Examinando por Autor "Ariza-Cardiel, Gloria"

Mostrando 1 - 5 de 5

Health condition and risk attitude in the Dutch population: an exploratory approach
(Taylor & Francis, 2018-03-30) Martín Fernández, Jesús; Medina-Palomino, Héctor; Ariza-Cardiel, Gloria; Polentinos-Castro , Elena; Rutkowski, Anne
Abstract Risk is a central aspect of health condition because attitudes towards risk may influence the inclination to adopt behaviours that can influence health condition. Taking preventive health care measures or purchasing a private health insurance are examples of decisions individuals make based on their preferences. This study analysed the relationship between health condition and behaviour under conditions of uncertainty and examined personal characteristics related to risk behaviour. Data was obtained from a survey on a representative sample of the Dutch adult population (n = 2,822) conducted between May and June of 2014. Risk attitude was assessed through a self-reported scale and risk behaviours through a simulated lottery game, both included in the same survey. The relationship between risk attitudes and behaviours was examined, as well as certain socio-economic variables, including health condition, demographic characteristics, social status, and confidence in government institutions. Surveyed participants perceived themselves as risk-avoiding. However, their behaviour tended to be risk-seeking when playing lottery games, even when they faced potential (but limited) economic losses. Participants with poorer mental health condition tended to be less risk-inclined, which was not the case for participants who reported poor general health status. Participants feeling a higher satisfaction with their lives were willing to take greater risks in the lottery games. These findings allow for understanding risk behaviour as the interaction between personal perception of risk attitude and the assessment of risk associated to a specific situation. This assessment may be directly modulated by one’s state of mind and not by physical health condition.
Impact of hypertension diagnosis on morbidity and mortality: a retrospective cohort study in primary care.
(Springer Nature, 2023-03) Martín Fernández, Jesús; Alonso-Safont, Tamara; Polentinos-Castro, Elena; Esteban-Vasallo, María Dolores; Ariza-Cardiel, Gloria; González-Anglada, Mª Isabel; Sánchez-Perruca, Luis; Rodríguez-Martínez, Gemma; Rotaeche-del-Campo, Rafael; Bilbao-González, Amaia
Background: Hypertension is responsible for a huge burden of disease. The aim of this study was to evaluate the impact of newly diagnosed hypertension on the occurrence of kidney or cardiovascular events (K/CVEs) and on mortality among community dwellers. Methods: Retrospective cohort study, conducted from January, 2007, to December, 2018. All patients (age > 18) newly diagnosed with hypertension and no previous K/CVEs in 2007 and 2008, in the primary care centers of Madrid (Spain) (n = 71,770), were enrolled. The control group (n = 72,946) included patients without hypertension, matched by center, sex and age. The occurrence of kidney or CV events, including mortality from these causes and total mortality were evaluated using Cox regression and multistate models. Data were collected from three sources: personal data from administrative records, clinical data from medical records, and mortality data from regional and national databases. Results: The median follow-up was 138.61 months (IQR: 124.68-143.97 months). There were 32,896 K/CVEs (including 3,669 deaths from these causes) and 12,999 deaths from other causes. Adjusted for sex, smoking, diabetes and socioeconomic status, K/CVEs HR was 4.36 (95% CI: 3.80-5.00) for diagnoses before 45 years of age, 2.45(95% CI: 2.28- 2.63) for diagnosis between 45 to 54 years, and HR decreased to 1.86 (95% CI: 1.64-210) for diagnoses over age 85. Total mortality risk was only higher for hypertension diagnosed before 55 years of age (HR: 2.47, 95% CI: 1.90-3.19 for ages 18 to 44; and HR: 1.14, 95% CI: 1.02-1.28 for ages 45 to 54). Conclusion: The diagnosis of hypertension in the community environment, in patients without evidence of previous kidney or CV disease, is associated with a large increase in the risk of K/CVEs, but especially in individuals diagnosed before the age of 55. This diagnosis is only associated with an increase in kidney or cardiovascular mortality or overall mortality when it occurs before age 55.
Impact of lower limb osteoarthritis on health-related quality of life: A cross-sectional study to estimate the expressed loss of utility in the Spanish population
(Public Library of Science, 2020-01-24) Martín Fernández, Jesús; García-Maroto, Roberto; Bilbao, Amaia; García-Pérez, Lidia; Gutiérrez-Teira, Blanca; Molina-Siguero, Antonio; Arenaza, Juan Carlos; Ramos-García, Vanesa; Rodríguez-Martínez, Gemma; Sánchez-Jiménez, Fco Javier; Ariza-Cardiel, Gloria
Objective: Osteoarthritis of the lower limb (OALL) worsens health-related quality of life (HRQL), but this impact has not been quantified with standardized measures. We intend to evaluate the impact of OALL on HRQL through measures based on individual preferences in comparison to the general population. Methods: A cross-sectional study was designed. A total of 6234 subjects aged 50 years or older without OALL were selected from the Spanish general population (National Health Survey 2011-12). An opportunistic sample of patients aged 50 years or older diagnosed with hip (n = 331) or knee osteoarthritis (n = 393), using the American Rheumatism Association criteria, was recruited from six hospitals and 21 primary care centers in Vizcaya, Madrid and Tenerife between January and December 2015. HRQL was measured with the EQ-5D-5L, and the results were transformed into utility scores. Sociodemographic variables (age, sex, social group, cohabitation), number of chronic diseases, and body mass index were considered. The clinical stage of OALL was collected using the Western Ontario and McMaster Universities Osteoarthritis Index and the Oxford hip score and Oxford knee score. Generalized linear models were constructed using the utility index as the dependent variable. Results: HRQL expressed by OALL patients was significantly worse than this of the general population. After adjustment for sociodemographic and clinical characteristics, the mean utility loss was -0.347 (95% CI: -0.390, -0.303) for osteoarthritis of the hip and -0.295 (95% CI: -0.336, -0.255) for osteoarthritis of the knee. OALL patients who were treated at a hospital had an additional utility loss of -0.112 (95% CI: -0.158, -0.065). Conclusion: OALL has a great impact on HRQL. People with OALL perceive a utility loss of approximately 0.3 points compared to the general population without osteoarthritis, which is very high in relation to the utility loss reported for other chronic diseases and for arthritis in general.
Mapping WOMAC Onto the EQ-5D-5L Utility Index in Patients With Hip or Knee Osteoarthritis
(Elsevier, 2020-03) Bilbao, Amaia; Martín Fernández, Jesús; García-Pérez, Lidia; Arenaza, Juan Carlos; Ariza-Cardiel, Gloria; Ramallo-Fariña, Yolanda; Ansola, Laura
Objectives: To map the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) onto the EQ-5D-5L in patients with hip or knee osteoarthritis (OA). Methods: A prospective observational study was conducted on 758 patients with hip or knee OA who completed the EQ-5D-5L and WOMAC questionnaires, of whom 644 completed them both again 6 months later. Baseline data were used to derive mapping functions. Generalized additive models were used to identify to which powers the WOMAC subscales should be raised to achieve a linear relationship with the response. For the modeling, general linear models (GLM), Tobit models, and beta regression models were used. Age, sex, and affected joints were also considered. Preferred models were selected based on Akaike and Bayesian information criteria, adjusted R2, mean absolute error (MAE), and root mean squared error (RMSE). The functions were validated with the follow-up data using MAE, RMSE, and the intraclass correlation coefficient. Results: The preferred models were a GLM with Pain2+Pain3+Function+Pain·Function as covariates and a beta model with Pain3+Function+Function2+Function3 as covariates. The adjusted R2 were similar (0.6190 and 0.6136, respectively). The predictive performance of these models in the validation sample was similar and both models showed an overprediction for health states worse than death. Conclusion: To our knowledge, these are the first functions mapping the WOMAC onto the EQ-5D-5L in patients with hip or knee OA. They showed an acceptable fit and precision and could be very useful for clinicians and researchers when cost-effectiveness studies are needed and generic preference-based health-related quality of life instruments to derive utilities are not available.
Risk aversion, trust in institutions and contingent valuation of healthcare services: trying to explain the WTA-WTP gap in the Dutch population
(Springer Nature, 2021-05) Martín Fernández, Jesús; López-Nicolás, Ángel; Oliva-Moreno, Juan; Medina-Palomino, Héctor; Polentinos-Castro, Elena; Ariza-Cardiel, Gloria
Background: The preferences of citizens are a basic element to incorporate into the decision-making process when planning health policies. Contingent valuation (CV) is a common method for calculating the value for citizens that new technologies, interventions, and the provision of services or policies have. However, choosing the correct CV tool may not be a neutral decision. This work aims to assess the substitution of a healthcare service by comparing valuation differences between the willingness to pay (WTP) for the maintenance of the service versus the willingness to accept compensation (WTA) for its substitution, both of which are related to subject characteristics, with a particular focus on trust in institutions and risk aversion. Methods: A CV study was designed to study Dutch population preferences when physician assistants replace anaesthesiologists. Differences between the distributions of WTA and WTP were compared through full decomposition methods, and conditional quantile regression was performed. Results: Nearly two-thirds of surveyed citizens expressed null values for WTA and WTP. The other third systematically reported a value of WTA higher than that of WTP, which increased further with lower income and the possible presence of a strategic bias. In contrast, being more than 65 years old, having trust in government, and preferring anaesthesiologists decreased the WTA-WTP difference. Risk aversion had no clear association with the WTA-WTP gap. Conclusions: Known differences between the perceived value of health services from the perspective of gains and losses could be related to people's characteristics. Trust in government but not aversion to risk was related to the WTA-WTP differences. Identifying a profile of citizens who are averse to losing health services should be considered when designing and implementing health services or interventions or making disinvestment decisions.