Are prescribing doctors sensitive to the price that their patients have to pay in the Spanish National Health System?

[EN] Background This study aims to design an empirical test on the sensitivity of the prescribing doctors to the price afforded for the patient, and to apply it to the population data of primary care dispensations for cardiovascular disease and mental illness in the Spanish National Health System (NHS). Implications for drug policies are discussed. Methods We used population data of 17 therapeutic groups of cardiovascular and mental illness drugs aggregated by health areas to obtain 1424 observations ((8 cardiovascular groups * 70 areas) + (9 psychotropics groups * 96 areas)). All drugs are free for pensioners. For non-pensioner patients 10 of the 17 therapeutic groups have a reduced copayment (RC) status of only 10% of the price with a ceiling of €2.64 per pack, while the remaining 7 groups have a full copayment (FC) rate of 40%. Differences in the average price among dispensations for pensioners and non-pensioners were modelled with multilevel regression models to test the following hypothesis: 1) in FC drugs there is a significant positive difference between the average prices of drugs prescribed to pensioners and non-pensioners; 2) in RC drugs there is no significant price differential between pensioner and non-pensioner patients; 3) the price differential of FC drugs prescribed to pensioners and non-pensioners is greater the higher the price of the drugs. Results The average monthly price of dispensations to pensioners and non-pensioners does not differ for RC drugs, but for FC drugs pensioners get more expensive dispensations than non-pensioners (estimated difference of €9.74 by DDD and month). There is a positive and significant effect of the drug price on the differential price between pensioners and non-pensioners. For FC drugs, each additional euro of the drug price increases the differential by nearly half a euro (0.492). We did not find any significant differences in the intensity of the price effect among FC therapeutic groups. Conclusions Doctors working in the Spanish NHS seem to be sensitive to the price that can be afforded by patients when they fill in prescriptions, although alternative hypothesis could also explain the results found.

An active vision system integrating fast and slow processes

[EN]This paper describes an Active Vision System whose design assumes a distinction between fast or reactive and slow or background processes. Fast processes need to operate in cycles with critical timeouts that may affect system stability. While slow processes, though necessary, do not compromise system stability if its execution is delayed. Based on this simple taxonomy, a control architecture has been proposed and a prototype implemented that is able to track people in real-time with a robotic head while trying to identify the target. In this system, the tracking module is considered as the reactive part of the system while person identification is considered a background task.

A multimedia system to produce and deliver video fragments on demand on parliamentary websites

[EN]Parliamentary websites have become one of the most important windows for citizens and media to follow the activities of their legislatures and to hold parliaments to account. Therefore, most parliamentary institutions aim to provide new multimedia solutions capable of displaying video fragments on demand on plenary activities. This paper presents a multimedia system for parliamentary institutions to produce video fragments on demand through a website with linked information and public feedback that helps to explain the content shown in these fragments. A prototype implementation has been developed for the Canary Islands Parliament (Spain) and shows how traditional parliamentary streaming systems can be enhanced by the use of semantics and computer vision for video analytics...