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Healthcare continuity and management of chronic diseases
When several diseases coexist in the same patient (comorbidities), care management becomes substantially more complex. In general, there is a growing interest in the measurement of complexity and chronicity in diseases involving multiple organs and systems.
Use of healthcare services
In Spain, which has high life expectancy, an aging population, and universal health care free at the point of use, both the number of persons with multiple comorbidities and the health costs attributable to them are rising sharply. The concept of integrated care has not formed part of the outlook of the Spanish health system. However, rising costs and increasing demand may be changing these attitudes.
The fragility - geriatrics - dependency - home care axis
The elderly population will increase in forthcoming decades, making frailty an increasing public health problem. There is evidence of the benefit of isolated or multifactorial interventions on frail individuals, but there is little evidence of comprehensive interventions performed in pre-frail community-dwelling patients.
Use of medicines
Irrational use of medicines is a major problem worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly. The overuse, underuse or misuse of medicines results in wastage of scarce resources and widespread health hazards.
Primary care and autoimmunity
Systemic autoimmune diseases (SADs) are a significant cause of morbidity and mortality worldwide, although their epidemiological profile varies significantly country by country. Epidemiologically, most SADs are classified as rare diseases (frequency 5 cases per 10,000 people). SADs are characterized by a wide spectrum of demographic patterns with respect to the age at diagnosis, gender distribution and ethnic differences. Studying the distribution of these diseases across various geographic regions and ethnic groups may help advance our understanding of the corresponding genetic and environmental underpinnings.
Atherogenesis, risk factors and cardiovascular diseases
Hypertension (HT), smoking, and hypercholesterolemia are the three most common cardiovascular risk factors in Spain. Prevalence of HT in adults > 18 years is about 38% in men and 28% in women, and these figures increase as the population ages. From a macroeconomic point of view, direct health costs associated with HT account for 2.6% to 3.9% of total health expenditure in Spain. The consequences of such high prevalence are seen at primary care clinics, where HT is one of the leading reasons for consultation.
Chronic widespread pain (CWP) is a health problem worldwide, with a reported prevalence ranging from 4.2% to 13.3%. The multifaceted reality of CWP, together with the social and demographic changes in Spain in recent years and the ongoing debate about health provision and costs, requires deeper analysis of the factors influencing and coexisting with this disorder in real clinical practice to provide solutions.
Mental health, smoking and other addictions
Cigarette smoking is the leading preventable cause of death in many countries. Moreover, smokers are more likely than nonsmokers to develop heart disease, stroke, and lung cancer.
Respiratory diseases are a common health problem. Many times, people are genetically more likely to get respiratory conditions, but work place or environmental exposures could also play a big role. One thing is for sure, smoking is the most common cause of respiratory disease.
Digestive and liver diseases
Digestive and liver diseases are associated with substantial morbidity and mortality in many countries. Statistics about the incidence, prevalence, mortality, and resource utilization of digestive and liver diseases may be cumbersome to obtain because they are scattered in multiple sources and these data may be useful for policy makers, authorities, and governmental institutes.
HIV infection – AIDS and other infectious diseases
The WHO estimates that one-third of patients with HIV infection in Europe are undiagnosed. This leads to transmission of the infection, late diagnoses, a poorer response to treatment, increased morbidity and mortality, and higher healthcare costs. Opportunities for HIV screening remain abundant and strategies to broaden HIV testing are needed.
The widespread of mobile smartphones among the population has resulted in a growing range of mobile applications in health using iOS and Android devices. The level of confidence that such applications deserve and the health information available online to the general population is a widely debated issue.