Medidas de resultados en salud para el análisis de la eficiencia de las intervenciones sanitarias.Una aplicación a la enfermedad del Parkinson

Abstract

The "New Public Management" approach aims to achieve effective and efficient management of public resources. In that sense, the health sector requires certain tools and analytical techniques to conduct economic evaluations in the best conditions. This thesis examines the importance of measures of health outcomes in patients with Parkinson’s disease for the analysis of the efficiency of health interventions in the Spanish context. Several health-related quality of life questionnaires (EQ-5D-3L, EQ-5D-5L, 15D and SF-6D) and a Parkinson’s disease-specific questionnaire (PDQ-8) were used in a population sample with this disease. In addition, a study on the normative values (according to the questionnaire EQ-5D-5L) was carried out in a representative sample of the Spanish population. The results derived from this thesis allow comparing the quality of life of the Parkinson’s disease patients and general population as well as to differentiate between the different questionnaires, since some of them seem to be more efficient and sensitive in terms of minimum variations of the quality of life and others as regards to symptomatology (measured in this case by the Hoehn & Yahr scale). Likewise, a mapping technique was developed to provide "weights” or “utilities" to the PDQ-8 questionnaire. This technique allows health managers to develop more complete economic evaluations through cost-utility analysis, since they take into account both the years of life gained and the quality of life in that period.