The use of cost per life year gained as a measurement of cost-effectiveness in Spain: a systematic review of recent publications

The objective of this study was to evaluate the methodological characteristics of cost-effectiveness evaluations carried out in Spain, since 1990, which include LYG as an outcome to measure the incremental cost-effectiveness ratio. METHODS: A systematic review of published studies was conducted describing their characteristics and methodological quality. We analyse the cost per LYG results in relation with a commonly accepted Spanish cost-effectiveness threshold and the possible relation with the cost per quality adjusted life year (QALY) gained when they both were calculated for the same economic evaluation. RESULTS: A total of 62 economic evaluations fulfilled the selection criteria, 24 of them including the cost per QALY gained result as well. The methodological quality of the studies was good (55%) or very good (26%). A total of 124 cost per LYG results were obtained with a mean ratio of 49,529 and a median of 11,490 (standard deviation of 183,080). Since 2003, a commonly accepted Spanish threshold has been referenced by 66% of studies. A significant correlation was found between the cost per LYG and cost per QALY gained results (0.89 Spearman-Rho, 0.91 Pearson). CONCLUSIONS: There is an increasing interest for economic health care evaluations in Spain, and the quality of the studies is also improving. Although a commonly accepted threshold exists, further information is needed for decision-making as well as to identify the relationship between the costs per LYG and per QALY gained

Neandertal spatial patterns and occupation dynamics: a regional focus on the central region in Mediterranean Iberia

En el siguiente trabajo se estudian varios conjuntos pertenecientes al Paleolítico medio procedentes del mediterráneo peninsular ibérico con el objetivo de examinar los patrones de ocupación y las estrategias de gestión del territorio. Se presta especial atención al abastecimiento de las materias primas y los comportamientos tecnológicos, los datos procedentes de la fauna y los análisis microespaciales. La variabilidad en los tipos de ocupación de los distintos conjuntos nos muestra una gran diversidad y una multitud de factores, aunque no parece tener una sola explicación cultural, funcional, temporal o ambiental. Más bien son explicaciones que responden a una amplia variabilidad en los comportamientos técnicos observados y que se explican en función de las propias necesidades de las poblaciones dentro de cada región. Los resultados obtenidos nos permiten analizar los datos y compararlos en el contexto del sudoeste de Europa de cara a elaborar un primer enfoque de las estrategias de subsistencia de los neandertales y su movilidad en una región hasta ahora poco conocida desde este punto de vista.HAR2017-85,153-P/MICINNPROMETEO/2017/060HAR2016-76,760-C3-1-P/MICINNThis paper focuses on the study of some Middle Palaeolithic assemblages from Mediterranean Iberia to examine Neanderthal occupation patterns and territory management strategies, paying special attention to raw material procurement and technological behaviours, zooarchaeological data and microspatial patterning. The site occupation types are variable, and some of the results may have more importance than is immediately apparent, but there does not seem to be a single cultural, functional, temporal or environmental explanation. Rather, the wide variability in the technical behaviours observed can be explained with reference to the particular requirements of the populations in each specific region. The results obtained allow us to interrogate the data and, drawing comparisons with the southwest European context, establish an initial approach to Neanderthal subsistence strategies and mobility in a region so far little known in this regard