A critical view to current economic topics through an Online-Forum activity

[EN] In order to address the critical thinking and the knowledge of contemporary problems an online forum activity is proposed in this paper. The activity was applied within the World Economy subject in the degree of Business Administration.  The main aim of this teaching proposal is to discuss some current issues and events in the international economic context which likely are not addressed in the syllabus. Through an online forum both teacher and pupils posted comments about some relevant topics related with the subject content. Students have the opportunity to express their own opinion and provide additional information and resources such as news links, documentaries, Youtube videos and other kind of audio-visual material. Despite of this activity was non mandatory, the response was positive, high proportion of pupils (67.1%) were involved in it and 877 comments were published. Thus, the result was satisfactory but there was also some aspects to improve. In addition, this activity is suitable for other subjects or even other university degrees as well and can be easily adapted and modificated.Acknowledges to the project EstadísTIC@ i MatemàTIC@, Servei de Formació Permanent i Innovacio Educativa (SFPIE) de la Universitat de València.http://ocs.editorial.upv.es/index.php/HEAD/HEAD18Caballer Tarazona, V.; Caballer Tarazona, M. (2018). A critical view to current economic topics through an Online-Forum activity. Editorial Universitat Politècnica de València. 221-227. https://doi.org/10.4995/HEAD18.2018.7953OCS22122

Rubrics for academic dissertation assessment. Does peer assessment work?

[EN] In the recent context of student-centered learning, they are more involved in the whole learning process, while the teacher is only a guide through their learning. This implies that students must be also involved in the assessment process. Following this idea, the peer assessment tries to give the students the opportunity to be in the evaluator position and maybe experience a reflexion about the criteria, what an external person sees in what he/she has to assess. When students have the role of assessing their classmates work, they pay more attention to the content and formal details of the presentation; therefore they can easily identify key points involved in an academic dissertation. This is a good opportunity to actively learn some basic transversal skills for any kind of presentation. Under this context, we present in this paper a comparison of the marks given by both students and teachers, to the same academic dissertation. In addition, we provide the rubric provided to students as a guide for the assessment. As results show, the students’ final decision to assess their peers’ work is quite close to the teacher’s decision. Only light differences were identified, on average, students gave a slightly higher mark to their classmates than the teacher did. However, a correlation on students and teacher marks was found.Pardo García, C.; Caballer Tarazona, V.; Caballer-Tarazona, M. (2019). Rubrics for academic dissertation assessment. Does peer assessment work?. En INNODOCT/18. International Conference on Innovation, Documentation and Education. Editorial Universitat Politècnica de València. 129-138. https://doi.org/10.4995/INN2018.2018.8835OCS12913

Benford Law to Monitor COVID-19 Registration Data. Comment on Farhadi, N.; Lahooti, H. Forensic Analysis of COVID-19 Data from 198 Countries Two Years after the Pandemic Outbreak. COVID 2022, 2, 472-484

In a recent study published in COVID by Farhadi & Lahooti, 2022 [1], the authors claim that the work carried out by Morillas-Jurado et al., 2022 [2] is an example of a poor application of Benford Law (BL) in the context of pandemic. Morillas-Jurado et al., 2022 examined the COVID-19 epidemic specifically during the first wave of the pandemic and document anomalies in the data that occurred in six Spanish regions. The main argument to Farhadi & Lahooti's criticism is that the regional data sets were too small to assess the conformity of COVID-19 data to BL

Applying Benford's law to monitor death registration data: A management tool for the COVID-19 pandemic.

In Spain, the COVID-19 pandemic has impacted the various regions of the country differently. The availability of reliable and up-to-date information has proved to be fundamental for the management of this health crisis. However, especially during the first wave of the pandemic (February-August 2020), the disparity in the recording criteria and in the timing of providing these figures to the central government created controversy and confusion regarding the real dimension of the pandemic. It is therefore necessary to have objective and homogeneous criteria at the national level to guide health managers in the correct recording and evaluation of the magnitude of the pandemic. Within this context, we propose using Benford's Law as an auditing tool to monitor the reliability of the number of daily COVID-related deaths to identify possible deviations from the expected trend

Modelización económica del ajuste por riesgo del gasto sanitario per cápita segun morbilidad en la Comunidad Valenciana

Introduction Increased life expectancy and the resulting aging population have led to a rise in population with one or more chronic diseases. This creates the need for a more targeted approach to the care and treatment of the chronic and pluripatological patients in the health system. On the economic front, an increasingly aging population and the growing morbidity, coupled with constant innovation in medical technology induce greater healthcare expenditure. For these reasons, in the current backdrop of economic crisis and budgetary constraints as happens in Spain, it is essential to introduce management tools that help improve the efficiency of the health system and enhance quality. In this regard the classification systems of patients are a valid tool that allows health managers to know the morbidity profile of the population served. In this way, it is possible to monitor and control the medical spending and manage health economic resources more appropriately. Within the patient classification system, the Clinical Risk Group (CRG) is a tool that brings the population into different groups depending on the number and severity of chronic conditions in each person, which can be very useful for management and addressing the problem of increased chronicity in Spain. Objective The aim of this PhD thesis is to analyze the explanatory power of the CRG on health expenditure on health department Valencia and establish a system of clinical risk adjustment. Methodology Observational, descriptive, retrospective and cross-sectional study, on total health expenditure, using stratified-predictive-explanatory models. A database of 156,811 inhabitants assigned to the Department of Health of Denia has been available, which included: age, CRG classification group and total health expenditure, among other variables. In the first part of the results, descriptive analysis showing the most relevant information about the total health expenditure in the health department of Denia was performed from different perspectives; type of expenditure, expenditure by demographic and according to the morbidity of the population varibales. In a later phase different econometric models have been iterated: linear regression model by ordinary least squares and generalized linear models, taking as a dependent variable the total sanitary expenditure and as independent variables: age, sex and CRG group. This is made to select the model that best explains the behavior of health expenditure and establish, in this way, a system of risk adjustment. We then compared the values estimated by the different models with the real value, to determine which of them was the most accurate. Results It has been found a high concentration of health spending in a small proportion of the population, namely 70% of health spending was generated by only 27% of the population with the highest morbidity. Econometric models based on CRG has much greater than those based on demographic variables explanatory power. The model greater statistical significance was reached employing the combination of the varibales age, sex, health status and level CRG gravity, coefficient of determination adjusted 41.9% in the case of linear regression and Akaike information criterion of 14.22 in the generalized linear model. In the subsequent verification with actual spending, the generalized linear model showed slightly higher. By type of expenditure, outpatient pharmacy was the highest level of explanation that obtained, while the lowest corresponded to hospital expenditure. Conclusions The CRG is a useful tool to explain the behavior of health spending depending on the morbidity of the population.Introducción El aumento de la esperanza de vida y el consiguiente envejecimiento demográfico, han provocado un incremento de la población con una o más enfermedades crónicas. Este hecho origina la necesidad de un planteamiento del sistema sanitario más orientado al cuidado y el tratamiento de los enfermos crónicos y pluripatológicos. Además, en el plano económico una población cada vez más envejecida y con mayor morbilidad, aunado con una constante innovación de la tecnología médica, inducen a un mayor gasto sanitario. Por estos motivos y ante un contexto de crisis económica y limitación presupuestaria como la que acontece en España, es imprescindible introducir herramientas de gestión que contribuyan a mejorar la eficiencia del sistema sanitario y aumentar la calidad del mismo. En este sentido los sistemas de clasificación de pacientes son una herramienta válida que permite a los gestores sanitarios conocer el perfil de morbilidad de la población atendida. Dentro los sistemas de clasificación de pacientes, los Clinical Risk Group (CRG) son una herramienta que agrupa a población en diferentes grupos en función del número y gravedad de las condiciones crónicas, lo que puede ser de gran utilidad para la gestión y el abordaje del problema del aumento de la cronicidad en España. Objetivo El objetivo de la presente Tesis Doctoral es analizar la capacidad explicativa de los CRG sobre el gasto sanitario en un departamento de salud de la Comunidad Valenciana y establecer un sistema de ajuste por riesgo clínico. Metodología Estudio observacional, descriptivo, retrospectivo y de corte transversal sobre el gasto sanitario total, usando modelos explicativos-predictivos-estratificados. Se ha dispuesto de una base de datos formada por los 156.811 habitantes asignados al Departamento de Denia, en la que constaba: la edad, el grupo de clasificación CRG y el gasto sanitario total, entre otras variables. En la primera parte de los resultados, se ha recogido un análisis descriptivo mostrando la información más relevante acerca del gasto sanitario total en el Departamento de Denia desde diferentes perspectivas: el tipo de gasto y el gasto según las variables demográficas y la morbilidad de la población. En una ulterior fase se ha iterado diferentes modelos econométricos: modelo de regresión lineal por mínimos cuadrados ordinarios y modelos lineales generalizados, tomando como variable dependiente, el gasto sanitario total y como variables independientes: la edad, el sexo y el grupo de pertenencia del CRG, con el fin de seleccionar el modelo que mejor explique el comportamiento del gasto sanitario y establecer, de esta manera, un sistema de ajuste por riesgo. A continuación, se compararon los valores estimados por los distintos modelos con el valor real, para determinar cuál de ellos era el más apropiado. Resultados Se ha comprobado la existencia de una alta concentración del gasto sanitario en una reducida proporción de la población; concretamente el 70% del gasto sanitario fue generado únicamente por el 27% de la población con mayor morbilidad. Los modelos econométricos basados en los CRG tienen una capacidad explicativa mucho mayor que los basados únicamente en variables demográficas. El modelo que mayor significación estadística alcanzó fue el que empleaba la combinación de las variables: edad, sexo, estado de salud CRG y nivel de gravedad, con un coeficiente de determinación ajustado del 41,9% en el modelo de regresión lineal y un criterio de información de Akaike de 14,22 en el modelo lineal generalizado. En la comprobación posterior con el gasto real, el modelo lineal generalizado se mostró ligeramente superior al modelo de regresión lineal. Por tipo de gasto, el gasto en farmacia ambulatoria fue el que mayor nivel de explicación obtuvo, mientras que el menor correspondió al gasto hospitalario. Conclusiones Los CRG son una herramienta útil para explicar el comportamiIntroducció L'augment de l'esperança de vida i el consegüent envelliment demogràfic, han provocat un increment de la població amb una o més malalties cròniques. Aquest fet origina la necessitat d'un plantejament del sistema sanitari més orientat al ciutat i el tractament dels malalts crònics i pluripatològics. A més, en el pla econòmic una població cada vegada més envellida i amb més morbiditat, conjuntament amb una constant innovació de la tecnologia mèdica indueixen a una major despesa sanitària. Per aquests motius i davant un context de crisi econòmica i limitació pressupostària com la que passa a Espanya, és primordial introduir eines de gestió que contribueixin a millorar l'eficiència del sistema sanitari i augmentar la qualitat del mateix. En aquest sentit, els sistemes de classificació de pacients són una eina vàlida que permet als gestors sanitaris conèixer el perfil de morbiditat de la població atesa, per d'aquesta manera, monitoritzar i controlar la despesa sanitaria i adequar i gestionar els recursos econòmics sanitaris d'una manera més apropiada a les necessitats assistencials requerides. Dins dels sistemes de classificació de pacients, els Clinical Risk Group (CRG) són una eina que agrupa a la població en diferents grups en funció del nombre i gravetat de les condicions cròniques que pateix cada individu Objectiu L'objectiu de la present Tesi Doctoral és analitzar la capacitat explicativa dels CRG sobre la despesa sanitària en un departament de salut de la Comunitat Valenciana i establir un sistema d'ajust per risc clínic. Metodologia Estudi observacional, descriptiu, retrospectiu i de tall transversal sobre la despesa sanitària total i aplicabilitat en la gestió clínica usant models explicatius-predictius-estratificats. S'ha comptat amb una base de dades de 156.811 habitants del departament de Dénia en la qual constava l'edat, el grup de classificació CRG i despesa sanitària total, entre altres variales. En una primera part dels resultats, s'ha realitzat una anàlisi descriptiva mostrant la informació més rellevant sobre de la despesa sanitària total en el departament de Dénia des de diferents perspectives; tipus de despesa, despesa segons varibales demogràfiques i segons la morbiditat de la població. En una ulterior fase s'ha iterat diferents models economètrics mitjançant la regressió lineal per mínims quadrats i els models lineals generalitzats, prenent com varibale dependent, la despesa sanitària total i com a variables independents; l'edat, el sexe i el grup de pertinença del CRG per tal d'selecciona el model que millor explique el comportament de la despesa sanitària i establir d'aquesta manera un sistema d'ajust per risc. A continuació es van comparar els valors estimats pels models amb el valor real per a determinar quin dels dos mètodes mètodes és el més apropiat. Resultats S'ha comprovat una alta concentració de la despesa sanitària en una reduïda proporció de la població, concretament el 70% de la despesa sanitària va ser generat per únicament el 27% de la població amb més moribilidad. Els models economètrics basats en els CRG té una capacitat explicativa molt més gran que els basats en variables demogràfiques. El model que més significació estadística aconsegueix va ser el que feia servir la combinació de les varibales edat, sexe, estat de salut CRG i nivell de gravetat amb un coeficent de determinació ajustat del 41,9% en el cas de la regressió lineal i criteri d'informació d'Akaike del 14,22 en el model lineal generalitzat. En la comprobació posterior amb la despesa real, el model lineal generalitzat es va mostrar lleugerament superior. Per tipus de despesa, la farmàcia ambulatòria va ser la que major nivell d'explicació va obtindre, mentre que el menor va correspondre a la despesa hospitalària. Conclusions Els CRG són una eina útil per explicar el comportament de la despesa sanitària en funció de la morbidiCaballer Tarazona, V. (2017). Modelización económica del ajuste por riesgo del gasto sanitario per cápita segun morbilidad en la Comunidad Valenciana [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/78616TESI

Recent trends and status of women in Higher Education in India

[EN] The Indian education system is one of the oldest and largest in the world. Some progress has been made in the field of women’s education. A recent trend shows that a huge number of female students are enrolling into higher education: 79.44 % Undergraduate, 11.39% for Post graduate & 0.72 % for Ph. D. The sex ratio in has increased; Gender Parity Index up to 0.88 in 2012. Women’s enrolment pattern has changed, currently it is much higher in Bachelor of Arts / Science / Commerce / Education than in non-technical / non-professional fields. A similar trend is being seen in Engineering Management and Technology in professional courses with less enrolment of women. This paper is an attempt to present the overall status of women in higher education.Ingole, K.; Gallear, S.; Caballer Tarazona, V. (2015). Recent trends and status of women in Higher Education in India. En 1ST INTERNATIONAL CONFERENCE ON HIGHER EDUCATION ADVANCES (HEAD' 15). Editorial Universitat Politècnica de València. 638-644. https://doi.org/10.4995/HEAD15.2015.541OCS63864

Analysis of hospital costs by morbidity group for patients with severe mental illness

Objectives: The goal of this study is to analyse hospital costs and length of stay of patients admitted to psychiatric units in hospitals in a European region of the Mediterranean Arc. The aim is to identify the effects of comorbidities and other variables in order to create an explanatory cost model. Methods: In order to carry out the study, the Ministry of Health was asked to provide data on access to the mental health facilities of all hospitals in the region. Among other questions, this database identifies the most important diagnostic variables related to admission, like comorbidities, age and gender. The method used, based on the Manning-Mullahy algorithm, was linear regression. The results were measured by the statistical significance of the independent variables to determine which of them were valid to explain the cost of hospitalization. Results: Psychiatric inpatients can be divided into three main groups (psychotic, organic and neurotic), which have statistically significant differences in costs. The independent variables that were statistically significant (p <.05) and their respective beta and confidence intervals were: psychotic group (19,833.0 ± 317.3), organic group (9,878.4 ± 276.6), neurotic group (11,060.1 ± 287.6), circulatory system diseases (19,170 ± 517.6), injuries and poisoning (21,101.6 ± 738.7), substance abuse (20,580.6 ± 514, 6) and readmission (19,150.9 ± 555.4). Conclusions: Unlike most health services, access to psychiatric facilities does not correlate with comorbidities due to the specific nature of this specialization. Patients admitted to psychosis had higher costs and a higher number of average stays

Analysis of hospital costs by morbidity group for patients with severe mental illness

[EN] Objectives The goal of this study is to analyse hospital costs and length of stay of patients admitted to psychiatric units in hospitals in a European region of the Mediterranean Arc. The aim is to identify the effects of comorbidities and other variables in order to create an explanatory cost model. Methods In order to carry out the study, the Ministry of Health was asked to provide data on access to the mental health facilities of all hospitals in the region. Among other questions, this database identifies the most important diagnostic variables related to admission, like comorbidities, age and gender. The method used, based on the Manning-Mullahy algorithm, was linear regression. The results were measured by the statistical significance of the independent variables to determine which of them were valid to explain the cost of hospitalization. Results Psychiatric inpatients can be divided into three main groups (psychotic, organic and neurotic), which have statistically significant differences in costs. The independent variables that were statistically significant (p <.05) and their respective beta and confidence intervals were: psychotic group (19,833.0 +/- 317.3), organic group (9,878.4 +/- 276.6), neurotic group (11,060.1 +/- 287.6), circulatory system diseases (19,170 +/- 517.6), injuries and poisoning (21,101.6 +/- 738.7), substance abuse (20,580.6 +/- 514, 6) and readmission (19,150.9 +/- 555.4). Conclusions Unlike most health services, access to psychiatric facilities does not correlate with comorbidities due to the specific nature of this specialization. Patients admitted to psychosis had higher costs and a higher number of average stays KEY MESSAGES The highest average hospital expenditure occurred in patients admitted for psychotic disorders. Due to the particularities of psychiatry units and unlike other medical specialties, the number of comorbidities did not influence the number of hospital stays or hospital expenditure. Apart from the main diagnostic group, the variables that were useful to explain hospital expenditure were the presence of poisoning and injuries as comorbidity, diseases of circulatory system as comorbidity, history of substance abuse and readmission.Caballer-Tarazona, V.; Zúñiga-Lagares, A.; Reyes Santia, F. (2022). Analysis of hospital costs by morbidity group for patients with severe mental illness. Annals of Medicine. 54(1):858-866. https://doi.org/10.1080/07853890.2022.204888485886654

Predicting healthcare expenditure by multimorbidity groups

[EN] Objectives: This article has two main purposes. Firstly, to model the integrated healthcare expenditure for the entire population of a health district in Spain, according to multimorbidity, using Clinical Risk Groups (CRG). Secondly, to show how the predictive model is applied to the allocation of health budgets. Methods: The database used contains the information of 156,811 inhabitants in a Valencian Community health district in 2013. The variables were: age, sex, CRG's main health statuses, severity level, and healthcare expenditure. The two-part models were used for predicting healthcare expenditure. From the coefficients of the selected model, the relative weights of each group were calculated to set a case-mix in each health district. Results: Models based on multimorbidity-related variables better explained integrated healthcare expenditure. In the first part of the two-part models, a logit model was used, while the positive costs were modelled with a log-linear OLS regression. An adjusted R-2 of 46-49% between actual and predicted values was obtained. With the weights obtained by CRG, the differences found with the case-mix of each health district proved most useful for budgetary purposes. Conclusions: The expenditure models allowed improved budget allocations between health districts by taking into account morbidity, as opposed to budgeting based solely on population size.This work was supported by "Instituto de Salud Carlos III - Ministerio de Economia y Competitividad" and the European Union (FEDER funds) - FIS PI12/00037.Caballer-Tarazona, V.; Guadalajara Olmeda, MN.; Vivas-Consuelo, D. (2019). Predicting healthcare expenditure by multimorbidity groups. Health Policy. 123(4):427-434. https://doi.org/10.1016/j.healthpol.2019.02.002S427434123

Impact of Morbidity on Health Care Costs of a Department of Health through Clinical Risk Groups. Valencian Community, Spain

[ES] Fundamentos: Los sistemas de ajuste de riesgo basados en diagnóstico estratifican la población según la morbilidad observada. El objetivo de este trabajo fue analizar el gasto sanitario total en un área de salud en función de la edad, el sexo y la morbilidad observada en la población. Métodos: Estudio observacional de corte transversal y de ámbito poblacional de los costes de atención sanitaria en el Departamento de salud Dénia-Marina Salud (Alicante) durante el año 2013. Se estratificó a la población (N=156.811) según Grupos de Riesgo Clínico en 9 estados de salud, siendo sano el estado 1 y el 9 el de mayor carga de morbilidad. A cada habitante se le imputaron los costes hospitalarios, de atención primaria y de farmacia ambulatoria para obtener los costes totales. Se analizaron los estados de salud y gravedad por edad y sexo así como los costes de cada grupo. Se aplicaron las pruebas estadísticas t de student y χ2 para verificar la existencia de diferencias significativas entre e intra grupos. Resultados: El coste medio por habitante fue de 983 euros oscilando desde 240 hasta 42.881 en el estado 9 y nivel de gravedad 6. Los pacientes de los estados de salud 5 y 6 realizaron el mayor gasto, pero los estados de salud 8 y 9 tuvieron el mayor gasto medio, siendo el 80% hospitalario. Conclusiones: Se corrobora una diferente composición del gasto sanitario por morbilidad individual, con un crecimiento exponencial del gasto hospitalario.[EN] Background: Risk adjustment systems based on diagnosis stratify the population according to the observed morbidity. The aim of this study was to analyze the total health expenditure in a health area, relating to age, gender and morbidity observed in the population. Methods: Observational cross-sectional study of population and area of health care costs in the Health District of Denia-Marina Salud (Alicante) in 2013. Population (N=156,811) were stratified by Clinical Risk Groups into 9 states of health, state 1 being healthy, and state 9 the highest disease burden. Each inhabitant was charged with the hospital costs, primary care and outpatient pharmacy to obtain the total costs. Health status and severity by age and gender, as well as the costs of each group were analysed. The statistical tests, student t and χ2 were applied to verify the existence of significant differences between and intra groups. Results: The average cost per inhabitant was 983 euros which increased from 240 euros to 42,881 at the state 9 and severity level 6. Patients of health states 5 and 6 caused the largest expenditure by concentration of the population, but health states 8 and 9 had the highest average expenditure, with 80% of hospitalised cost. Conclusions: A different composition of health expenditure per individual morbidity was corroborated, with an exponential growth in hospital spendingCaballer Tarazona, V.; Guadalajara Olmeda, MN.; Vivas Consuelo, DJJ.; Clemente Collado, AC. (2016). Impacto de la morbilidad en los costes asistenciales de un Departamento de Salud de la Comunidad Valenciana a través de estudio de Grupos de Riesgo Clínico. Revista Española de Salud Pública. 90:e1-e15. http://hdl.handle.net/10251/80836Se1e159