Estimation of lung cancer diagnosis and treatment costs based on a patient-level analysis in Catalonia (Spain)

Background: Assessing of the costs of treating disease is necessary to demonstrate cost-effectiveness and to estimate the budget impact of new interventions and therapeutic innovations. However, there are few comprehensive studies on resource use and costs associated with lung cancer patients in clinical practice in Spain or internationally. The aim of this paper was to assess the hospital cost associated with lung cancer diagnosis and treatment by histology, type of cost and stage at diagnosis in the Spanish National Health Service. Methods: A retrospective, descriptive analysis on resource use and a direct medical cost analysis were performed. Resource utilisation data were collected by means of patient files from nine teaching hospitals. From a hospital budget impact perspective, the aggregate and mean costs per patient were calculated over the first three years following diagnosis or up to death. Both aggregate and mean costs per patient were analysed by histology, stage at diagnosis and cost type. Results: A total of 232 cases of lung cancer were analysed, of which 74.1% corresponded to non-small cell lung cancer (NSCLC) and 11.2% to small cell lung cancer (SCLC); 14.7% had no cytohistologic confirmation. The mean cost per patient in NSCLC ranged from 13,218 Euros in Stage III to 16,120 Euros in Stage II. The main cost components were chemotherapy (29.5%) and surgery (22.8%). Advanced disease stages were associated with a decrease in the relative weight of surgical and inpatient care costs but an increase in chemotherapy costs. In SCLC patients, the mean cost per patient was 15,418 Euros for limited disease and 12,482 Euros for extensive disease. The main cost components were chemotherapy (36.1%) and other inpatient costs (28.7%). In both groups, the Kruskall-Wallis test did not show statistically significant differences in mean cost per patient between stages. Conclusions: This study provides the costs of lung cancer treatment based on patient file reviews, with chemotherapy and surgery accounting for the major components of costs. This cost analysis is a baseline study that will provide a useful source of information for future studies on cost-effectiveness and on the budget impact of different therapeutic innovations in Spain.

Yield in double cropping system as affected by N fertilization rate with pig slurry in a Catalonia dryland region

Intensive swine production is an important agricultural and economical activity in Europe. The high availability of pig slurry (PS) lead to attractive fertilization strategy to reduce costs, therefore is mainly applied as fertilizer in agricultural systems. The optimization N fertilization in these areas should be taken in into to avoid nitrates losses by lixiviation and to achieve maximum efficiency in crop nutrition. Many studies have shown that PS applications can achieve satisfactory yields in different crops by partially or completely replacing synthetic fertilizers. In addition, for the last years, in Northeast Spain (Catalonia) has been widely extended the double-cropping forage system.

Impacts of climate change on water resources in the Mediterranean basin : a case study in Catalonia, Spain

Most climate change projections show important decreases in water availability in the Mediterranean region by the end of this century. We assess those main climate change impacts on water resources in three medium-sized catchments with varying climatic conditions in north-eastern Spain. A combination of hydrological modelling and climate projections with B1 and A2 IPCC emission scenarios is performed to infer future stream flows. The largest reduction (22-48% for 2076-2100) of stream flows is expected in the headwaters of the two wettest catchments, while lower decreases (22-32% for 2076-2100) are expected in the drier one. In all three catchments, autumn and summer are the seasons with the most notable projected decreases in stream flow, 50% and 34%, respectively (2076-2100). Thus, ecological flows might be noticeably impacted by climate change in the catchments, especially in the headwaters of those wet catchments.

Projecte bàsic per a la consolidació de l’accés al pont de maçoneria sobre els FGC entre av. Can Gatxet i l’av. del Carril. Pla de millora de la mobilitat a l’entorn de la cta. de Vallvidrera. Sant Cugat del Vallès.

L’objecte del projecte és la definició de les obres i valoració pressupostària de consolidació de l’accés al pont de maçoneria sobre els FGC que connecta el camí de Can Gatxet i l’Av. del Carril, dintre de l’actuació general de millora de la mobilitat a l’entorn de la carretera de Vallvidrera en l’encreuament amb els FGC a Sant Cugat del Vallès.

Du Pont puhdistus- ja kiilloitusaineita N:o 7

kuv., 14 x 11 cm

Carte géographique representant la Mer Méditerranée où la seconde partie du théatre de la guerre entre les Russes et les Turcs ... avec la Mer Noire où Pont Euxine et une partie de la Province Georgie en Asia

Kartta kuuluu A. E. Nordenskiöldin kokoelmaan

Mi-Carême 1920, char de l'Alimentation [passant sur le pont de la Concorde] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58407

Mi-Carême 1920, char de la Reine des reines [passant sur le pont de la Concorde] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58408

Les vedettes du Rhin où on souscrit à l'emprunt [national, vedettes amarrées près du pont de la Concorde] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58510

Maubeuge, pont du moulin [dégâts dus à la guerre] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59651

Maubeuge, pont du moulin [dégâts dus à la guerre] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59652

Maubeuge, pont du Moulin [dégâts dus à la guerre] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59662

25/7/20, traversée de Paris à la nage [participants posant sur la berge près du pont National de Bercy] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 60194