Person:
Urbanos Garrido, Rosa María

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First Name
Rosa María
Last Name
Urbanos Garrido
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Ciencias Económicas y Empresariales
Department
Economía Aplicada, Pública y Política
Area
Economía Aplicada
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UCM identifierORCIDScopus Author IDDialnet IDGoogle Scholar ID

Search Results

Now showing 1 - 10 of 10
  • Publication
    Decomposing socio-economic inequalities in leisure-time physical inactivity: The case of Spanish children
    (Springer Nature, 2016) Gonzalo Almorox, Eduardo; Urbanos Garrido, Rosa María
    Background: Physical inactivity is associated with an increased risk of all-cause mortality and entails a substantial economic burden for health systems. Also, the analysis of inequality in lifestyles for young populations may contribute to reduce health inequalities during adulthood. This paper examines the income-related inequality regarding leisure-time physical inactivity in Spanish children. Methods: In this cross-sectional study based on the Spanish National Health Survey for 2011-12, concentration indices are estimated to measure socioeconomic inequalities in leisure-time physical inactivity. A decomposition analysis is performed to determine the factors that explain income-related inequalities. Results: There is a significant socioeconomic gradient favouring the better-off associated with leisure-time physical inactivity amongst Spanish children, which is more pronounced in the case of girls. Income shows the highest contribution to total inequality, followed by education of the head of the household. The contribution of several factors (education, place of residence, age) significantly differs by gender. Conclusions: There is an important inequity in the distribution of leisure-time physical inactivity. Public policies aimed at promoting physical activity for children should prioritize the action into the most disadvantaged subgroups of the population. As the influence of determinants of health styles significantly differ by gender, this study points out the need of addressing the research on income-related inequalities in health habits from a gender perspective.
  • Publication
    Medical costs of asbestos-related diseases in Spain between 2004 and 2011
    (National Institute of Industrial Health, 2017) García Gómez, Montserrat; Urbanos Garrido, Rosa María; Castañeda lópez, Rosario; Menéndez Navarro, Alfredo
    The objective of this article was to estimate the medical costs derived from malignant ARD treatment in the Spanish National Health System (NHS) between 2004 and 2011. Estimation of direct healthcare costs was based on national primary data on the cost of specialized care for inpatients and outpatients treated at NHS hospitals and on national and regional secondary data on costs of primary healthcare and pharmaceutical prescriptions. A prevalence approach was used to estimate the overall burden of ARDs. Direct medical costs of 37,557 ARDs attended in Spanish NHS facilities in 2004 – 2011 were estimated at 464 million euros; specialist care accounted for 50.9% of total costs, primary healthcare 10.15%, and drug prescription 38.9%. The cost was 27.8-fold higher in males than in females. Bronchopulmonary cancers represented the greatest healthcare cost, 281 million euros. The cost of delivering healthcare to ARDs victims in Spain has a negative economic impact on the NHS due to the gross under-recognition of occupational victims under the Spanish National Insurance System.
  • Publication
    La desigualdad en el acceso a las prestaciones sanitarias. Propuestas para lograr la equidad
    (ELSEVIER, 2016) Urbanos Garrido, Rosa María
    El artículo pone de manifiesto la presencia de desigualdades en el acceso a las prestaciones sanitarias, que pueden calificarse de indeseables y evitables. Entre ellas, las relacionadas con la cobertura de necesidades, la dificultad para completar tratamientos médicos como consecuencia de dificultades económicas, o las desigualdades en los tiempos de espera y en el uso de servicios a igual necesidad. Una parte importante de las desigualdades parece haberse incrementado como consecuencia de las medidas adoptadas frente a la crisis. Las propuestas para lograr la equidad afectan a distintos ejes del Sistema Nacional de Salud: entre otros, la definición del aseguramiento, el reparto de costes entre aseguradores y asegurados, la distribución de competencias entre atención primaria y especializada, la gestión clínica y la producción y la difusión de información para favorecer la toma de decisiones de autoridades sanitarias, profesionales y ciudadanía. Además, se recomienda prestar especial atención a colectivos específicos particularmente vulnerables.
  • Publication
    The influence of the economic crisis on the association between unemployment and health: an empirical analysis for Spain
    (Springer Verlag, 2015-03) Urbanos Garrido, Rosa María; Lopez Valcarcel, Beatriz G.
    To estimate the impact of (particularly longterm) unemployment on the overall and mental health of the Spanish working-age population and to check whether the effects of unemployment on health have increased or been tempered as a consequence of the economic crisis. Methods We apply a matching technique to cross-sectional microdata from the Spanish Health Survey for the years 2006 and 2011–2012 to estimate the average treatment effect of unemployment on self-assessed health (SAH) in the last year, mental problems in the last year and on the mental health risk in the short term. We also use a differences-in-differences estimation method between the two periods to check if the impact of unemployment on health depends on the economic context.
  • Publication
    What to expect from assisted reproductive technologies? Experts' forecasts for the next two decades
    (Elsevier Inc., 2019-08-30) Alon, Ido; Guimón, José; Urbanos Garrido, Rosa María
    In recent years, In-Vitro Fertilization (IVF), Pre-implantation Genetic Diagnosis (PGD) and genetic engineering (GE) have developed substantially, raising hopes but also concerns. Relying on a panel of experts, this article explores expected scenarios related to the evolution of Assisted Reproductive Technologies (ART), thus helping to ascertain which expectations might materialize over the next twenty years. We use the Delphi method, whereby forecasts are extracted from a survey, and combine it with in-depth interviews with experienced doctors and geneticists in Israel and Spain. Our results reveal prospects for an increase in birth rates per InVitro Fertilization (IVF) cycle, an improvement in treatment quality, and advances in reproductive genetics. Experts predict that within 20 years, 14-19% of births in their countries will result from IVF, among which 34-47% will involve PGD. However, they remain skeptic regarding the increase in the number of oocytes required for an expanded PGD, thus skeptic regarding inflated hopes or dystopian scenarios and indicating that GE by CRISPR/Cas could set the tone. We conclude that ART’s market development in the next two decades will continue to be mainly linked to growing infertility rates and improvement in outcomes, while reproductive genetics will advance but remain secondary.
  • Publication
    Sostenibilidad del sistema sanitario y contribución de los servicios de urgencias
    (Grupo Saned, 2015-06) Urbanos Garrido, Rosa María; López-Valcárcel, Beatriz G.
    El objetivo del artículo consiste en describir las principales propuestas orientadas a garantizar la sostenibilidad del Sistema Nacional de Salud (SNS), a partir de la revisión de los informes de diagnóstico y recomendaciones más relevantes que han sido publicados desde el comienzo de la crisis. Entre las propuestas más recurrentes aparecen la financiación selectiva de las tecnologías, la reorganización hacia una mayor atención a la cronicidad y una mejor coordinación entre niveles asistenciales y con la red sociosanitaria, y el impulso de la atención primaria. También abundan las relativas a la reforma del gobierno de la sanidad. Asimismo, el artículo examina brevemente las medidas adoptadas hasta el momento con el fin de reforzar la sostenibilidad del sistema, y de qué modo los servicios de urgencia pueden contribuir a este objetivo.
  • Publication
    Changes in income-related inequalities in cervical cancer screening during the Spanish economic crisis: a decomposition analysis
    (Springer Nature, 2018) Merino-Ventosa, María; Urbanos Garrido, Rosa María
    Background: Cervical cancer is one of the most prevalent cancers, but it may be prevented by early detection. Social inequalities in the use of cytology testing have been identified in the literature. However, the degree of income-related inequality has not been quantified and determinants of inequality changes during the economic crisis remain unknown. Methods: Using the Spanish National Health Surveys (2006–07 / 2011–12), we analyzed how income-related inequalities in the use of cervical cancer screening for women aged 25–64 changed across the economic crisis. We used corrected concentration indices (CCI) which were further decomposed in order to compute the contribution of the explanatory variables. An Oaxaca-type approach was employed to investigate the origin of changes over time. Results: Our final sample consisted of 10,743 observations in 2006–07 and 6587 in 2011–12. Despite the higher prevalence of screening over time (from 73.9 to 77.9%), pro-rich inequality significantly increased (from CCI = 0.1726 to CCI = 0.1880, p < 0.001). Income was the main determinant of inequality in cervical screening, although its contribution decreased over time, as well as the contribution of the type of health insurance, mainly due to changes in elasticity. Other factors, such as nationality or the educational level, seem to have played an important role in the increase of pro-rich inequality of cytology testing. Conclusions: Reducing cervical screening inequalities would require actions focused on most vulnerable groups such as migrants, low income and low educated population. The implementation of population-based screening programs would also help to cope with income-related inequalities in cytology testing.
  • Publication
    Disentangling effects of socioeconomic status on obesity: A cross-sectional study of the Spanish adult population
    (ELSEVIER, 2016) Merino Ventosa, María; Urbanos Garrido, Rosa María
    This paper complements previous estimations regarding socioeconomic inequalities in obesity for Spanish adults, and provides new evidence about the mechanisms through which socioeconomic status (SES) affects obesity. Microdata from the Spanish National Health Survey (SNHS) 2011–2012 are analysed. Corrected concentration indices (CCI) are calculated to measure inequality. Path analysis is employed to disentangle direct and indirect effects of SES on obesity, where dietary patterns, physical activity and sleep habits act as mediator variables. Multivariate logistic models are used to select those exogenous variables to be included in the path diagram. Men and women are analysed separately. Our results show significant pro-rich inequality in the distribution of obesity (the poorer the more obese), particularly for women (CCI = -0.070 for men, CCI = -0.079 for women). The indirect effects of SES on obesity (those transmitted via mediator variables) are quite modest (3.3% for males, 2.4% for females) due to three reasons. Firstly, dietary habits do not show a significant mediating effect. Secondly, the mediating effect of physical activity in leisure time, although significant (14% for males, 11.1% for females), is offset by that related to main activity. Finally, sleep habits contribution to total effect of SES on obesity is statistically significant but small (roughly 1%). Our results indicate that promoting physical activity in leisure time for those with a low SES, particularly for men, would contribute to prevent obesity and to reduce health inequalities. Promotion of adequate sleep habits for women with a low SES might have a similar effect. However, interventions aimed to reduce sedentarism related to main activity, although useful to prevent obesity, would amplify the obesity socioeconomic gradient. Since effects of SES are different for men and women, socioeconomic health inequalities should be addressed also from a gender perspective.
  • Publication
    Regulatory responses to assisted reproductive technology: a comparative analysis of Spain and Israel
    (Springer New York LLC, 2019-07-25) Alon, Ido; Guimón, José; Urbanos Garrido, Rosa María
    Purpose: The market of assisted reproductive technologies (ARTs) is rapidly evolving, raising growing ethical and social dilemmas. This paper compares the regulatory responses to technological and market developments in Israel and Spain, both intensive users of ART. We identify strengths and deficiencies in the regulation of ART in these two countries. Methods: We developed a conceptual framework to classify the factors affecting regulations and priority setting, and applied it using a Delphi survey combined with in-depth interviews. We selected two panels of experts from various fields, trying to simulate the bioethics committees of Israel and Spain. Results: ART is often wrongfully perceived as a solution to age-related infertility. Both panels embraced alternative solutions. The impact of private commercial interest on regulations is resulting in excessive practices such as the repeat of ineffective cycles and the push of sometimes unnecessary treatment add-ons. Our findings show experts dissatisfaction with the regulations of donor-eggs concerning reimbursement and registries in both countries. Conclusions: The adequacy of ART to solve age-related infertility should be confronted with alternative approaches, with emphasis on the distribution of accurate information. The magnitude of ART markets, particularly the use of donor-eggs, should raise the need for additional societal debate and the reform of regulations. The impact factors analysis leads us to question the current regulatory framework, which could be improved by nominating a non-governmental statutory central regulatory agency in Israel and by reforming the Spanish agency. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.
  • Publication
    Estimating direct effects of parental occupation on Spaniards’ health by birth cohort
    (Springer Nature, 2017) Pinilla, Jaime; López Valcarcel, Beatriz G; Urbanos Garrido, Rosa María
    Background: Social health inequalities in adult population are partly due to socioeconomic circumstances in childhood. A better understanding of how those circumstances affect health during adulthood may improve the opportunities for reducing health disparities. The objective of this study is to investigate the effect of parental socioeconomic status, which is proxied by occupation, on adult Spaniards’ health by birth cohort. The analysis will allow checking not only the direct impact of parental occupation on their offspring’s health, but also whether inherited inequality has been reduced over time. Methods: We use data from the Bank of Spain’s Survey of Household Finances on Spanish households from 2002 to 2008. Sequential models were used to estimate the influence of the father’s and mother’s occupation on their offspring’s health, trying to disentangle direct from indirect effects. With a sample of 26,832 persons we consider effects for four different cohorts by birth periods ranging from 1916 to 1981. Results: The results show that parental occupation has a significant direct impact on individuals’ health (p < 0.01). The effect of father’s occupation exceeds that of mother’s. For those born before 1936, the probability of reporting a good health status ranges from 0.31 (95% confidence interval (CI) 0.14–0.48), when fathers were classified as unskilled elementary workers, to 0.98 (95% CI 0.98–0.99) when they were managers or mid-level professionals. For those born during the period 1959–1975, those probabilities are 0.49 (95% CI 0.39–0.59) and 0.97 (95% CI 0.96–0.98), respectively. Therefore, health inequalities linked to parental socioeconomic status have been noticeably reduced, although discrimination against unskilled workers persists over time. Conclusions: Great progress has been made in the health area during the twentieth century, so that the impact of parental socioeconomic status on individuals’ health has been significantly tempered for those at the bottom of the social scale. However, more efforts focused on the improvement of living conditions for most socioeconomically disadvantaged are needed in order to further reduce social inequalities in health.