity and efficiency. The present article reviews the issue of setting health care priorities by examining the experiences that have been put into practice in Spain and abroad. The problem is analyzed at three levels: the "macro" level (strategic planning, identification of higher priority areas and the selection of health care interventions); the "meso" level (incorporation of cost-effectiveness analy...
Health Technology Assessment and Health Policy Today: A Multifaceted View of their Unstable Crossroads, 2015
‘Dynamic’ and ‘energy’ are two modern words coming from the Ancient Greek words ‘dunamis’ and ‘en... more ‘Dynamic’ and ‘energy’ are two modern words coming from the Ancient Greek words ‘dunamis’ and ‘energeia’, respectively. In times of Aristotle these terms described the tension between potency and actuality. Something can exist potentially in the sense that there is the capability that allows it to become real. In contrast, actuality denotes the fulfilment of that potentiality. Therefore, the dichotomy power-act finishes when, thanks to an activity, something merely possible becomes fully actual.
SSRN Electronic Journal, 2004
En este trabajo estimamos el Valor Monetario de una Vida Estadística en España a partir de prefer... more En este trabajo estimamos el Valor Monetario de una Vida Estadística en España a partir de preferencias declaradas por la población general. El contexto de valoración elegido es el de los accidentes de tráfico. La metodología empleada es la Valoración Contingente. En la encuesta realizada se intentaron comunicar correctamente los riesgos mediante el recurso a ayudas visuales. Los valores obtenidos
SSRN Electronic Journal, 2000
Spanish Economic Review, 2001
Social Choice and Welfare, 2012
Revista Española de Salud Pública, 2009
The aim of this paper is to promote the efficiency in the process of incorporating new health tec... more The aim of this paper is to promote the efficiency in the process of incorporating new health technologies, as well as to guide their implementation by physicians. An iterative method has been used to draw a checklist based on parsimony and measurability criteria. Authors made a first version of the checklist on the basis of theoretical literature and economic evaluation guidelines. This preliminary version was discussed and its validity was tested in two focus groups by doctors and managers of the regional public health systems of Murcia and Andalusia. As a result of this iterative process, we present a 12 criteria checklist in which a score is assigned to everyone of its items. The overall score a study receives (with a maximum of 100 points) is confronting to a set of cost per QALY thresholds, in order to assess if the technology been evaluated is cost-effective or not. The thresholds was selected from a previous study. We present a checklist and user guide which includes a cost per QALY thresholds matrix. This is an original proposal that has not been previously published in the Spanish literature. Our instrument needs some future improvements in terms of its validation and its spread to other types of cost-effectiveness analysis, apart from those that use QALYs. Nevertheless, our proposal may be useful to provide guidance on the usage and financing of new health technologies in Spain.
The patient, Jan 7, 2018
The aim of this study was to compare the Parkinson's Disease Questionnaire-8 (PDQ-8) with thr... more The aim of this study was to compare the Parkinson's Disease Questionnaire-8 (PDQ-8) with three multi-attribute utility (MAU) instruments (EQ-5D-3L, EQ-5D-5L, and 15D) and to develop mapping algorithms that could be used to transform PDQ-8 scores into MAU scores. A cross-sectional study was conducted. A final sample of 228 evaluable patients was included in the analyses. Sociodemographic and clinical data were also collected. Two EQ-5D questionnaires were scored using Spanish tariffs. Two models and three statistical techniques were used to estimate each model in the direct mapping framework for all three MAU instruments, including the most widely used ordinary least squares (OLS), the robust MM-estimator, and the generalized linear model (GLM). For both EQ-5D-3L and EQ-5D-5L, indirect response mapping based on an ordered logit model was also conducted. Three goodness-of-fit tests were employed to compare the models: the mean absolute error (MAE), the root-mean-square error (RMS...
Nutricion hospitalaria, 2015
generic, preference-based Health- Related Quality of Life instruments are receiving growing atten... more generic, preference-based Health- Related Quality of Life instruments are receiving growing attention in health-care decision-making process. In spite of this, to our knowledge, EQ-5D and SF-6D have never been compared in a Parkinson´s disease population sample. the aim of this paper was to assess the psychometric properties of both instruments in a Spanish PD population sample. a total sample of 133 patients were interviewed using EQ-5D-3L and SF-6D. The validity, level of agreement and sensitivity of both instruments were computed and then compared. The Spanish tariff has been used in both instruments. utilities of EQ-5D-3L and SF-6D have shown a strong correlation (r >0.50 and p.
Value in Health, 2015
To elicit willingness-to-accept (WTA) values for informal care based on the preferences of inform... more To elicit willingness-to-accept (WTA) values for informal care based on the preferences of informal carers and noncarers. Methods: Two surveys were conducted with a sample of carers (n ¼ 202) and a sample of noncarers (n ¼ 200). Individuals in both groups were asked three questions in which they had to state the minimum monetary compensation they would require (WTA) if they had to look after a person described in a hypothetical scenario for one extra hour per day. Furthermore, carers were asked for the compensation they would demand if they had to be in charge of their actual care recipient for one extra hour per day. Results: No significant differences were found between the distributions of carers' and noncarers' WTA values. Overall, respondents' valuations were sensitive to and consistent with their preferences over the tasks to be carried out in the extra hour of informal care. On average, carers required a lower monetary compensation for one extra hour taking care of their loved one (mean/median WTA values €5.2/€4.5) than if they had to devote that time to look after the hypothetical care recipient (mean/median WTA values €6.4/€5.5). More than half of the carers stated the same value under the two caring situations, which suggests that carers' WTA values were influenced by their own experience providing informal care. Conclusions: Our results show that it is feasible to derive a monetary valuation for informal care from the preferences of noncarers.
Gaceta sanitaria / S.E.S.P.A.S, 2014
It is often asserted that public management of healthcare facilities is inefficient. On the basis... more It is often asserted that public management of healthcare facilities is inefficient. On the basis of that unproven claim, it is argued that privatization schemes are needed. In this article we review the available evidence, in Spain and other countries, on the application of private management mechanisms to publicly funded systems similar to the Spanish national health system. The evidence suggests that private management of healthcare services is not necessarily better than public management, nor vice versa. Ownership-whether public or private-of health care centers does not determine their performance which, on the contrary, depends on other factors, such as the workplace culture or the practice of suitable monitoring by the public payer. Promoting competition among centers (irrespective of the specific legal form of the management arrangements), however, could indeed lead to improvements under some circumstances. Therefore, it is advisable to cease the narrow-minded debate on the...
Health Economics, 2011
This paper presents a new scoring algorithm for the SF-6D, one of the most popular preference-bas... more This paper presents a new scoring algorithm for the SF-6D, one of the most popular preference-based health status measures. Previous SF-6D value sets have a minimum (a floor), which is substantially higher than the lowest value generated by the EQ-5D model. Our algorithm expands the range of SF-6D utility scores in such a way that the floor is significantly lowered. We obtain the wider range because of the use of a lottery equivalent method through which preferences from a representative sample of Spanish general population are elicited.
Cost Effectiveness and Resource Allocation, 2020
Although the choice of the comparator is one of the aspects with a highest effect on the results ... more Although the choice of the comparator is one of the aspects with a highest effect on the results of cost-effectiveness analyses, it is one of the less debated issues in international methodological guidelines. The inclusion of an inappropriate comparator may introduce biases on the outcomes and the recommendations of an economic analysis. Although the rules for cost-effectiveness analyses of sets of mutually exclusive alternatives have been widely described in the literature, in practice, they are hardly ever applied. In addition, there are many cases where the efficiency of the standard of care has never been assessed; or where the standard of care has demonstrated to be cost-effective with respect to a non-efficient option. In all these cases the comparator may lie outside the efficiency frontier, so the result of the CEA may be biased. Through some hypothetical examples, the paper shows how the complementary use of an independent reference may help to identify potential inappropr...
Tanto el actual marco normativo como el escenario económico del Sistema Nacional de Salud debería... more Tanto el actual marco normativo como el escenario económico del Sistema Nacional de Salud deberían favorecer un marco institucional adecuado para dar respuesta al diseño de un sistema de financiación selectiva de los medicamentos, y de forma muy especial al alud de innovaciones, tanto las adoptadas como las que están en camino, que con unos costes muy elevados pueden aportar mejoras significativas, pero muchas veces con una elevada incertidumbre, en la esperanza de vida en la última etapa de la vida, como es el caso de las terapias oncológicas. Este informe huye de las prescripciones normativas y de tener ánimo de exhaustividad pero aporta sin complejos y con el apoyo del mejor conocimiento disponible la opinión de los expertos sobre aspectos concretos de este diseño institucional a los que la política sanitaria deberá dar una respuesta. El informe se estructura alrededor de tres puntos concretos, algunos con referencia normativa reciente, y que precisamente dan respuesta a varias d...
Gaceta sanitaria / S.E.S.P.A.S, 2008
The conflict between scarce resources and unlimited needs is perhaps more prominent in the health... more The conflict between scarce resources and unlimited needs is perhaps more prominent in the healthcare sector than in any other areas. Thus, setting priorities in health care emerges as an unavoidable task. The laudable aim of adopting any health technology that improves the population's health is impossible when confronted by budgetary constraints. Therefore, the outstanding health problems of a society and the most efficient health technologies in terms of their cost-effectiveness must be identified and patients must be prioritized, bearing in mind aspects of equity and efficiency. The present article reviews the issue of setting health care priorities by examining the experiences that have been put into practice in Spain and abroad. The problem is analyzed at three levels: the "macro" level (strategic planning, identification of higher priority areas and the selection of health care interventions); the "meso" level (incorporation of cost-effectiveness analy...
Health Technology Assessment and Health Policy Today: A Multifaceted View of their Unstable Crossroads, 2015
‘Dynamic’ and ‘energy’ are two modern words coming from the Ancient Greek words ‘dunamis’ and ‘en... more ‘Dynamic’ and ‘energy’ are two modern words coming from the Ancient Greek words ‘dunamis’ and ‘energeia’, respectively. In times of Aristotle these terms described the tension between potency and actuality. Something can exist potentially in the sense that there is the capability that allows it to become real. In contrast, actuality denotes the fulfilment of that potentiality. Therefore, the dichotomy power-act finishes when, thanks to an activity, something merely possible becomes fully actual.
SSRN Electronic Journal, 2004
En este trabajo estimamos el Valor Monetario de una Vida Estadística en España a partir de prefer... more En este trabajo estimamos el Valor Monetario de una Vida Estadística en España a partir de preferencias declaradas por la población general. El contexto de valoración elegido es el de los accidentes de tráfico. La metodología empleada es la Valoración Contingente. En la encuesta realizada se intentaron comunicar correctamente los riesgos mediante el recurso a ayudas visuales. Los valores obtenidos
SSRN Electronic Journal, 2000
Spanish Economic Review, 2001
Social Choice and Welfare, 2012
Revista Española de Salud Pública, 2009
The aim of this paper is to promote the efficiency in the process of incorporating new health tec... more The aim of this paper is to promote the efficiency in the process of incorporating new health technologies, as well as to guide their implementation by physicians. An iterative method has been used to draw a checklist based on parsimony and measurability criteria. Authors made a first version of the checklist on the basis of theoretical literature and economic evaluation guidelines. This preliminary version was discussed and its validity was tested in two focus groups by doctors and managers of the regional public health systems of Murcia and Andalusia. As a result of this iterative process, we present a 12 criteria checklist in which a score is assigned to everyone of its items. The overall score a study receives (with a maximum of 100 points) is confronting to a set of cost per QALY thresholds, in order to assess if the technology been evaluated is cost-effective or not. The thresholds was selected from a previous study. We present a checklist and user guide which includes a cost per QALY thresholds matrix. This is an original proposal that has not been previously published in the Spanish literature. Our instrument needs some future improvements in terms of its validation and its spread to other types of cost-effectiveness analysis, apart from those that use QALYs. Nevertheless, our proposal may be useful to provide guidance on the usage and financing of new health technologies in Spain.