Articles publicats (D-EM)http://hdl.handle.net/10256/15412024-03-29T04:48:32Z2024-03-29T04:48:32ZArtisanal food production in rural Argentina: Finding solace in cheese tourism?Magri Harsich, GabrielaFusté Forné, FrancescFernandes, CarlosVidal Casellas, Dolorshttp://hdl.handle.net/10256/244942024-02-19T13:38:40Z2024-03-01T00:00:00ZArtisanal food production in rural Argentina: Finding solace in cheese tourism?
Magri Harsich, Gabriela; Fusté Forné, Francesc; Fernandes, Carlos; Vidal Casellas, Dolors
The Argentine countryside shows a strong identity link between rural products and income factors for peasant families. Artisanal cheese is a manifestation of identity in the region Campos, Ríos y Lagunas in Buenos Aires, where the visitors attracted by regional products are increasing in the context of rural tourism. The objective of this article is to analyse the development of entrepreneurship projects of gastronomic products based on the production of cheeses in the region and the relationships between cheese and tourism from the perspective of the producers. Departing from interviews with ten producers from the region conducted in 2022 and a content analysis of the responses, the results show the cultural and economic role of dairy production, the know-how of the producers through the agrotechnical school of the area and the opportunity of the Argentine countryside to participate in food tourism through cheese. The paper reveals the challenges and opportunities that exists regarding the process of awarding tourism value to cheese for the local development, the empowerment of rural producers and the synergies between public and private stakeholders
2024-03-01T00:00:00ZEvaluación de la efectividad de un programa de atención integrada y proactiva a pacientes crónicos complejosCoderch, JordiPerez Berruezo, XavierSánchez Pérez, InmaSánchez González, ElviraIbern, PerePérez, MarcCarreras Pijuan, MarcInoriza, José Maríahttp://hdl.handle.net/10256/241842024-01-30T10:27:27Z2018-01-01T00:00:00ZEvaluación de la efectividad de un programa de atención integrada y proactiva a pacientes crónicos complejos
Coderch, Jordi; Perez Berruezo, Xavier; Sánchez Pérez, Inma; Sánchez González, Elvira; Ibern, Pere; Pérez, Marc; Carreras Pijuan, Marc; Inoriza, José María
Objetivo Evaluar la efectividad de un programa de atención integrada y proactiva para adecuar el uso de recursos sanitarios en pacientes crónicos complejos con riesgo de alto consumo según un modelo predictivo basado en morbilidad y utilización previa. Métodos Ensayo clínico controlado aleatorizado con grupo control enmascarado, grupo de intervención parcial informado en la historia clínica y grupo de intervención total informado además a atención primaria, en una organización sanitaria integrada con 128.281 residentes en 2011. Variables dependientes: visitas de atención primaria, urgencias hospitalarias, hospitalización, coste farmacéutico y muerte. Variables independientes: grupo de intervención, edad, sexo, área básica, morbilidad (según grupo de riesgo clínico) y recurrencia como paciente crónico complejo. Análisis bivariado con ANOVA y t de Student, y multivariado mediante regresión logística y regresión lineal múltiple, con un nivel de confianza del 95%. Resultados Se incluyeron 4.236 y 4.223 pacientes crónicos complejos en el primer y el segundo año de intervención, respectivamente. El 72% eran recurrentes. Edad media: 73,2 años. El 54,2% eran mujeres. Más del 70% tenían al menos dos enfermedades crónicas. El número de visitas a atención primaria fue significativamente mayor en el grupo de intervención total respecto al grupo de intervención parcial y el grupo control. La intervención solo tuvo un efecto significativo independiente en las estancias hospitalarias, que fueron menos en el grupo de intervención parcial. Este efecto diferencial se dio en el primer año y en los pacientes crónicos complejos nuevos del segundo año. Los indicadores asistenciales generales de la organización sanitaria integrada eran buenos, antes y durante la intervención. Conclusiones Una buena situación general previa y mantenida, y una inevitable contaminación entre grupos, dificultaron la demostración de efectividad marginal del programa
2018-01-01T00:00:00ZA 14-Year Longitudinal Analysis of Healthcare Expenditure on Dementia and Related Factors (DEMENCOST Study)Inoriza, José MaríaCarreras Pijuan, MarcCoderch, JordiTurró Garriga, OriolSáez Zafra, MarcGarre Olmo, Josephttp://hdl.handle.net/10256/241832024-01-30T09:54:37Z2023-08-29T00:00:00ZA 14-Year Longitudinal Analysis of Healthcare Expenditure on Dementia and Related Factors (DEMENCOST Study)
Inoriza, José María; Carreras Pijuan, Marc; Coderch, Jordi; Turró Garriga, Oriol; Sáez Zafra, Marc; Garre Olmo, Josep
Background: The large number of dementia cases produces a great pressure on health and social care services, which requires efficient planning to meet the needs of patients through infrastructure, equipment, and financial, technical, and personal resources adjusted to their demands. Dementia analysis requires studies with a very precise patient characterization of both the disease and comorbidities present, and long-term follow-up of patients in clinical aspects and patterns of resource utilization and costs generated. Objective: To describe and quantify direct healthcare expenditure and its evolution from three years before and up to ten years after the diagnosis of dementia, compared to a matched group without dementia. Methods: Retrospective cohort design with follow-up from 6 to 14 years. We studied 996 people with dementia (PwD) and 2,998 controls matched for age, sex, and comorbidity. This paper adopts the provider's perspective as the perspective of analysis and refers to the costs actually incurred in providing the services. Aggregate costs and components per patient per year were calculated and modelled. Results: Total health expenditure increases in PwD from the year of diagnosis and in each of the following 7 years, but not thereafter. Health status and mortality are factors explaining the evolution of direct costs. Dementia alone is not a statistically significant factor in explaining differences between groups. Conclusion: The incremental direct cost of dementia may not be as high or as long as studies with relatively short follow-up suggest. Dementia would have an impact on increasing disease burden and mortality
2023-08-29T00:00:00ZEstimating lifetime healthcare costs with morbidity dataCarreras Pijuan, MarcIbern, PereCoderch, JordiSánchez Pérez, InmaInoriza, José Maríahttp://hdl.handle.net/10256/241752024-01-29T16:32:58Z2013-10-25T00:00:00ZEstimating lifetime healthcare costs with morbidity data
Carreras Pijuan, Marc; Ibern, Pere; Coderch, Jordi; Sánchez Pérez, Inma; Inoriza, José María
Background: In many developed countries, the economic crisis started in 2008 producing a serious contraction of the financial resources spent on healthcare. Identifying which individuals will require more resources and the moment in their lives these resources have to be allocated becomes essential. It is well known that a small number of individuals with complex healthcare needs consume a high percentage of health expenditures. Conversely, little is known on how morbidity evolves throughout life. The aim of this study is to introduce a longitudinal perspective to chronic disease management. Methods: Data used relate to the population of the county of Baix Empordà in Catalonia for the period 2004-2007 (average population was N = 88,858). The database included individual information on morbidity, resource consumption, costs and activity records. The population was classified using the Clinical Risk Groups (CRG) model. Future morbidity evolution was simulated under different assumptions using a stationary Markov chain. We obtained morbidity patterns for the lifetime and the distribution function of the random variable lifetime costs. Individual information on acute episodes, chronic conditions and multimorbidity patterns were included in the model. Results: The probability of having a specific health status in the future (healthy, acute process or different combinations of chronic illness) and the distribution function of healthcare costs for the individual lifetime were obtained for the sample population. The mean lifetime cost for women was 111,936, a third higher than for men, at 81,566 (all amounts calculated in 2007 Euros). Healthy life expectancy at birth for females was 46.99, lower than for males (50.22). Females also spent 28.41 years of life suffering from some type of chronic disease, a longer period than men (21.9). Conclusions: Future morbidity and whole population costs can be reasonably predicted, combining stochastic microsimulation with a morbidity classification system. Potential ways of efficiency arose by introducing a time perspective to chronic disease management
2013-10-25T00:00:00Z