Análisis de los indicadores de calidad entre los diferentes centros públicos españoles en técnicas de reproducción asistida; benchmarking

Romero, Bárbara; Rodríguez-Guirado, Sara; Casas, Ana; Fuente, Laura de la; Martín, B. Sarró; Monzó, Ana; Castell, Ana B.; Sáez, María Jesús; Llaneza, Plácido; Inarra, M.J.; Ortega, Sofía; Castilla, José Antonio

doi:10.1016/j.medre.2019.12.001

Cited by 3 publications

(6 citation statements)

References 29 publications

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“…1 ). Some patients exercise their right for public coverage first, whereas others begin treatment in a private clinic while remaining on the public clinic’s waiting list [ 13 , 48 ]. However, public coverage is limited to three cycles and the average waiting time between cycles is around one year.…”

Section: Discussionmentioning

confidence: 99%

“…We can conclude that, following 36 months, most patients are treated in private clinics, although the gap remains constant. Based on the National Activity Registry by the Spanish Fertility Society (SEF) and as analyzed by Romero et al [ 48 ], we may assume that the quality of care and success rates in public ART clinics in Spain does not fall from the sector’s standards [ 48 , 52 ]. It is difficult to determine that private clinics produce a significantly better outcome [ 13 ], as they usually handle better prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, patients spend around one year on average on waiting lists for public clinics [ 25 , 40 ], which may delay the potential solution, harm treatment outcomes [ 13 ], and produce distrust. In practice, about 75% of cycles are elaborated by private clinics, which are also responsible for nearly all donor eggs 3 and PGT (therefore for the majority of reproductive tourism) [ 42 , 48 , 53 ]. Some private insurance policies cover a limited number of cycles, usually one or two, with few exceptions.…”

Section: Introductionmentioning

confidence: 99%

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Assisted reproduction in Spain, outcome and socioeconomic determinants of access

Alón

Pinilla

2021

Int J Equity Health

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Research question We analyzed two questions. First, the effectiveness of public Assisted Reproductive Technologies (ART) in Spain compared with private ones, measured by the time since initiating ART treatment until achieving pregnancy, accounting for age and socioeconomic factors. Second, socioeconomic determinants of access to ART, referring primarily to financial means derived by employment, income, and wealth. Design We applied statistical models on data extracted from the national Spanish Fertility Survey from 2018. The first topic was analyzed by competing risk survival analysis conducted on a sample of 667 women who initiate ART treatment since 2000. The second, by a Bivariate Probit model conducted on a sample of 672 women older than 41 years who required ART services. Results The first analysis raised that throughout the treatment, patients treated exclusively in private clinics had on average a higher cumulative incidence of becoming pregnant compared with patients who approached public clinics. The second analysis raised that both higher household equivalent income and higher education increase the likelihood of accessing ART in a private clinic and decrease the tendency of accessing public clinics or failing to access any service. Moreover, being single decreases the likelihood of accessing public clinics or ART services in general. Conclusions Long waiting periods could be the main reason for the lower incidence of getting pregnant in public healthcare, explaining why patients choose private over public care. We develop a broader discussion over the extent of Spanish public funding of ART, the unequal medical outcome, and potential options for optimization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assisted reproduction in Spain, outcome and socioeconomic determinants of access

Alón

Pinilla

2021

Int J Equity Health

View full text Add to dashboard Cite

show abstract

“…We can conclude that, following 36 months, most patients are treated in private clinics, although the gap remains constant. Based on the National Activity Registry by the Spanish Fertility Society (SEF) and as analyzed by Romero et al [ 49], we may assume that the quality of care and success rates in public ART clinics in Spain does not fall from the sector's standards [49,53]. It is di cult to determine that private clinics produce a signi cantly better outcome [ 13], since they may handle better prognosis and treat "good" patients with their own eggs and patients of poor embryonic development or low ovarian reserve with donor eggs.…”

Section: Discussionmentioning

confidence: 99%

“…However, patients spend around one year on average on waiting lists for public clinics [ 25,40], which may delay the potential solution, harm treatment outcomes [ 13], and produce distrust. In practice, about 75% of cycles are elaborated by private clinics, which are also responsible for nearly all donor eggs 3 and PGT (therefore for the majority of reproductive tourism) [ 42,49,54]. Some private insurance policies cover a limited number of cycles, usually one or two, with few exceptions.…”

Section: Introductionmentioning

confidence: 99%

Assisted Reproduction in Spain, Outcome and Socioeconomic Determinants of Access

Alón

Domínguez

2021

Preprint

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Research Question: We analyzed two questions. First, the effectiveness of public Assisted Reproductive Technologies (ART) in Spain compared with private ones, measured by the time since initiating ART treatment until achieving pregnancy, accounting for age and socioeconomic factors. Second, socioeconomic determinants of access to ART, referring primarily to financial means derived by employment, income, and wealth. Design: We applied statistical models on data extracted from the national Spanish Fertility Survey from 2018. The first topic was analyzed by competing risk survival analysis conducted on a sample of 667 women who initiate ART treatment since 2000. The second, by a Bivariate Probit model conducted on a sample of 672 women older than 41 years who required ART services. Results: The first analysis raised that throughout the treatment, patients treated exclusively in private clinics had on average a higher cumulative incidence of becoming pregnant compared with patients who approached public clinics. The second analysis raised that both higher household equivalent income and higher education increase the likelihood of accessing ART in a private clinic and decrease the tendency of accessing public clinics or failing to access any service. Moreover, being single decreases the likelihood of accessing public clinics or ART services in general. Conclusions: Long waiting periods could be the main reason for the lower incidence of getting pregnant in public healthcare, explaining why patients choose private over public care. We develop a broader discussion over the extent of Spanish public funding of ART, the unequal medical outcome, and potential options for optimization.

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Depression and Anxiety in Women Pursuing Fertility Treatment in Spain

Martínez-Borba,

Andreu-Pejó,

Crespo-Delgado

et al. 2024

An Integrated Approach to Perinatal Depression and Anxiety in Spanish-Speaking and Latina Women

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Análisis de los indicadores de calidad entre los diferentes centros públicos españoles en técnicas de reproducción asistida; benchmarking

Cited by 3 publications

References 29 publications

Assisted reproduction in Spain, outcome and socioeconomic determinants of access

Assisted reproduction in Spain, outcome and socioeconomic determinants of access

Assisted Reproduction in Spain, Outcome and Socioeconomic Determinants of Access

Depression and Anxiety in Women Pursuing Fertility Treatment in Spain

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