Technical efficiency in primary health care: does quality matter?

The accuracy required in the measurement of output is an issue that has as yet still not been satisfactorily addressed in empirical research on efficiency in primary health care. We exploit information retrieved from a newly constructed database (APEX06) for the Spanish region of Extremadura. The richness of our dataset allows us to consider original synthetic measures of output that take into account both the quantity and the quality of services provided by 85 primary care centres (PCCs) in 2006. We provide evidence that neglecting the issue of properly accounting for the quality of health services can lead to misleading results. Our main finding is that adjusting output for quality influences efficiency analysis in three senses. First, inefficiency now explains relatively more of the deviation from the potential output. Second, the average technical efficiency in the sector is lower, while its dispersion among PCCs is significantly higher. And third, the efficiency ranking of the PCCs is also affected.Primary Health Care; Stochastic Frontier Analysis; Technical Efficiency; Quality

The Use of Parametric and Non Parametric Frontier Methods to Measure the Productive Efficiency in the Industrial Sector. A Comparative Study

Parametric frontier models and non-parametric methods have monopolised the recent literature on productive efficiency measurement. Empirical applications have usually dealt with either one or the other group of techniques. This paper applies a range of both types of approaches to an industrial organisation setup. The joint use can improve the accuracy of both, although some methodological difficulties can arise. The robustness of different methods in ranking productive units allows us to make an comparative analysis of them. Empirical results concern productive and market demand structure, returns-to-scale, and productive inefficiency sources. The techniques are illustrated using data from the US electric power industry.Productive efficiency; parametric frontiers; DEA; industrial sector

An active learning experience in regional and urban economics

El objetivo de este trabajo es presentar una experiencia docente encaminada a favorecer el desarrollo de un conjunto de competencias transversales tales como la capacidad de análisis y síntesis, el trabajo en grupo, la comunicación oral y escrita o la capacidad de organización y planificación. La experiencia docente que presentamos se ha llevado a cabo en el ámbito curricular del Grado en Economía impartido en la Facultad de Ciencias Económicas y Empresariales de la Universidad de Extremadura. La metodología de trabajo incluye dos innovaciones docentes significativas: el empleo de técnicas de Aprendizaje Cooperativo y la utilización de Rúbricas para la evaluación de actividades. Los resultados muestran una metodología de enseñanza-aprendizaje con un alto valor añadido.The aim of this paper is to present an educational experience led to promoting the development of a set of generic skills such as the ability to analyze and synthesize, the teamwork, the oral and written communication or the ability to organize and plan. This teaching experience was carried out regarding the Degree in Economics taught at the Faculty of Economics and Business, University of Extremadura. The methodological approach includes two significant educational innovations: the use of Cooperative Learning techniques and the usage of Rubrics for evaluating the activities. The results show a teaching- learning methodology with a high added value.peerReviewe

Far Proximal and Far Distal Tibial Fractures: Management with Intramedullary Nails

Operative treatment of tibial fractures located at the proximal metaphyseal-epiphyseal and distal metaphyseal-epiphyseal areas, including those with articular extensions, is a technical challenge. Common methods for surgical management include plates (locking and nonlocking), external fixation devices, and intramedullary nails. All these methods have shown satisfactory results in terms of quality of reduction and clinical and radiological outcomes. The authors present some technical methods and strategies that have been useful for the surgical approach, reduction, and fixation of these lesions with the use of locked nails

Análisis palinológico del yacimiento arqueológico del Patio de las Doncellas del Real Alcázar de Sevilla

XV lnternational A.P.L.E. Symposium of Palynolog

Preclinical models of congestive heart failure, advantages, and limitations for application in clinical practice.

Congestive heart failure (CHF) has increased over the years, in part because of recent progress in the management of chronic diseases, thus contributing to the maintenance of an increasingly aging population. CHF represents an unresolved health problem and therefore the establishment of animal models that recapitulates the complexity of CHF will become a critical element to be addressed, representing a serious challenge given the complexity of the pathogenesis of CHF itself, which is further compounded by methodological biases that depend on the animal species in use. Animal models of CHF have been developed in many different species, with different surgical procedures, all with promising results but, for the moment, unable to fully recapitulate the human disease. Large animal models often provide a more promising reality, with all the difficulties that their use entails, and which limit their performance to fewer laboratories, the costly of animal housing, animal handling, specialized facilities, skilled methodological training, and reproducibility as another important limiting factor when considering a valid animal model versus potentially better performing alternatives. In this review we will discuss the different animal models of CHF, their advantages and, above all, the limitations of each procedure with respect to effectiveness of results in terms of clinical application.post-print608 K