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      Austerity Policies and Mortality in Spain After the Financial Crisis of 2008

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          Abstract

          Objectives. To analyze mortality in Spain and the United States before and after these countries implemented divergent policies in response to the financial crisis of 2008. Methods. We examined mortality statistics in both countries in the years 2000 to 2015. Spain started austerity policies in 2010. We compared differences in mortality ratios, on the basis of trends and effect size analysis. Results. During 2000 to 2010, overall mortality rates ( r  = 0.98; P  < .001; Cohen’s d  = −0.228) decreased in both countries. In 2011, this trend changed abruptly in Spain, where observed mortality surpassed expected mortality by 29% in 2011 and by 41% in 2015. By contrast, observed mortality surpassed expected mortality in the United States by only 8% in 2015. As the mortality statistics diverged, the effect size greatly increased ( d  = 7.531). During this 5-year period, there were 505 559 more deaths in Spain than the expected number, while in the United States the difference was 431 501 more deaths despite the 7-fold larger population in the United States compared with Spain. Conclusions. The marked excess mortality in 2011 to 2015 in Spain is attributable to austerity policies.

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              Is Open Access

              Measuring and comparing health care waiting times in OECD countries.

              Waiting times for elective treatments are a key health-policy concern in several OECD countries. This study describes common measures of waiting times from administrative data across OECD countries. It focuses on common elective procedures, such as hip and knee replacement, and cataract surgery, where waiting times are notoriously long. It provides comparative data on waiting times across 12 OECD countries and presents trends in waiting times over the last decade. Waiting times appear to be low in the Netherlands and Denmark. In the last decade the United Kingdom (in particular England), Finland and the Netherlands have witnessed large reductions in waiting times which can be attributed to a range of policy initiatives, including higher spending, waiting-times target schemes and incentive mechanisms, which reward higher levels of activity. The negative trend in these countries has, however, halted or reversed in recent years. The analysis also emphasizes systematic differences across different waiting-time measures, in particular between the distribution of waiting times of patients treated versus that of patients on the list. Mean waiting times are systematically higher than median waiting times and the difference can be quantitatively large.
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                Author and article information

                Journal
                American Journal of Public Health
                Am J Public Health
                American Public Health Association
                0090-0036
                1541-0048
                August 2018
                August 2018
                : 108
                : 8
                : 1091-1098
                Affiliations
                [1 ]All authors are with Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain. Antonio Cabrera de León is also with Área de Medicina Preventiva y Salud Pública, Universidad de La Laguna, La Laguna, Spain.
                Article
                10.2105/AJPH.2018.304346
                6050863
                29995474
                0b902617-708d-4119-b304-8456a502e30b
                © 2018
                History

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