Nuevo diseño de la Encuesta de Salud de Cataluña (2010-2014): un paso adelante en planificación y evaluación sanitaria / New design of the Health Survey of Catalonia (Spain, 2010-2014): A step forward in health planning and evaluation

Se presenta la génesis de la Encuesta de Salud de Cataluña (2010-2014) con sus submuestras semestrales. Se detallan las características básicas de su diseño muestral polietápico. Entre las ventajas organizativas de esta nueva operación, en comparación con las anteriores, destacan la agilidad en la disponibilidad de datos y la capacidad de monitorización continuada de la población. Se señalan como beneficios la puntualidad en la obtención de indicadores y la posibilidad de introducir nuevos tópicos a través del cuestionario complementario, según las necesidades de información. Como limitación se apunta la mayor complejidad del diseño muestral y la falta de seguimiento longitudinal de la muestra. Se hace hincapié en la necesidad de utilizar ponderaciones adaptadas a las submuestras para el análisis estadístico que emplee microdatos, así como de acumular oleadas si se desea elevar el grado de desagregación del análisis, ya sea en el territorio o por subgrupos de población (AU)

This article presents the genesis of the Health Survey of Catalonia (Spain, 2010-2014) with its semiannual subsamples and explains the basic characteristics of its multistage sampling design. In comparison with previous surveys, the organizational advantages of this new statistical operation include rapid data availability and the ability to continuously monitor the population. The main benefits are timeliness in the production of indicators and the possibility of introducing new topics through the supplemental questionnaire as a function of needs. Limitations consist of the complexity of the sample design and the lack of longitudinal follow-up of the sample. Suitable sampling weights for each specific subsample are necessary for any statistical analysis of micro-data. Accuracy in the analysis of territorial disaggregation or population subgroups increases if annual samples are accumulated (AU)

[New design of the Health Survey of Catalonia (Spain, 2010-2014): a step forward in health planning and evaluation]. / Nuevo diseño de la Encuesta de Salud de Cataluña (2010-2014): un paso adelante en planificación y evaluación sanitaria.

This article presents the genesis of the Health Survey of Catalonia (Spain, 2010-2014) with its semiannual subsamples and explains the basic characteristics of its multistage sampling design. In comparison with previous surveys, the organizational advantages of this new statistical operation include rapid data availability and the ability to continuously monitor the population. The main benefits are timeliness in the production of indicators and the possibility of introducing new topics through the supplemental questionnaire as a function of needs. Limitations consist of the complexity of the sample design and the lack of longitudinal follow-up of the sample. Suitable sampling weights for each specific subsample are necessary for any statistical analysis of micro-data. Accuracy in the analysis of territorial disaggregation or population subgroups increases if annual samples are accumulated.

Características metodológicas de la Encuesta de Salud de Cataluña 2006 / Methodological characteristics of the Catalan Health Survey 2006

La Encuesta de Salud de Cataluña (ESCA) aporta información poblacional imprescindible para la planificación y evalución sanitaria. En la edición de 2006 se entrevistó a 18.126 personas no institucionalizadas. La muestra tiene un diseño complejo con el objetivo de garantizar la representatividad en las áreas geográficas pequeñas que son de interés en la planificación de salud y servicios. Algunas novedades de esta tercera edición son: relevancia otorgada al territorio; adaptación de los cuestionarios a la población entrevistada, e inclusión de nuevos ámbitos temáticos. El artículo presenta aquellos aspectos metodológicos que pueden ser utiles para los usuarios de la ESCA 2006. Concretamente, en el primer apartado de metodología se describe el diseño muestral, los cuestionarios, el trabajo de campo, la formación de los encuestadores, la codificación y control de calidad, y la cesión de los microdatos. En el segundo apartado se presentan las variables compuestas y los instrumentos utilizados y sus referencias. En el tercer apartado se describe la construcción de indicadores, puesto que el diseño muestral condiciona el uso de factores de ponderación y elevación para obtener estimadores representativos (AU)

The Health Survey of Catalonia (ESCA) gives essential population information for health planning and evaluation. On the edition of 2006, 18,126 non-institutionalized persons were interviewed. The sample design is complex with the aim to guarantee the representatively also in small geographic areas with interest in health and service planning. There are certain novelties in the third edition such as the relevance given to the territory, questionnaires adaptations to the interviewed population and new subject areas studied. This paper describes the useful methodological aspects for the ESCA 2006 users. In the first part we describe the sample design, questioners, field work, interviewer’s formation, codification and quality micro data control. In the second part compound variables, used tools and their references are shown. And the third part describes the indicators construction since the sample design determines the use of weighing and elevation factors to obtain representative estimation values (AU)

[Methodological characteristics of the Catalan Health Survey 2006]. / Características metodológicas de la Encuesta de Salud de Cataluña 2006.

The Health Survey of Catalonia (ESCA) gives essential population information for health planning and evaluation. On the edition of 2006, 18,126 non-institutionalized persons were interviewed. The sample design is complex with the aim to guarantee the representatively also in small geographic areas with interest in health and service planning. There are certain novelties in the third edition such as the relevance given to the territory, questionnaires adaptations to the interviewed population and new subject areas studied. This paper describes the useful methodological aspects for the ESCA 2006 users. In the first part we describe the sample design, questioners, field work, interviewer's formation, codification and quality micro data control. In the second part compound variables, used tools and their references are shown. And the third part describes the indicators construction since the sample design determines the use of weighing and elevation factors to obtain representative estimation values.

[Scenarios for the impact of immigration on longevity and dependency among the elderly in the Spanish population]. / Escenarios del impacto de la inmigración en la longevidad y la dependencia de los mayores en la población española.

INTRODUCTION: The composition of the Spanish population has recently changed due to immigration. The present study aimed to estimate the magnitude of change in the calculation of healthy life expectancy and life expectancy in disability, taking the population of foreign residents into account. For this population, there is no information on mortality or the prevalence of disability. MATERIAL AND METHODS: Data were extracted from the 1999 Survey on Disabilities, Handicaps and Health Status to estimate healthy life expectancy and life expectancy in disability using the Sullivan method. Data were taken from the Spanish Statistical Institute and the World Health Organization, Sullivan's method was adapted to the case of two different populations, and possible scenarios were established. RESULTS: The differences between the mortality table estimated for the foreign resident population and that estimated for the Spanish population were considerable and were more evident in women. At 65 years of age and in the worst scenario, which occurs when all the members of the foreign resident population are disabled, life expectancy in disability would be 2 more years for men and 3 more years for women than when the foreign population was not considered. CONCLUSIONS: Our scenarios reveal that the impact of immigration on the calculation of healthy life expectancy and life expectancy in disability is moderate.

Escenarios del impacto de la inmigración en la longevidad y la dependencia de los mayores en la población española / Scenarios for the impact of immigration on longevity and dependency among the elderly in the Spanish population

Introducciónla composición de la población española ha cambiado recientemente debido a la inmigración. En este trabajo se acota la magnitud del cambio que experimenta el cálculo de la esperanza de vida en salud o en discapacidad de la población española al contemplar el colectivo de extranjeros residentes en España, para el que se desconocen la experiencia de mortalidad y las tasas de prevalencia de la discapacidad.Material y métodoscon los datos extraídos de la Encuesta de Discapacidades, Deficiencias y Estado de Salud (EDDES) de 1999, se estima la esperanza de vida en salud y en discapacidad mediante el método de Sullivan. A partir de datos del Instituto Nacional de Estadística (INE) y la Organización Mundial de la Salud (OMS), y adaptando el método de Sullivan para el caso de disponer de dos poblaciones diferenciadas, establecimos distintos escenarios posibles.Resultadoslas diferencias entre la tabla de mortalidad estimada de la población extranjera residente y la tabla de la población española son apreciables y mayores en el caso de las mujeres. A los 65 años, y en el peor de los casos, es decir si toda la población extranjera residente en España fuera discapacitada, la esperanza de vida en discapacidad sería 2 años mayor para los varones y 3 años para las mujeres que cuando no se ha contemplado este colectivo.Conclusioneslos escenarios planteados revelan que la magnitud de variación experimentada por la esperanza de vida y la esperanza de vida en discapacidad es moderada (AU)

IntroductionThe composition of the Spanish population has recently changed due to immigration. The present study aimed to estimate the magnitude of change in the calculation of healthy life expectancy and life expectancy in disability, taking the population of foreign residents into account. For this population, there is no information on mortality or the prevalence of disability.Material and methodsData were extracted from the 1999 Survey on Disabilities, Handicaps and Health Status to estimate healthy life expectancy and life expectancy in disability using the Sullivan method. Data were taken from the Spanish Statistical Institute and the World Health Organization, Sullivan's method was adapted to the case of two different populations, and possible scenarios were established.ResultsThe differences between the mortality table estimated for the foreign resident population and that estimated for the Spanish population were considerable and were more evident in women. At 65 years of age and in the worst scenario, which occurs when all the members of the foreign resident population are disabled, life expectancy in disability would be 2 more years for men and 3 more years for women than when the foreign population was not considered.ConclusionsOur scenarios reveal that the impact of immigration on the calculation of healthy life expectancy and life expectancy in disability is moderate (AU)

[Sociodemographic typologies of individuals with dependence in Spain and healthy life expectancy]. / Tipologías sociodemográficas de individuos con dependencia en España y su supervivencia en estado de salud.

INTRODUCTION: the main objective of this study was to construct indicators that would allow individuals with dependence to be grouped, based on their socioeconomic situation, with special interest in the elderly. MATERIAL AND METHODS: data were taken from the Survey of Disabilities, Deficiencies and Health Status (Spanish National Institute of Statistics). The distinct typologies of dependent individuals were analyzed by means of multivariate statistical techniques. Firstly, the factors that best established differences among individuals with dependence were determined; secondly, the sample was segmented to identify disabled individuals with dependence; and finally, healthy life expectancy and dependent life expectancy after the age of 65 years were calculated for the different groups. RESULTS: the characteristics that best defined individuals with dependence were related to marital status, the care received, economic and work situation, and educational level. With these factors, seven groups for each degree of dependence were defined. The greatest differences in dependent life expectancy were found between pensioners who retired due to age and those who retired due to disability. CONCLUSIONS: the profiles defined and their differences in dependent life expectancy are useful to plan long-term care resources and to quantify the costs of dependency, as well as to create systems that ensure that sufficient resources are used to decrease the differences among the groups of dependent individuals, thus inducing convergence among them.

Tipologías sociodemográficas de individuos con dependencia en España y su supervivencia en estado de salud / Sociodemographic typologies of individuals with dependence in Spain and healthy life expectancy

Introducción: el principal objetivo de este trabajo es la construcción de indicadores que permitan agrupar a los individuos con dependencia en función de su situación sociodemográfica, con especial interés por las personas mayores. Material y métodos: a partir de los datos que ofrece la Encuesta de Discapacidades, Deficiencias y Estado de Salud, del Instituto Nacional de Estadística (INE), y mediante técnicas de estadística multivariante y el análisis de supervivencia, se analizan las distintas tipologías de individuos con dependencia. En primer lugar, se determinan cuáles son los factores sociodemográficos que establecen diferencias entre los individuos con dependencia; en segundo lugar, se segmenta la muestra para encontrar grupos de discapacitados con dependencia. Finalmente, se realiza el cálculo de las esperanzas de vida en salud y en dependencia a partir de los 65 años para los grupos de individuos. Resultados: las características que mejor diferencian a los individuos con dependencia están relacionadas con el estado civil, los cuidados que reciben, la situación económica-laboral y el nivel de estudios que poseen. Con estos factores se determinan y definen 7 grupos para cada grado de dependencia. Referente a la esperanza de vida en dependencia, las mayores diferencias las encontramos entre los jubilados por edad o por invalidez. Conclusiones: los perfiles definidos y sus diferencias en esperanza de vida en situación de dependencia ayudan a la planificación de recursos para los cuidados de larga duración y la cuantificación de los costes de la dependencia, así como la creación de sistemas que aseguren que los recursos disponibles se utilizan para disminuir las diferencias entre los grupos de personas con dependencia, incidiendo en la convergencia entre ellas

Introduction: the main objective of this study was to construct indicators that would allow individuals with dependence to be grouped, based on their socioeconomic situation, with special interest in the elderly. Material and methods: data were taken from the Survey of Disabilities, Deficiencies and Health Status (Spanish National Institute of Statistics). The distinct typologies of dependent individuals were analyzed by means of multivariate statistical techniques. Firstly, the factors that best established differences among individuals with dependence were determined; secondly, the sample was segmented to identify disabled individuals with dependence; and finally, healthy life expectancy and dependent life expectancy after the age of 65 years were calculated for the different groups. Results: the characteristics that best defined individuals with dependence were related to marital status, the care received, economic and work situation, and educational level. With these factors, seven groups for each degree of dependence were defined. The greatest differences in dependent life expectancy were found between pensioners who retired due to age and those who retired due to disability. Conclusions: the profiles defined and their differences in dependent life expectancy are useful to plan long-term care resources and to quantify the costs of dependency, as well as to create systems that ensure that sufficient resources are used to decrease the differences among the groups of dependent individuals, thus inducing convergence among them (AU)

Tasa de dependencia de la población española no institucionalizada y criterios de valoración de la severidad / Dependency Rate among Spain's Non-Institutionalized Population and Criteria for Evaluating Severity

Fundamento: El criterio de valoración del grado de severidad dela dependencia influye en la estimación de los costes de los serviciosde cuidados de larga duración, especialmente en la población de 65 ymás años. El objetivo de este trabajo es analizar las diferencias en latasa de dependencia en personas con discapacidades de carácter permanentedependiendo del criterio de severidad utilizado.Métodos: Se utilizan los datos de la Encuesta sobre Discapacidades,Deficiencias y Estado de Salud recogidos por el InstitutoNacional de Estadística en 1999. Se comparan dos criterios de valoraciónde la severidad de las discapacidades padecidas por un individuo.Se ajusta el logaritmo de las tasas de prevalencia por edad, paracada sexo y se contrasta estadísticamente la existencia de diferenciassignificativas entre los criterios a partir de intervalos de confianza al95%.Resultados: El criterio basado en la máxima severidad (empleadopor el Instituto Nacional de Estadística) infravalora entre 10%-25% el grado de dependencia absoluto medido por el criterio alternativo, sobrevalorando hasta un 25% los grados de dependenciamoderados a partir de los 65 años. En la población masculina esemismo criterio produce una infravaloración del 10% en la dependenciagrave a partir de los 95 años.Conclusiones: El criterio de máxima severidad utilizado por elInstituto Nacional de Estadística infravalora la tasa de dependenciamás grave, especialmente a partir de los 80 años

Background: The criteria for evaluating the degree of severityof dependence has an impact on estimating the costs of the long termcare services, especially among the population over 65 yearsof age. The sensitivity of the dependency rate must be analyzed inview of different definitions of seriousness, whether by the maximumseverity observed in the disability in activities of daily livingor by the number and severity of all these disabilities.Methods: The data from the Disability, Deficiency and HealthCondition Survey conducted by the Spanish National Institute ofStatistics in 1999 are used. A comparison is drawn between two criteriafor evaluating the severity of an individual's disabilities.Models are made with the logarithms of the prevalence rates by age,for each sex, a comparison of the existence of significant differencesbetween these criteria being drawn based on 95% confidence intervals.Results: The criterion based on the maximum severity (employedby the Spanish National Institute of Statistics) underestimatesthe degree of total dependency measured by the alternative criterionby 10%-25%, overestimating the degrees of moderate dependency asof age 65 by up to 25%. Among the male population, this same criteriongives rise the medium dependency as of age 95 being underestimatedby 10%.Conclusions: The maximum severity criterion employed by theSpanish National Institute of Statistics underestimates the mostserious dependency rate, especially as of 80 years of age

[Dependency Rate among Spain's Non-Institutionalized Population and Criteria for Evaluating Severity]. / Tasa de dependencia de la población españolano institucionalizada y criterios de valoración de la severidad.

OBJECTIVE: The criteria for evaluating the degree of severity of dependence has an impact on estimating the costs of the longterm care services, especially among the population over 65 years of age. The sensitivity of the dependency rate must be analyzed in view of different definitions of seriousness, whether by the maximum severity observed in the disability in activities of daily living or by the number and severity of all these disabilities. METHODS: The data from the Disability, Deficiency and HealthCondition Survey conducted by the Spanish National Institute ofStatistics in 1999 are used. A comparison is drawn between two criteriafor evaluating the severity of an individual's disabilities.Models are made with the logarithms of the prevalence rates by age,for each sex, a comparison of the existence of significant differencesbetween these criteria being drawn based on 95% confidence intervals. RESULTS: The criterion based on the maximum severity (employed by the Spanish National Institute of Statistics) underestimates the degree of total dependency measured by the alternative criterion by 10%-25%, overestimating the degrees of moderate dependency as of age 65 by up to 25%. Among the male population, this same criterion gives rise the medium dependency as of age 95 being underestimated by 10%. CONCLUSIONS: The maximum severity criterion employed by the Spanish National Institute of Statistics underestimates the most serious dependency rate, especially as of 80 years of age.

OBJETIVO: El criterio de valoración del grado de severidad de la dependencia influye en la estimación de los costes de los servicios de cuidados de larga duración, especialmente en la población de 65 y más años. El objetivo de este trabajo es analizar las diferencias en la tasa de dependencia en personas con discapacidades de carácter permanente dependiendo del criterio de severidad utilizado. METODOS: Se utilizan los datos de la Encuesta sobre Discapacidades,Deficiencias y Estado de Salud recogidos por el Instituto Nacional de Estadística en 1999. Se comparan dos criterios de valoración de la severidad de las discapacidades padecidas por un individuo. Se ajusta el logaritmo de las tasas de prevalencia por edad, para cada sexo y se contrasta estadísticamente la existencia de diferencias significativas entre los criterios a partir de intervalos de confianza al 95. RESULTADOS: El criterio basado en la máxima severidad (empleado por el Instituto Nacional de Estadística) infravalora entre 10%-25% el grado de dependencia absoluto medido por el criterio alternativo, sobrevalorando hasta un 25% los grados de dependencia moderados a partir de los 65 años. En la población masculina ese mismo criterio produce una infravaloración del 10% en la dependencia grave a partir de los 95 años. CONCLUSIONES: El criterio de máxima severidad utilizado por el Instituto Nacional de Estadística infravalora la tasa de dependencia más grave, especialmente a partir de los 80 años.