Association between a comprehensive smoking ban and hospitalization for acute myocardial infarction: An observational study in the Autonomous Community of Valencia, Spain.

OBJECTIVE: To assess the association between a comprehensive smoking ban and hospitalization rates for acute myocardial infarction (AMI). METHODS: An observational study was conducted to assess changes in hospital admission rates for AMI in the Autonomous Community of Valencia, Spain (population 5 million), during the period 1995-2013. Law 28/2005 prohibited smoking in all enclosed spaces (public and private), and Law 42/2010 extended the ban to bars and restaurants as well as children's playgrounds and access areas of schools and hospitals. Data on hospital admissions were obtained from the Hospital Discharge Database (CMBD) of the Autonomous Community. Annual hospital admission rates per 100000 population for AMI (ICD-9-CM code 410) for men and women were calculated. RESULTS: Adjusted hospital admission rates per 100000 population for AMI decreased markedly from 141.1 in 2005 to 119.2 in 2007, with a further reduction to 102.9 in 2013. Reductions in hospital admission were recorded in both men and women, but the downward trends were stronger in women. CONCLUSION: The Spanish comprehensive smoking ban was associated with a marked reduction in the adjusted rate of hospital admissions due to AMI in the Autonomous Community of Valencia. This decrease in the number of persons requiring in-patient care due to AMI is important from both a health care and a societal perspective.

[Activities to catch up and Vaccinate the Susceptible Population in Valencian Community, Spain]. / Actividades para captar y vacunar a la población susceptible en la Comunidad Valenciana.

Eliminating measles and rubella and preventing congenital rubella infection plan of WHO highlighted the need to assess vaccination coverage and develop strategies to improve it and eliminate pockets of low immunization coverage. It exists evidence about the potential role of immunization information systems to improve coverage. The aim of this article is to describe the actions taken from the Vaccine Information System of Valencian Community addressed to improve the vaccination coverage. The Vaccine Information System is a comprehensive information system that allows the management of vaccination programs. It is connected to other systems so that decisions related to vaccinations as clinical and epidemiological management is facilitated. Regarding the role in improving vaccination coverage, the Vaccine Information System facilitates the implementation of all alternatives that have been proven effective: calculate coverage and feedback of results, active recruitment, cooperate with the epidemiological surveillance and logistics management of vaccines. We can conclude, therefore, that the Vaccine Information System is a useful tool to improve vaccination coverage and thus contribute to the elimination of measles and rubella.

Pharmacoeconomic assessment of implementing a universal PCV-13 vaccination programme in the Valencian public health system (Spain).

BACKGROUND: Heptavalent pneumococcal conjugate vaccine (PCV-7) was licensed to provide immunity against pneumococcal disease caused by seven serotypes of S. pneumoniae. Thirteen-valent pneumococcal conjugate vaccine (PCV-13) includes 6 additional serotypes for preventing invasive pneumococcal disease. OBJECTIVE: The objective of this study was to estimate the potential health benefits, costs, and cost-effectiveness of vaccination with PCV-13 in the Community of Valencia and to generate valuable information for policy makers at regional and country levels. METHODS: A decision tree was designed to determine the health and economic outcomes in hypothetical cohorts of vaccinated and unvaccinated children followed over their lifetime. Information about disease incidence and serotype distribution were gathered from local databases and from published and unpublished local records. PCV-13 effectiveness was extrapolated from PCV-7 efficacy data. A 5% of herd effect and a serotype replacement of 25% were considered for the base case scenario. Only direct costs were taken into account and results were expressed in terms of life-years gained (LYG) and quality adjusted life years (QALY). RESULTS: Implementing a universal PCV-13 vaccination program in the Community of Valencia would decrease the number of hospital admitted pneumonia to less than 4571 cases while avoiding 310 cases of IPD and 82,596 cases of AOM throughout the cohort lifetime. A total of 190 S. pneumoniae related deaths would be averted over the same period. Total medical costs of non-vaccinating the cohort of newborns would reach up to 403,850.859€ compared to 438,762.712€ that would represent vaccinating the cohort. The incremental cost of vaccinating the children was estimated in 12,794€/LYG and 10,407€/QALY, respectively. CONCLUSIONS: A universal PCV-13 vaccination program in the Community of Valencia would be a cost-effective intervention from the payer perspective after preventing for pneumococcal infections and for decreasing its associated mortality and morbidity.