Mortality and life expectancy trends in Spain by pension income level for male pensioners in the general regime retiring at the statutory age, 2005-2018

Background Research has generally found a significant inverse relationship in mortality risk across socioeconomic (SE) groups. This paper focuses on Spain, a country for which there continues to be very little evidence available concerning retirement pensioners. We draw on the Continuous Sample of Working Lives (CSWL) to investigate disparities in SE mortality among retired men aged 65 and above over the longest possible period covered by this data source: 2005-2018. We use the initial pension income (PI) level as our single indicator of the SE status of the retired population. Methods The mortality gradient by income is quantified in two ways: via an indicator referred to as 'relative mortality', and by estimating changes in total life expectancy (LE) by PI level at ages 65 and 75 over time. We show that, should the information provided by the relative mortality ratio not be completely clear, a second indicator needs to be introduced to give a broad picture of the true extent of inequality in mortality. Results The first indicator reveals that, for the period covered and for all age groups, the differences in death rates across PI levels widens over time. At older age groups, these differences across PI levels diminish. The second indicator shows that disparities in LE at ages 65 and 75 between pensioners in the lowest and highest income groups are relatively small, although slightly higher than previously reported for Spain. This gap in LE widens over time, from 1.49 to 2.54 years and from 0.71 to 1.40 years respectively for pensioners aged 65 and 75. These differences are statistically significant. Conclusions Along with other behavioral and structural aspects, a combination of factors such as the design of the pension system, the universality and quality of the health system, and high levels of family support could explain why LE inequalities for retired Spanish men are relatively small. To establish the reasons for this increased inequality in LE, more research needs to be carried out. An analysis of all Spanish social security records instead of just a sample would provide us with more information

Automatic regrouping of strata in the Goodness-of-Fit chi-square test

Pearson's chi-square test is widely employed in social and health sciences to analyse categorical data and contingency tables. For the test to be valid, the sample size must be large enough to provide a minimum number of expected elements per category. This paper develops functions for regrouping strata automatically, thus enabling the goodness-of-fit test to be performed within an iterative procedure. The usefulness and performance of these functions is illustrated by means of a simulation study and the application to different datasets. Finally, the iterative use of the functions is applied to the Continuous Sample of Working Lives, a dataset that has been used in a considerable number of studies, especially on labour economics and the Spanish public pension system

Análisis de la representatividad de la MCVL: el caso de las prestaciones del sistema público de pensiones

El objetivo de este trabajo es contribuir a aumentar el conocimiento de la Muestra Continua de Vidas Laborales (MCVL) en cuanto a la información sobre prestaciones y advertir de posibles errores que se podrían cometer a la hora de realizar cierto tipo de estudios sobre el sistema público de pensiones. Se analiza el conjunto de datos de prestaciones de la MCVL de 2010 teniendo en cuenta los datos agrupados por tipo de pensión, grupos de edad y género, así como por cuantía. Después de realizar las pruebas estadísticas apropiadas sobre el ajuste de la muestra a la población basada en los datos del Informe Estadístico anual del INSS del mismo año, se concluye que los datos extraídos de la MCVL pueden no ser una fiel réplica de la población objeto de estudio, para cierto tipo de investigaciones, debido a su concepción inicial (Muestra Aleatoria Simple), algunos errores originados en las fuentes administrativas y problemas de reclasificación. Este resultado advierte de las implicaciones que pudiera tener en aquellos estudios que seleccionaran una submuestra de los datos de la MCVL sobre determinado tipo de prestaciones

Improving the representativeness of a simple random sample: an optimization model and its application to the continuous sample of working lives

This paper proposes an optimization model for selecting a larger subsample that improves the representativeness of a simple random sample previously obtained from a population larger than the population of interest. The problem formulation involves convex mixed-integer nonlinear programming (convex MINLP) and is, therefore, NP-hard. However, the solution is found by maximizing the size of the subsample taken from a stratified random sample with proportional allocation and restricting it to a p-value large enough to achieve a good fit to the population of interest using Pearson’s chi-square goodness-of-fit test. The paper also applies the model to the Continuous Sample of Working Lives (CSWL), which is a set of anonymized microdata containing information on individuals from Spanish Social Security records and the results prove that it is possible to obtain a larger subsample from the CSWL that (far) better represents the pensioner population for each of the waves analyzed

Outcome of older (≥70 years) APL patients frontline treated with or without arsenic trioxide-an International Collaborative Study

Data on outcome in older (≥70 years) patients with acute promyelocytic leukemia after treatment with arsenic trioxide (ATO) compared with standard chemotherapy (CTX) is scarce. We evaluated 433 patients (median age, 73.4 years) treated either with ATO+ all-trans retinoic acid (ATO/ATRA; n = 26), CTX/ATRA + ATO during consolidation (CTX/ATRA/ATO; n = 148), or with CTX/ATRA (n = 259). Median follow-up for overall survival (OS) was 4.8 years. Complete remissions (CR) were achieved in 92% with ATO/ATRA and 82% with CTX/ATRA; induction death rates were 8% and 18%, respectively. For analysis of postremission outcomes we combined the ATO/ATRA and CTX/ATRA/ATO groups (ATO/ATRA ± CTX). Cumulative incidence of relapse (CIR) was significantly lower after ATO/ATRA ± CTX compared with CTX/ATRA (P 10 × 10 9 /l) white blood cell (WBC) counts at diagnosis were associated with higher CIR (P < 0.001) compared with lower WBC in the CTX/ATRA group, but not in the ATO/ATRA ± CTX group (P = 0.48). ATO, when added to ATRA or CTX/ATRA is feasible and effective in elderly patients for remission induction and consolidation, particularly in patients with high WBC at diagnosis

Análisis de la efectividad de los Centros de Rehabilitación Psicosocial

Introducción: Los Centros de Rehabilitación Psicosocial para personas con trastorno mental grave son recursos de la red pública de atención social de la Comunidad de Madrid. A pesar de su larga tradición son pocos los estudios que intentan evaluar su efectividad. En el presente trabajo se analizan retrospectivamente los resultados obtenidos en tres dominios centrales en la recuperación: el funcionamiento psicosocial, la calidad de vida y la discapacidad.Material y método: Se analizan las 3173 puntuaciones de 1457 personas atendidas durante 5 años (2008-2012) en 10 Centros de Rehabilitación Psicosocial. Se utilizaron los siguientes instrumentos: cuestionario de datos sociodemográficos y clínicos de elaboración propia, Satisfaction with Life Domain Scale (SLDS), Escala de Evaluación del Funcionamiento Global (EEFG) y WHO Short Disability Assessment Schedule (WHO DAS-S).Resultados: Se observan correlaciones estadísticamente significativas entre todas las medidas de los diferentes instrumentos y la duración de la estancia en los centros, de tal forma que a más tiempo de intervención se obtienen mejores resultados, al menos durante los primeros 5 años. Desagregando los datos por sexo se constata que las mujeres mejoran más y más rápido que los hombres.Conclusiones: Las personas que son atendidas en los Centros de Rehabilitación Psicosocial mejoran en calidad de vida, funcionamientos psicosocial y discapacidad. Esa mejoría es más pronunciada en los primeros cinco a ocho años de intervención y es mayor en mujeres que en hombres