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En los escasos estudios revisados se observa una gran variabilidad en cuanto a la metodolog&#237;a empleada para su c&#225;lculo&#59; adem&#225;s&#44; han sido desarrollados en colectivos de pacientes muy diversos &#40;cohorte de empleados&#44; ancianos&#44; etc&#46;&#41;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18-21</span></a>&#44; circunstancia que dificulta la comparaci&#243;n y la validez externa de los resultados&#46; Ante este escenario&#44; y dada la ausencia de datos disponibles en nuestro pa&#237;s en el seguimiento de los pacientes con gota en situaci&#243;n de pr&#225;ctica cl&#237;nica habitual&#44; la realizaci&#243;n de este estudio puede ser pertinente&#46; El objetivo del estudio fue determinar el uso de recursos y el impacto econ&#243;mico &#40;costes sanitarios y no sanitarios&#41; de los pacientes con gota en un &#225;mbito poblacional espa&#241;ol durante un periodo de seguimiento de 2 a&#241;os&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Poblaci&#243;n de estudio</span><p id="par0020" class="elsevierStylePara elsevierViewall">Se realiz&#243; 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Fueron excluidos los sujetos trasladados a otros centros&#44; los fallecidos y los desplazados o fuera de zona&#46; El seguimiento de los pacientes fue de 24 meses &#40;2 a&#241;os&#41; para el c&#225;lculo de los costes &#40;sanitarios y no sanitarios&#41;&#46; En funci&#243;n del n&#250;mero de brotes&#47;recurrencias&#44; se confeccionaron <span class="elsevierStyleItalic">2 grupos de estudio</span>&#58; pacientes con 1-2 brotes y pacientes con 3 o m&#225;s brotes &#40;ataques agudos&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Medidas relacionadas con la gota</span><p id="par0030" class="elsevierStylePara elsevierViewall">El diagn&#243;stico de gota se obtuvo a partir de la Clasificaci&#243;n Internacional de la AP &#40;CIAP-2&#41;&#44; c&#243;digo T92&#44; en el componente 7 de las enfermedades y problemas de salud<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#44; y de la Clasificaci&#243;n Internacional de Enfermedades&#44; 9&#46;&#170; Revisi&#243;n&#44; Modificaci&#243;n Cl&#237;nica &#40;CIE-9-MC&#41;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> &#40;c&#243;digos&#58; 274&#46;x&#41;&#46; Se efectu&#243; una validaci&#243;n cl&#237;nica de los casos de gota mediante su confirmaci&#243;n en los cursos cl&#237;nicos de la historia cl&#237;nica&#46; La validaci&#243;n consisti&#243; en obtener una muestra aleatoria de 20 historias cl&#237;nicas&#44; donde se comprob&#243; si el diagn&#243;stico cl&#237;nico de gota concordaba con los criterios de la ACR<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#46; En todos los casos se constat&#243; la certeza diagn&#243;stica&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se estim&#243; la prevalencia de la enfermedad como el porcentaje de individuos de la poblaci&#243;n asignada que presentaron un episodio de gota durante el periodo de estudio &#40;prevalencia de periodo&#41;&#46; La tasa de incidencia acumulada fue definida como la proporci&#243;n de individuos sanos que desarrollaron la enfermedad &#40;n&#250;mero de casos nuevos&#41;&#59; la incidencia acumulada&#44; proporciona una estimaci&#243;n de la probabilidad o el riesgo de que un individuo libre de una determinada enfermedad la desarrolle durante un periodo espec&#237;fico de tiempo&#46; No se estandarizaron los resultados puesto que la pir&#225;mide poblacional distribuida por edad y g&#233;nero de los pacientes estudiados fue similar a la de la poblaci&#243;n de Catalu&#241;a &#40;fuente&#58; Instituto Nacional de Estad&#237;stica&#41;&#46; Adem&#225;s&#44; se determin&#243; la fecha de inicio de la enfermedad &#40;a&#241;os de evoluci&#243;n de la enfermedad&#41;&#44; la presencia de hiperuricemia &#40;dicot&#243;mica&#41; y la procedencia de los pacientes &#40;AP&#44; urgencias hospitalarias y&#47;o consultas externas&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Variables sociodemogr&#225;ficas y de morbilidad</span><p id="par0040" class="elsevierStylePara elsevierViewall">Las principales variables de estudio fueron&#58; edad &#40;continua y por rangos&#41; y sexo&#44; as&#237; como los antecedentes personales obtenidos a partir de la CIAP-2<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#58; hipertensi&#243;n arterial &#40;K86&#44; K87&#41;&#44; diabetes mellitus &#40;T89&#44;T90&#41;&#44; dislipidemia &#40;T93&#41;&#44; obesidad &#40;T82&#41;&#44; tabaquismo &#40;P17&#41;&#44; alcoholismo &#40;P15&#44; P16&#41;&#44; insuficiencia renal&#44; accidente vasculocerebral &#40;K90&#44; K91&#44; K93&#41;&#44; enfermedad pulmonar obstructiva cr&#243;nica &#40;R95&#44; obstrucci&#243;n cr&#243;nica del flujo a&#233;reo&#41;&#44; asma bronquial &#40;R96&#41;&#44; demencias o trastornos de memoria &#40;P70&#44; P20&#41;&#44; enfermedades neurol&#243;gicas&#58; enfermedad de Parkinson &#40;N87&#41;&#44; epilepsia &#40;N88&#41;&#44; esclerosis m&#250;ltiple &#40;N86&#41; y otras enfermedades neurol&#243;gicas &#40;N99&#41;&#59; s&#237;ndrome depresivo &#40;P76&#41; y neoplasias malignas &#40;todos los tipos&#59; A79&#44; B72-75&#44; D74-78&#44; F75&#44; H75&#44; K72&#44; L71&#44; L97&#44; N74-76&#44; R84-86&#44; T71-73&#44; U75-79&#44; W72-73&#44; X75-81&#44; Y77-79&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Como variable resumen de la comorbilidad general&#44; para cada paciente atendido&#44; se utilizaron&#58; <span class="elsevierStyleItalic">a&#41;</span> el &#237;ndice de comorbilidad de Charlson<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">24</span></a>&#44; como una aproximaci&#243;n a la gravedad del paciente&#44; y <span class="elsevierStyleItalic">b&#41;</span> el &#237;ndice de casu&#237;stica individual&#44; obtenido a partir de los Adjusted Clinical Groups &#40;ACG&#41;&#44; un sistema de clasificaci&#243;n de pacientes por isoconsumo de recursos<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">25</span></a>&#46; El aplicativo ACG proporciona las bandas de utilizaci&#243;n de recursos &#40;BUR&#41;&#44; con lo que cada paciente en funci&#243;n de su morbilidad general queda agrupado en una de las 5 categor&#237;as mutuamente excluyentes &#40;1&#58; usuarios sanos o de morbilidad muy baja&#44; 2&#58; morbilidad baja&#44; 3&#58; morbilidad moderada&#44; 4&#58; morbilidad elevada&#44; y 5&#58; morbilidad muy elevada&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">La definici&#243;n del SM se estableci&#243; cuando se cumpl&#237;an 3 de los 5 criterios del NCEP-ATP III modificado<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#58; <span class="elsevierStyleItalic">a&#41;</span> triglic&#233;ridos de 150<span class="elsevierStyleHsp" style=""></span>mg&#47;dl o mayor&#59; <span class="elsevierStyleItalic">b&#41;</span> colesterol unido a lipoprote&#237;nas de alta densidad menor de 40<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en varones o menor de 50<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en mujeres&#59; <span class="elsevierStyleItalic">c&#41;</span> presi&#243;n arterial sist&#243;lica&#47;diast&#243;lica de 130&#47;85<span class="elsevierStyleHsp" style=""></span>mmHg o mayor o en tratamiento antihipertensivo&#59; <span class="elsevierStyleItalic">d&#41;</span> glucemia basal en ayunas de 110<span class="elsevierStyleHsp" style=""></span>mg&#47;dl o m&#225;s&#44; o tratamiento hipogluc&#233;mico o diabetes mellitus previamente diagnosticada&#44; y&#47;o <span class="elsevierStyleItalic">e&#41;</span> &#237;ndice de masa corporal de 28&#44;8<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> o superior &#40;este valor fue considerado equivalente al de obesidad o adiposidad abdominal&#58; per&#237;metro de cintura &#62; 102<span class="elsevierStyleHsp" style=""></span>cm en hombres y &#62; 88<span class="elsevierStyleHsp" style=""></span>cm en mujeres&#59; criterio seguido por diferentes autores&#41;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">26</span></a>&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Uso de recursos y modelo de costes</span><p id="par0055" class="elsevierStylePara elsevierViewall">Se consideraron como costes no sanitarios o indirectos los relativos a las p&#233;rdidas de productividad laboral &#40;n&#250;mero de bajas y d&#237;as de incapacidad&#41;&#46; El dise&#241;o del sistema de costes se defini&#243; teniendo en cuenta las caracter&#237;sticas de las organizaciones y el grado de desarrollo de los sistemas de informaci&#243;n disponibles&#46; La unidad de producto que sirvi&#243; de base al c&#225;lculo final &#40;durante el periodo de estudio&#41; fue el paciente atendido y el coste fue expresado en coste medio por paciente &#40;coste&#47;unitario&#41;&#46; Los diferentes conceptos de estudio y su valoraci&#243;n econ&#243;mica se detallan en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> &#40;correspondientes al a&#241;o 2007&#41;&#46; Las diferentes tarifas se obtuvieron a partir de la contabilidad anal&#237;tica de los centros&#44; excepto la medicaci&#243;n y los d&#237;as de baja laboral&#46; Las prescripciones se cuantificaron seg&#250;n el precio de venta al p&#250;blico por envase en el momento de la prescripci&#243;n&#46; Los d&#237;as de incapacidad laboral o p&#233;rdidas de productividad se consideraron como costes no sanitarios &#40;costes indirectos&#41;&#46; El coste se cuantific&#243; seg&#250;n el salario m&#237;nimo interprofesional &#40;fuente&#58; Instituto Nacional de Estad&#237;stica&#41;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&#46; Los costes se determinar&#225;n a los 2 a&#241;os de seguimiento de los pacientes&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Confidencialidad de la informaci&#243;n</span><p id="par0060" class="elsevierStylePara elsevierViewall">Se respet&#243; la confidencialidad de los registros marcada por la Ley Org&#225;nica de Protecci&#243;n de Datos &#40;15&#47;1999&#44; de 13 de diciembre&#41;&#44; con disociaci&#243;n de los datos&#46; El estudio fue clasificado por la Agencia Espa&#241;ola de Medicamentos y Productos Sanitarios &#40;EPA-OD&#41; y&#44; posteriormente&#44; aprobado por el Comit&#233; de &#201;tica de Investigaci&#243;n Cl&#237;nica del Hospital Universitario Germans Trias i Pujol de Badalona&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">An&#225;lisis estad&#237;stico</span><p id="par0065" class="elsevierStylePara elsevierViewall">Se efectu&#243; un an&#225;lisis estad&#237;stico descriptivo-univariante con valores de media&#44; desviaci&#243;n t&#237;pica&#47;est&#225;ndar &#40;DE&#41; e intervalos de confianza &#40;IC&#41; del 95&#37;&#44; y se comprob&#243; la normalidad de la distribuci&#243;n con la prueba de Kolmogorov-Smirnov&#46; En el an&#225;lisis bivariante se utilizaron las pruebas de ANOVA y de la ji al cuadrado&#44; y correlaci&#243;n lineal de Pearson&#46; Se efectu&#243; un an&#225;lisis de regresi&#243;n log&#237;stica para determinar las variables asociadas a la presencia de &#8805; 3 brotes &#40;variable dependiente&#41;&#44; con procedimiento <span class="elsevierStyleItalic">enter</span> &#40;estad&#237;stico&#58; Wald&#41;&#46; La comparaci&#243;n del coste ambulatorio y hospitalario se realiz&#243; seg&#250;n las recomendaciones de Thompson y Barber<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> mediante el an&#225;lisis de la covarianza &#40;ANCOVA&#41;&#44; con el sexo&#44; la edad y las BUR&#44; y el &#237;ndice de Charlson como covariables &#40;procedimiento&#58; estimaci&#243;n de medias marginales&#59; ajuste de Bonferroni&#41;&#46; Se utiliz&#243; el programa SPSSWIN versi&#243;n 18&#44; estableciendo una significaci&#243;n estad&#237;stica para valores de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p id="par0070" class="elsevierStylePara elsevierViewall">De una selecci&#243;n inicial de 96&#46;206 sujetos &#8805; 18 a&#241;os asignados a los centros&#44; se reclut&#243; a 3&#46;130 pacientes con gota&#46; La prevalencia global fue del 3&#44;3&#37; &#40;IC del 95&#37;&#44; 2&#44;7-3&#44;9&#37;&#41;&#46; La estimaci&#243;n de la tasa de incidencia acumulada fue de 1&#44;1 casos nuevos&#47;1&#46;000 habitantes&#47;a&#241;o&#46; Por grupos de estudio&#44; 2&#46;142 &#40;68&#44;4&#37;&#41; presentaron 1-2 ataques agudos y 988 &#40;31&#44;6&#37;&#41; 3 o m&#225;s recurrencias&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#46; La media &#177; DE de edad fue de 55&#44;8 &#177; 12&#44;2 a&#241;os y el 81&#44;1&#37; fueron varones&#46; Del conjunto de pacientes&#44; el 43&#44;6&#37; fueron hipertensos&#44; el 43&#44;1&#37; obesos y el 40&#44;5&#37; con dislipidemia&#46; La prevalencia del SM fue del 28&#44;8&#37; &#40;IC del 95&#37;&#44; 27&#44;2-30&#44;4&#37;&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se describen las caracter&#237;sticas generales de la serie y las comorbilidades asociadas a los pacientes con gota seg&#250;n los 2 grupos de estudio&#46; Los sujetos con &#8805; 3 ataques agudos&#47;recurrencias mostraron una media de edad superior &#40;57&#44;2 frente a 55&#44;2 a&#241;os&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; y una mayor proporci&#243;n de varones &#40;84&#44;1&#37; frente a 79&#44;7&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46; Estos sujetos presentaron una mayor proporci&#243;n de comorbilidades&#58; BUR &#40;3&#44;1 frente a 2&#44;9&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e &#237;ndice de Charlson &#40;1&#44;1 frente a 0&#44;9&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; En el modelo de regresi&#243;n log&#237;stica corregido&#44; los sujetos con &#8805; 3 ataques agudos&#47;recurrencias se asociaron con el SM <span class="elsevierStyleItalic">&#40;odds ratio</span> &#91;OR&#93;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44;2&#59; IC del 95&#37;&#44; 4&#44;6-8&#44;3&#41;&#44; la obesidad &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;1&#59; IC del 95&#37;&#58; 1&#44;7-2&#44;5&#41; y la hipertensi&#243;n arterial &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;6&#59; IC del 95&#37;&#58; 1&#44;3-1&#44;9&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#46; El SM tuvo una moderada correlaci&#243;n lineal con el n&#250;mero de ataques agudos &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;517&#41;&#44; los a&#241;os de evoluci&#243;n de la enfermedad &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;321&#41; y los niveles iniciales de &#225;cido &#250;rico &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;278&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#46; Las caracter&#237;sticas basales de la artropat&#237;a gotosa se detallan en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#59; el 89&#44;1&#37; de los sujetos presentaron hiperuricemia y el 84&#44;7&#37; de los casos procedieron de AP&#46; Los sujetos con &#8805; 3 ataques agudos&#47;recurrencias mostraron un mayor seguimiento en las consultas de reumatolog&#237;a &#40;el 3&#44;6 frente al 0&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Cabe destacar que &#250;nicamente en el 16&#44;9&#37; de los pacientes existi&#243; un diagn&#243;stico de certeza de gota &#40;visualizaci&#243;n de cristales de urato monos&#243;dico en el microscopio&#41;&#46; Por grupos de estudio&#44; en sujetos con &#8805; 3 ataques agudos&#47;recurrencias fue del 29&#44;0 frente al 11&#44;3&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">El modelo de costes brutos y corregidos prospectivos &#40;seguimiento de 24 meses&#41; asociados a la gota seg&#250;n los grupos de estudio se describe en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#46; El coste total de los pacientes incluidos en el estudio ascendi&#243; a 7 millones de euros&#44; de los cuales el 96&#44;9&#37; correspondi&#243; a costes sanitarios directos y el 3&#44;1&#37; a costes no sanitarios &#40;p&#233;rdidas de productividad&#41;&#44; con un promedio&#47;unitario total de 2&#46;228&#44;6 &#8364;&#46; Por grupos&#44; los costes totales &#40;sanitarios&#44; no sanitarios&#41; de los sujetos con 1-2 ataques de gota fueron inferiores en comparaci&#243;n con los que presentaron &#8805; 3 ataques &#40;2&#46;028&#44;6 &#8364; frente a 2&#46;662&#44;2 &#8364;&#41;&#46; La distribuci&#243;n porcentual del coste representa el 90&#44;8&#37; en AP y el 6&#44;2&#37; en atenci&#243;n especializada&#59; de estos&#44; el 23&#44;5&#37; en visitas en AP y el 57&#44;7&#37; en prescripci&#243;n farmac&#233;utica&#46; En el modelo multivariante corregido&#44; los costes fueron inferiores en el grupo de 1-2 ataques&#44; en especial los costes sanitarios totales &#40;2&#46;101&#44;5 &#8364; frente a 2&#46;517&#44;4 &#8364;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y en AP &#40;1&#46;987&#44;6 &#8364; frente a 2&#46;331&#44;3 &#8364;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; El promedio&#47;unitario corregido de los costes totales por paciente fue de 2&#46;130&#44;6 &#8364; frente a 2&#46;605&#44;4 &#8364;&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; En todos los componentes del coste los resultados fueron mayores en el grupo con &#8805; 3 ataques&#46; Durante el periodo de estudio&#44; los pacientes con &#8805; 3 ataques agudos&#47;recurrencias mostraron un mayor promedio de n&#250;mero de bajas laborales &#40;2&#44;3 frente a 1&#44;2&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41; y d&#237;as de incapacidad laboral &#40;0&#44;6 frente a 2&#44;6 d&#237;as&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">El subgrupo de pacientes diab&#233;ticos &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>641&#59; 20&#44;5&#37;&#59; IC del 95&#37;&#44; 19&#44;1-21&#44;9&#37;&#41;&#44; en comparaci&#243;n con los no diab&#233;ticos&#44; present&#243; un mayor promedio unitario del coste total &#40;3&#46;124&#44;8 &#8364; frente a 1&#46;997&#44;8 &#8364;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#59; estos pacientes mostraron mayor edad &#40;61&#44;9 frente a 54&#44;2 a&#241;os&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; carga de morbilidad &#40;3&#44;1 frente a 2&#44;8 BUR&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y SM &#40;63&#44;2 frente a 20&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p id="par0090" class="elsevierStylePara elsevierViewall">Los resultados generales del estudio muestran una prevalencia de gota del 3&#44;3&#37;&#59; con un mayor predominio en varones y con 1-2 ataques agudos&#46; Estas caracter&#237;sticas son similares a la mayor&#237;a de los estudios revisados de &#225;mbito poblacional<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; Aunque cabe destacar que la propia historia natural de la enfermedad puede dificultar su diagn&#243;stico&#44; especialmente en AP y en los servicios de urgencias&#44; donde la presencia del ataque agudo articular puede enmascarar otras entidades nosol&#243;gicas dificultando el diagn&#243;stico diferencial<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;6-8</span></a>&#46; Seg&#250;n los criterios del NCEP<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#44; la prevalencia del SM fue del 28&#44;8&#37;&#44; destacando su asociaci&#243;n con la obesidad&#44; la hipertensi&#243;n arterial y los niveles basales elevados de &#225;cido &#250;rico&#46; Nuestros resultados son similares a los datos de otros estudios revisados<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8&#44;11-13</span></a>&#46; Cabe considerar que en nuestro pa&#237;s la prevalencia del SM y su asociaci&#243;n con la gota podr&#237;an ser m&#225;s altas&#46; Algunos autores la sit&#250;an en cifras alrededor del 50&#37; en pacientes mayores de 60 a&#241;os y del 35&#37; en pacientes con gota en poblaci&#243;n general<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En el estudio&#44; el promedio&#47;unitario del coste fue de 2&#46;228&#44;6 &#8364;&#46; En el modelo corregido el promedio&#47;unitario de los costes totales por paciente fueron de 2&#46;130&#44;6 &#8364; &#40;1-2 ataques&#41; frente a 2&#46;605&#44;4 &#8364; &#40;&#8805; 3 ataques&#41;&#46; En todos los componentes del coste los resultados fueron mayores en el grupo con &#8805; 3 ataques y en el subgrupo de pacientes diab&#233;ticos&#46; En este aspecto&#44; para Brook et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> el coste total anual en una cohorte de empleados con gota fue de &#36; 6&#46;870&#44; 2 veces superior a los pacientes en ausencia de gota&#59; destacando que solo el 1&#37; de los empleados con gota generaron el 20&#37; de los costes&#46; Wu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> en un excelente trabajo realizado en pacientes ancianos&#44; en el que relacionan los niveles de &#225;cido &#250;rico s&#233;rico con el coste de los pacientes con gota fue de &#36; 2&#44;555&#46; En el estudio realizado por Mould-Quevedo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#44; sobre las principales enfermedades reum&#225;ticas inflamatorias desde la perspectiva del paciente en M&#233;xico&#44; el coste&#47;anual fue de &#36; 1&#46;006&#44; mayoritariamente en los costes ambulatorios&#46; Nuestros resultados estar&#237;an en consonancia con los aportados por Wu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&#44; donde la metodolog&#237;a empleada fue similar a la descrita en el presente trabajo&#44; aun teniendo presente que sus pacientes eran mayores y seguramente con mayor comorbilidad&#46; Los otros 2 estudios mencionados con anterioridad &#40;Wu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> y Mould-Quevedo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#41; son de dif&#237;cil comparaci&#243;n&#44; puesto que est&#225;n realizados con pacientes de mayor edad y&#44; adem&#225;s&#44; con metodolog&#237;as de trabajo distintas&#46; Todos los estudios son coincidentes en el peso de los costes ambulatorios&#46; En nuestro estudio&#44; el 96&#44;9&#37; fueron costes sanitarios directos y los mayores costes fueron debidos a las visitas de seguimiento y a la medicaci&#243;n&#46; En este aspecto&#44; un mayor seguimiento de estos pacientes en la AP podr&#237;a reducir los costes de la enfermedad&#59; aunque es indudable que la morbilidad asociada&#44; la falta de cumplimiento y los posibles factores predisponentes pueden repercutir en el uso de los recursos y del coste de estos pacientes<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Cabe destacar los escasos costes en p&#233;rdida de productividad laboral &#40;bajas laborales&#41; que genera la gota&#46; Una posible explicaci&#243;n se debe a que se utiliz&#243; una fuente de informaci&#243;n conservadora &#40;el salario m&#237;nimo interprofesional en lugar del coste salarial medio&#44; lo que ya en s&#237; mismo es una limitaci&#243;n del estudio&#41;&#59; adem&#225;s&#44; es posible que se produzcan bajas de corta duraci&#243;n &#40;inicios de tratamiento o descompensaciones&#41; que no se registren en los partes de incapacidad laboral&#46; Las evidencias disponibles en este terreno de los costes estar&#237;an en consonancia con Ferraz<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> y Joish<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a>&#44; donde evidencian que los pacientes con ataques agudos de artritis gotosa pierden un promedio de 3-5 d&#237;as de trabajo al a&#241;o&#44; ocasionando importantes repercusiones econ&#243;micas por p&#233;rdidas de productividad laboral en algunos casos poco cuantificadas&#46; Aunque&#44; en general&#44; los pacientes con 1-2 ataques son m&#225;s j&#243;venes y&#44; por tanto&#44; tienen menor frecuencia de la mayor&#237;a de las enfermedades asociadas&#44; ello por s&#237; solo puede ser lo que determina el menor coste de la enfermedad en esos pacientes&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Las posibles limitaciones del estudio inciden en la categorizaci&#243;n de la enfermedad&#44; el posible sesgo de clasificaci&#243;n de los pacientes &#40;por exceso&#41; y en la medida operativa de los costes&#44; atribuibles al sistema de informaci&#243;n desarrollado&#46; Por tanto&#44; en el art&#237;culo se muestran las limitaciones propias de los estudios retrospectivos&#59; como por ejemplo&#44; el infrarregistro de los datos o la posible variabilidad de los profesionales y de los pacientes al ser un dise&#241;o observacional&#46; Adem&#225;s&#44; el n&#250;mero de ataques agudos atendidos puede verse comprometido debido a la posible automedicaci&#243;n de los pacientes&#46; El estudio detalla el uso de los recursos y los costes asociados a los pacientes con artritis gotosa en situaci&#243;n de pr&#225;ctica cl&#237;nica habitual&#46; No obstante&#44; cabe destacar que sin una adecuada estandarizaci&#243;n de las metodolog&#237;as en cuanto a las caracter&#237;sticas de los pacientes&#44; as&#237; como en el n&#250;mero y la medida de las variables estudiadas&#44; los resultados obtenidos deben de interpretarse con prudencia oblig&#225;ndonos a ser cautelosos en la validez externa de los resultados&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Futuras investigaciones hacen necesario disponer de estudios de coste&#47;efectividad y de eficacia diagn&#243;stica y de tratamiento&#44; adem&#225;s de replicar el estudio en otras organizaciones sanitarias&#46; Por otra parte&#44; la propiedad inflamatoria de los cristales no est&#225; a&#250;n completamente aclarada&#59; podr&#237;a estar vinculada a la habilidad de ligar inmunoglobulinas&#44; complemento y l&#237;pidos&#46; Se necesitan ensayos cl&#237;nicos a largo plazo para probar la hip&#243;tesis de que la terapia hipouricemiante puede reducir el riesgo cardiovascular en estos pacientes&#46; Tampoco se ha establecido una pauta terap&#233;utica derivada de ensayos cl&#237;nicos en el tratamiento de la inflamaci&#243;n articular aguda&#46; El &#233;xito de la atenci&#243;n a los pacientes con enfermedades cr&#243;nicas como la gota deber&#237;a de basarse en intervenciones de equipos pluridisciplinarios que promuevan intervenciones efectivas en las que los pacientes est&#233;n altamente comprometidos en su autocuidado&#46; Es indudable que el diagn&#243;stico y el tratamiento de la gota deben exigir una mayor estrategia de intervenci&#243;n y de seguimiento por parte de nuestros profesionales sanitarios&#46; En conclusi&#243;n&#44; la gota est&#225; asociada a una elevada morbilidad&#44; SM y consumo de recursos sanitarios&#46; El estudio proporciona datos &#250;tiles sobre el coste de la gota en Espa&#241;a&#46; Los costes m&#225;s destacados corresponden al seguimiento ambulatorio de los pacientes&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Responsabilidades &#233;ticas</span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Protecci&#243;n de personas y animales</span><p id="par0115" class="elsevierStylePara elsevierViewall">Los autores declaran que para esta investigaci&#243;n no se han realizado experimentos en seres humanos ni en animales&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Confidencialidad de los datos</span><p id="par0120" class="elsevierStylePara elsevierViewall">Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicaci&#243;n de datos de pacientes y que todos los pacientes incluidos en el estudio han recibido informaci&#243;n suficiente y han dado su consentimiento informado por escrito para participar en dicho estudio&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Derecho a la privacidad y consentimiento informado</span><p id="par0125" class="elsevierStylePara elsevierViewall">Los autores han obtenido el consentimiento informado de los pacientes y&#47;o sujetos referidos en el art&#237;culo&#46; Este documento obra en poder del autor de correspondencia&#46;</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Autor&#237;a</span><p id="par0130" class="elsevierStylePara elsevierViewall">A&#46; Sicras y R&#46; Navarro realizaron la b&#250;squeda bibliogr&#225;fica&#44; obtuvieron los datos&#44; realizaron el an&#225;lisis y la interpretaci&#243;n de los resultados iniciales&#46; Todos los autores aportaron ideas&#44; interpretaron los hallazgos y revisaron los borradores del manuscrito&#46; Todos los autores aprobaron la versi&#243;n final del art&#237;culo&#46; A&#46; Sicras es el responsable principal del estudio&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicto de intereses</span><p id="par0135" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        0 => array:2 [
          "identificador" => "xres124274"
          "titulo" => array:5 [
            0 => "Resumen"
            1 => "Objetivo"
            2 => "Pacientes y m&#233;todos"
            3 => "Resultados"
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          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Objective"
            2 => "Patients and methods"
            3 => "Results"
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        3 => array:2 [
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        4 => array:2 [
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          "titulo" => "Introducci&#243;n"
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        5 => array:3 [
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          "titulo" => "Pacientes y m&#233;todos"
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            0 => array:2 [
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              "titulo" => "Poblaci&#243;n de estudio"
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            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Criterios de inclusi&#243;n y exclusi&#243;n"
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            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Medidas relacionadas con la gota"
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            3 => array:2 [
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              "titulo" => "Variables sociodemogr&#225;ficas y de morbilidad"
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              "titulo" => "Uso de recursos y modelo de costes"
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              "titulo" => "Confidencialidad de la informaci&#243;n"
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              "titulo" => "An&#225;lisis estad&#237;stico"
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              "titulo" => "Protecci&#243;n de personas y animales"
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            1 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Confidencialidad de los datos"
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            2 => array:2 [
              "identificador" => "sec0075"
              "titulo" => "Derecho a la privacidad y consentimiento informado"
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        9 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Autor&#237;a"
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        10 => array:2 [
          "identificador" => "sec0085"
          "titulo" => "Conflicto de intereses"
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        11 => array:2 [
          "identificador" => "xack38004"
          "titulo" => "Agradecimientos"
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        12 => array:1 [
          "titulo" => "Bibliograf&#237;a"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-05-19"
    "fechaAceptado" => "2012-06-27"
    "PalabrasClave" => array:2 [
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec111558"
          "palabras" => array:4 [
            0 => "Gota"
            1 => "Uso de recursos"
            2 => "Costes"
            3 => "S&#237;ndrome metab&#243;lico"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec111557"
          "palabras" => array:4 [
            0 => "Gout"
            1 => "Resources use"
            2 => "Cost"
            3 => "Metabolic syndrome"
          ]
        ]
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar el uso de recursos y el impacto econ&#243;mico de los pacientes con gota en un &#225;mbito poblacional&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dise&#241;o observacional &#40;multic&#233;ntrico&#41; realizado a partir de registros pertenecientes a 6 centros de atenci&#243;n primaria y 2 hospitales&#46; Se incluy&#243; a pacientes &#8805; 18 a&#241;os con un episodio agudo de gota durante los a&#241;os 2003-2007&#46; El seguimiento de los pacientes fue de 2 a&#241;os&#46; Se confeccionaron 2 grupos de estudio&#58; pacientes con 1-2 ataques&#47;recurrencias agudas y con 3 o m&#225;s&#46; Principales variables&#58; sociodemogr&#225;ficas&#44; comorbilidad&#44; s&#237;ndrome metab&#243;lico &#40;SM&#41;&#44; y uso de recursos y costes sanitarios&#47;no sanitarios&#46; An&#225;lisis estad&#237;stico&#58; regresi&#243;n-log&#237;stica&#44; modelo de ANCOVA&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 3&#46;130 pacientes con gota&#46; Prevalencia&#58; 3&#44;3&#37;&#59; edad media&#58; 55&#44;8 a&#241;os&#59; varones&#58; 81&#44;1&#37;&#46; Por grupos&#58; el 68&#44;4&#37; present&#243; 1-2 ataques agudos y el 31&#44;6&#37;&#44; 3 o m&#225;s&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#46; La prevalencia del SM fue del 28&#44;8&#37; &#40;intervalo de confianza &#91;IC&#93; del 95&#37;&#44; 27&#44;2-30&#44;4&#37;&#41;&#46; El promedio&#47;unitario del coste fue de 2&#46;228&#44;6 &#8364; &#40;costes directos&#58; 96&#44;9&#37;&#41;&#44; el 90&#44;8&#37; en AP &#40;visitas&#58; 23&#44;5&#37;&#59; medicamentos&#58; 57&#44;7&#37;&#41;&#46; Por grupos&#44; en el modelo corregido el promedio&#47;unitario de los costes totales por paciente fue de 2&#46;130&#44;6 &#8364; frente a 2&#46;605&#44;4 &#8364;&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; En todos los componentes del coste los resultados fueron mayores en el grupo con &#8805; 3 ataques&#46; El subgrupo de pacientes diab&#233;ticos &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>641&#59; 20&#44;5&#37;&#41; present&#243; un mayor coste &#40;3&#46;124&#44;8 &#8364; frente a 1&#46;997&#44;8 &#8364;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La gota se asocia a una elevada morbilidad&#44; presencia de SM y consumo de recursos&#46; El estudio proporciona datos &#250;tiles sobre el coste de la enfermedad&#59; siendo los costes de seguimiento ambulatorio los m&#225;s elevados&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine the use of resources and economic impact of patients with gout at the population level&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Observational design analysing records belonging to 6 primary care centers and 2 hospitals&#46; We included patients&#8217; &#8805;18 years with an acute episode of gout over the years 2003-2007&#46; Patient follow-up was 2 years&#46; It produced two study groups&#58; patients with 1-2 attacks&#47;acute recurrences and 3 or more events&#46; Main variables were&#58; demographic&#44; co-morbidity&#44; metabolic syndrome &#40;MS&#41;&#44; and resource use and health&#47;non-health costs&#46; Statistical analysis&#58; logistic regression-model ANCOVA&#44; <span class="elsevierStyleItalic">P</span>&#60;&#46;05&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">3&#44;130 patients with gout were included&#46; Prevalence&#58; 3&#46;3&#37;&#44; mean age&#58; 55&#46;8 years male&#58; 81&#46;1&#37;&#46; Groups were distributed as follows&#58; 68&#46;4&#37; had 1-2 acute attacks and 31&#46;6&#37; with 3 or more&#44; <span class="elsevierStyleItalic">P</span>&#60;&#46;001&#46; The prevalence of MS was 28&#46;8&#37; &#40;confidence interval &#91;CI&#93; 95&#37; CI 27&#46;2 to 30&#46;4&#37;&#41;&#46; The average&#47;unit cost was &#8364; 2&#44;228&#46;6 &#40;direct costs&#58; 96&#46;9&#37;&#41;&#44; 90&#46;8&#37; in primary care &#40;visits&#58; 23&#46;5&#37;&#59; drugs&#58; 57&#46;7&#37;&#41;&#46; For groups&#44; the average corrected model&#47;unit total cost per patient was &#8364; 2&#44;130&#46;6 vs&#46; &#8364; 2&#44;605&#46;4&#44; respectively &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;001&#41;&#46; In all cost components&#44; the results were higher in the group with &#8805; 3 attacks&#46; The subgroup of diabetic patients &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>641&#44; 20&#46;5&#37;&#41; had a higher cost &#40;&#8364; 3&#44;124&#46;8&#8364; vs&#46; &#8364; 1&#44;997&#46;8&#44; <span class="elsevierStyleItalic">P</span>&#60;&#46;001&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Gout is associated with substantial morbidity&#44; presence of MS and resource consumption&#46; The study provides useful data on the cost of the disease&#59; the costs of outpatient follow up is the highest&#46;</p>"
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Visita m&#233;dica a Urgencias&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">115&#44;23&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hospitalizaci&#243;n &#40;un d&#237;a&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#177; 0&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Consultas hospitalarias&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">PU&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Uso &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">PU&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PU&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">P<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Coste total&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">N&#250;mero de pacientes&#44; &#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">N &#61; 2&#46;142 &#40;68&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">N &#61; 988 &#40;31&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">N &#61; 3&#46;130 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="13" align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes sanitarios</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;993&#44;6 &#177; 1&#46;538&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;522&#44;4 &#177; 1&#46;773&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#46;160&#44;5 &#177; 1&#46;634&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;762&#46;332&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">96&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Costes en atenci&#243;n primaria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;881&#44;3 &#177; 1&#46;390&#44;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;328&#44;6 &#177; 1&#46;628&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;022&#44;5 &#177; 1&#46;484&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#46;330&#46;381&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">90&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Visitas m&#233;dicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">499 &#177; 383&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">576&#44;7 &#177; 374&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">23&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">523&#44;7 &#177; 382&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">1&#46;639&#46;281&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">23&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Pruebas de laboratorio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">95&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">130&#44;3 &#177; 92&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">97&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">7&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">160&#44;5 &#177; 91&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#44;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">139&#44;8 &#177; 93&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">437&#46;571&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Radiolog&#237;a convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">81&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">38&#44;6 &#177; 38&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">88&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">46&#44;1 &#177; 41&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">41&#44;0 &#177; 39&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">128&#46;267&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Pruebas complementarias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">43&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">29&#44;2 &#177; 47&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">55&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">1&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">39&#44;5 &#177; 52&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">47&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">32&#44;5 &#177; 49&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&#46;586&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Prescripci&#243;n farmac&#233;utica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;183&#44;9 &#177; 1&#46;166&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;505&#44;9 &#177; 1&#46;421&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;285&#44;5 &#177; 1&#46;261&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">4&#46;023&#46;674&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Costes en atenci&#243;n especializada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">112&#44;3 &#177; 501&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">193&#44;8 &#177; 545&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138&#44;0 &#177; 517&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">431&#46;951&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Visitas m&#233;dicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#44;9 &#177; 186&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;4 &#177; 249&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#44;6 &#177; 209&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">211&#46;578&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>D&#237;as de hospitalizaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;9 &#177; 425&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#44;2 &#177; 436&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#44;0 &#177; 429&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">172&#46;091&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Urgencias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;5 &#177; 49&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;2 &#177; 44&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;4 &#177; 47&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&#46;281&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes no sanitarios</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;1 &#177; 550&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">139&#44;8 &#177; 1&#46;116&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#44;1 &#177; 775&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">213&#46;189&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes totales &#40;sanitarios&#47;no sanitarios&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;028&#44;6 &#177; 1&#46;661&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">2&#46;662&#44;2 &#177; 2&#46;143&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;228&#44;6 &#177; 1&#46;850&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Modelo de costes corregidos</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Diferencia</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes sanitarios totales</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;415&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">2&#46;024&#44;1-2&#46;179&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;391&#44;2-2&#46;643&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes en atenci&#243;n primaria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;987&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;343&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">1&#46;917&#44;5-2&#46;057&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;217&#44;3-2&#46;445&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes en atenci&#243;n especializada</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">186&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;72&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#44;9-141&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">141&#44;9-230&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes no sanitarios</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;046&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;9-69&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#44;8-154&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes totales &#40;sanitarios&#47;no sanitarios&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;130&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;605&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;474&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;041&#44;18-2&#46;220&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;459&#44;9-2&#46;750&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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Original
Uso de recursos e impacto económico de los pacientes con gota: estudio multicéntrico de ámbito poblacional
Resource use and economic impact of patients with gout: A multicenter, population-wide study
Antoni Sicras-Mainara,
Autor para correspondencia
asicras@bsa.cat

Autor para correspondencia.
, Ruth Navarro-Artiedab, Jordi Ibáñez-Nollac
a Dirección de Planificación, Badalona Serveis Assistencials SA, Badalona, Barcelona, España
b Documentación Médica, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
c Dirección Asistencial, Badalona Serveis Assistencials SA, Badalona, Barcelona, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La gota es una de las causas m&#225;s comunes de artritis en mayores de 40 a&#241;os&#59; su prevalencia oscila entre el 0&#44;5 y el 5&#37; de la poblaci&#243;n general<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Es una enfermedad que se caracteriza por la presencia de episodios inflamatorios&#44; habitualmente monoarticulares y recurrentes&#44; que suelen ser intensos y autolimitados<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; Las manifestaciones cl&#237;nicas de la gota se presentan en 3 fases diferenciadas&#58; <span class="elsevierStyleItalic">a&#41;</span> ataque agudo&#59; <span class="elsevierStyleItalic">b&#41;</span> periodo entre crisis &#40;la visualizaci&#243;n de tofos es un s&#237;ntoma tard&#237;o de la enfermedad&#41;&#44; y <span class="elsevierStyleItalic">c&#41;</span> artropat&#237;a cr&#243;nica &#40;ataques m&#250;ltiples y&#47;o cl&#237;nica persistente&#41;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5-8</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Los estudios disponibles ponen de manifiesto que en pacientes con obesidad&#44; hipertensi&#243;n arterial y&#47;o diabetes &#40;elevado riesgo cardiovascular&#41;&#44; los niveles de urato s&#233;rico pueden ser considerados como un marcador de inflamaci&#243;n&#44; isquemia y estr&#233;s oxidativo en el sistema cardiovascular<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a>&#46; La asociaci&#243;n entre la gota y el s&#237;ndrome metab&#243;lico &#40;SM&#41; es conocida&#46; Diversos estudios demuestran que los niveles de uratos s&#233;ricos aumentan a medida que se incrementa el n&#250;mero de componentes del SM&#44; incluso cuando se ajusta frente a factores de confusi&#243;n como la edad&#44; 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En los escasos estudios revisados se observa una gran variabilidad en cuanto a la metodolog&#237;a empleada para su c&#225;lculo&#59; adem&#225;s&#44; han sido desarrollados en colectivos de pacientes muy diversos &#40;cohorte de empleados&#44; ancianos&#44; etc&#46;&#41;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18-21</span></a>&#44; circunstancia que dificulta la comparaci&#243;n y la validez externa de los resultados&#46; Ante este escenario&#44; y dada la ausencia de datos disponibles en nuestro pa&#237;s en el seguimiento de los pacientes con gota en situaci&#243;n de pr&#225;ctica cl&#237;nica habitual&#44; la realizaci&#243;n de este estudio puede ser pertinente&#46; El objetivo del estudio fue determinar el uso de recursos y el impacto econ&#243;mico &#40;costes sanitarios y no sanitarios&#41; de los pacientes con gota en un &#225;mbito poblacional espa&#241;ol durante un periodo de seguimiento de 2 a&#241;os&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Poblaci&#243;n de estudio</span><p id="par0020" class="elsevierStylePara elsevierViewall">Se realiz&#243; un dise&#241;o observacional multic&#233;ntrico&#44; elaborado a partir de la revisi&#243;n de historias cl&#237;nicas informatizadas&#44; en pacientes seguidos en r&#233;gimen ambulatorio y hospitalario&#46; La poblaci&#243;n de estudio estuvo formada por personas pertenecientes a 6 centros reformados de Atenci&#243;n Primaria &#40;AP&#41;&#59; gestionados por Badalona Serveis Assistencials &#40;BSA&#41;&#46; Se obtuvo informaci&#243;n de los recursos de 2 centros hospitalarios de referencia&#58; Hospital Municipal de Badalona y Hospital Germans Trias i Pujol &#40;atenci&#243;n especializada&#41;&#46; La poblaci&#243;n asignada a los centros fue&#44; en su mayor&#237;a&#44; urbana&#44; de nivel socioecon&#243;mico medio-bajo&#44; con predominio industrial&#46; BSA es una organizaci&#243;n sanitaria integrada que da cobertura a una poblaci&#243;n de referencia de unos 120&#46;000 habitantes de Badalona &#40;Barcelona&#44; Espa&#241;a&#41; y cuenta con 6 centros de AP&#44; el hospital de agudos &#40;Hospital Municipal de Badalona&#41; y un centro sociosanitario&#46; Su modelo de financiaci&#243;n es p&#250;blico y la provisi&#243;n de servicios privada&#59; est&#225; concertada <span class="elsevierStyleItalic">&#40;contrato programa&#41;</span> con el Servicio Catal&#225;n de la Salud &#40;CatSalut&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Criterios de inclusi&#243;n y exclusi&#243;n</span><p id="par0025" class="elsevierStylePara elsevierViewall">Se incluy&#243; en el estudio a todos los pacientes que demandaron atenci&#243;n por un episodio de gota &#40;nuevo o recurrente&#41; desde el 1&#47;01&#47;2003 hasta el 31&#47;12&#47;2007&#44; y que reun&#237;an las siguientes caracter&#237;sticas&#58; <span class="elsevierStyleItalic">a&#41;</span> edad &#8805; 18 a&#241;os&#59; <span class="elsevierStyleItalic">b&#41;</span> seguir de forma regular el protocolo&#47;gu&#237;a de pr&#225;ctica cl&#237;nica establecido en los centros&#44; y <span class="elsevierStyleItalic">c&#41;</span> estar en el programa de prescripciones agudas y cr&#243;nicas del centro&#46; Fueron excluidos los sujetos trasladados a otros centros&#44; los fallecidos y los desplazados o fuera de zona&#46; El seguimiento de los pacientes fue de 24 meses &#40;2 a&#241;os&#41; para el c&#225;lculo de los costes &#40;sanitarios y no sanitarios&#41;&#46; En funci&#243;n del n&#250;mero de brotes&#47;recurrencias&#44; se confeccionaron <span class="elsevierStyleItalic">2 grupos de estudio</span>&#58; pacientes con 1-2 brotes y pacientes con 3 o m&#225;s brotes &#40;ataques agudos&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Medidas relacionadas con la gota</span><p id="par0030" class="elsevierStylePara elsevierViewall">El diagn&#243;stico de gota se obtuvo a partir de la Clasificaci&#243;n Internacional de la AP &#40;CIAP-2&#41;&#44; c&#243;digo T92&#44; en el componente 7 de las enfermedades y problemas de salud<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#44; y de la Clasificaci&#243;n Internacional de Enfermedades&#44; 9&#46;&#170; Revisi&#243;n&#44; Modificaci&#243;n Cl&#237;nica &#40;CIE-9-MC&#41;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> &#40;c&#243;digos&#58; 274&#46;x&#41;&#46; Se efectu&#243; una validaci&#243;n cl&#237;nica de los casos de gota mediante su confirmaci&#243;n en los cursos cl&#237;nicos de la historia cl&#237;nica&#46; La validaci&#243;n consisti&#243; en obtener una muestra aleatoria de 20 historias cl&#237;nicas&#44; donde se comprob&#243; si el diagn&#243;stico cl&#237;nico de gota concordaba con los criterios de la ACR<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#46; En todos los casos se constat&#243; la certeza diagn&#243;stica&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se estim&#243; la prevalencia de la enfermedad como el porcentaje de individuos de la poblaci&#243;n asignada que presentaron un episodio de gota durante el periodo de estudio &#40;prevalencia de periodo&#41;&#46; La tasa de incidencia acumulada fue definida como la proporci&#243;n de individuos sanos que desarrollaron la enfermedad &#40;n&#250;mero de casos nuevos&#41;&#59; la incidencia acumulada&#44; proporciona una estimaci&#243;n de la probabilidad o el riesgo de que un individuo libre de una determinada enfermedad la desarrolle durante un periodo espec&#237;fico de tiempo&#46; No se estandarizaron los resultados puesto que la pir&#225;mide poblacional distribuida por edad y g&#233;nero de los pacientes estudiados fue similar a la de la poblaci&#243;n de Catalu&#241;a &#40;fuente&#58; Instituto Nacional de Estad&#237;stica&#41;&#46; Adem&#225;s&#44; se determin&#243; la fecha de inicio de la enfermedad &#40;a&#241;os de evoluci&#243;n de la enfermedad&#41;&#44; la presencia de hiperuricemia &#40;dicot&#243;mica&#41; y la procedencia de los pacientes &#40;AP&#44; urgencias hospitalarias y&#47;o consultas externas&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Variables sociodemogr&#225;ficas y de morbilidad</span><p id="par0040" class="elsevierStylePara elsevierViewall">Las principales variables de estudio fueron&#58; edad &#40;continua y por rangos&#41; y sexo&#44; as&#237; como los antecedentes personales obtenidos a partir de la CIAP-2<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#58; hipertensi&#243;n arterial &#40;K86&#44; K87&#41;&#44; diabetes mellitus &#40;T89&#44;T90&#41;&#44; dislipidemia &#40;T93&#41;&#44; obesidad &#40;T82&#41;&#44; tabaquismo &#40;P17&#41;&#44; alcoholismo &#40;P15&#44; P16&#41;&#44; insuficiencia renal&#44; accidente vasculocerebral &#40;K90&#44; K91&#44; K93&#41;&#44; enfermedad pulmonar obstructiva cr&#243;nica &#40;R95&#44; obstrucci&#243;n cr&#243;nica del flujo a&#233;reo&#41;&#44; asma bronquial &#40;R96&#41;&#44; demencias o trastornos de memoria &#40;P70&#44; P20&#41;&#44; enfermedades neurol&#243;gicas&#58; enfermedad de Parkinson &#40;N87&#41;&#44; epilepsia &#40;N88&#41;&#44; esclerosis m&#250;ltiple &#40;N86&#41; y otras enfermedades neurol&#243;gicas &#40;N99&#41;&#59; s&#237;ndrome depresivo &#40;P76&#41; y neoplasias malignas &#40;todos los tipos&#59; A79&#44; B72-75&#44; D74-78&#44; F75&#44; H75&#44; K72&#44; L71&#44; L97&#44; N74-76&#44; R84-86&#44; T71-73&#44; U75-79&#44; W72-73&#44; X75-81&#44; Y77-79&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Como variable resumen de la comorbilidad general&#44; para cada paciente atendido&#44; se utilizaron&#58; <span class="elsevierStyleItalic">a&#41;</span> el &#237;ndice de comorbilidad de Charlson<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">24</span></a>&#44; como una aproximaci&#243;n a la gravedad del paciente&#44; y <span class="elsevierStyleItalic">b&#41;</span> el &#237;ndice de casu&#237;stica individual&#44; obtenido a partir de los Adjusted Clinical Groups &#40;ACG&#41;&#44; un sistema de clasificaci&#243;n de pacientes por isoconsumo de recursos<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">25</span></a>&#46; El aplicativo ACG proporciona las bandas de utilizaci&#243;n de recursos &#40;BUR&#41;&#44; con lo que cada paciente en funci&#243;n de su morbilidad general queda agrupado en una de las 5 categor&#237;as mutuamente excluyentes &#40;1&#58; usuarios sanos o de morbilidad muy baja&#44; 2&#58; morbilidad baja&#44; 3&#58; morbilidad moderada&#44; 4&#58; morbilidad elevada&#44; y 5&#58; morbilidad muy elevada&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">La definici&#243;n del SM se estableci&#243; cuando se cumpl&#237;an 3 de los 5 criterios del NCEP-ATP III modificado<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#58; <span class="elsevierStyleItalic">a&#41;</span> triglic&#233;ridos de 150<span class="elsevierStyleHsp" style=""></span>mg&#47;dl o mayor&#59; <span class="elsevierStyleItalic">b&#41;</span> colesterol unido a lipoprote&#237;nas de alta densidad menor de 40<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en varones o menor de 50<span class="elsevierStyleHsp" style=""></span>mg&#47;dl en mujeres&#59; <span class="elsevierStyleItalic">c&#41;</span> presi&#243;n arterial sist&#243;lica&#47;diast&#243;lica de 130&#47;85<span class="elsevierStyleHsp" style=""></span>mmHg o mayor o en tratamiento antihipertensivo&#59; <span class="elsevierStyleItalic">d&#41;</span> glucemia basal en ayunas de 110<span class="elsevierStyleHsp" style=""></span>mg&#47;dl o m&#225;s&#44; o tratamiento hipogluc&#233;mico o diabetes mellitus previamente diagnosticada&#44; y&#47;o <span class="elsevierStyleItalic">e&#41;</span> &#237;ndice de masa corporal de 28&#44;8<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> o superior &#40;este valor fue considerado equivalente al de obesidad o adiposidad abdominal&#58; per&#237;metro de cintura &#62; 102<span class="elsevierStyleHsp" style=""></span>cm en hombres y &#62; 88<span class="elsevierStyleHsp" style=""></span>cm en mujeres&#59; criterio seguido por diferentes autores&#41;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">26</span></a>&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Uso de recursos y modelo de costes</span><p id="par0055" class="elsevierStylePara elsevierViewall">Se consideraron como costes no sanitarios o indirectos los relativos a las p&#233;rdidas de productividad laboral &#40;n&#250;mero de bajas y d&#237;as de incapacidad&#41;&#46; El dise&#241;o del sistema de costes se defini&#243; teniendo en cuenta las caracter&#237;sticas de las organizaciones y el grado de desarrollo de los sistemas de informaci&#243;n disponibles&#46; La unidad de producto que sirvi&#243; de base al c&#225;lculo final &#40;durante el periodo de estudio&#41; fue el paciente atendido y el coste fue expresado en coste medio por paciente &#40;coste&#47;unitario&#41;&#46; Los diferentes conceptos de estudio y su valoraci&#243;n econ&#243;mica se detallan en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> &#40;correspondientes al a&#241;o 2007&#41;&#46; Las diferentes tarifas se obtuvieron a partir de la contabilidad anal&#237;tica de los centros&#44; excepto la medicaci&#243;n y los d&#237;as de baja laboral&#46; Las prescripciones se cuantificaron seg&#250;n el precio de venta al p&#250;blico por envase en el momento de la prescripci&#243;n&#46; Los d&#237;as de incapacidad laboral o p&#233;rdidas de productividad se consideraron como costes no sanitarios &#40;costes indirectos&#41;&#46; El coste se cuantific&#243; seg&#250;n el salario m&#237;nimo interprofesional &#40;fuente&#58; Instituto Nacional de Estad&#237;stica&#41;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&#46; Los costes se determinar&#225;n a los 2 a&#241;os de seguimiento de los pacientes&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Confidencialidad de la informaci&#243;n</span><p id="par0060" class="elsevierStylePara elsevierViewall">Se respet&#243; la confidencialidad de los registros marcada por la Ley Org&#225;nica de Protecci&#243;n de Datos &#40;15&#47;1999&#44; de 13 de diciembre&#41;&#44; con disociaci&#243;n de los datos&#46; El estudio fue clasificado por la Agencia Espa&#241;ola de Medicamentos y Productos Sanitarios &#40;EPA-OD&#41; y&#44; posteriormente&#44; aprobado por el Comit&#233; de &#201;tica de Investigaci&#243;n Cl&#237;nica del Hospital Universitario Germans Trias i Pujol de Badalona&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">An&#225;lisis estad&#237;stico</span><p id="par0065" class="elsevierStylePara elsevierViewall">Se efectu&#243; un an&#225;lisis estad&#237;stico descriptivo-univariante con valores de media&#44; desviaci&#243;n t&#237;pica&#47;est&#225;ndar &#40;DE&#41; e intervalos de confianza &#40;IC&#41; del 95&#37;&#44; y se comprob&#243; la normalidad de la distribuci&#243;n con la prueba de Kolmogorov-Smirnov&#46; En el an&#225;lisis bivariante se utilizaron las pruebas de ANOVA y de la ji al cuadrado&#44; y correlaci&#243;n lineal de Pearson&#46; Se efectu&#243; un an&#225;lisis de regresi&#243;n log&#237;stica para determinar las variables asociadas a la presencia de &#8805; 3 brotes &#40;variable dependiente&#41;&#44; con procedimiento <span class="elsevierStyleItalic">enter</span> &#40;estad&#237;stico&#58; Wald&#41;&#46; La comparaci&#243;n del coste ambulatorio y hospitalario se realiz&#243; seg&#250;n las recomendaciones de Thompson y Barber<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> mediante el an&#225;lisis de la covarianza &#40;ANCOVA&#41;&#44; con el sexo&#44; la edad y las BUR&#44; y el &#237;ndice de Charlson como covariables &#40;procedimiento&#58; estimaci&#243;n de medias marginales&#59; ajuste de Bonferroni&#41;&#46; Se utiliz&#243; el programa SPSSWIN versi&#243;n 18&#44; estableciendo una significaci&#243;n estad&#237;stica para valores de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p id="par0070" class="elsevierStylePara elsevierViewall">De una selecci&#243;n inicial de 96&#46;206 sujetos &#8805; 18 a&#241;os asignados a los centros&#44; se reclut&#243; a 3&#46;130 pacientes con gota&#46; La prevalencia global fue del 3&#44;3&#37; &#40;IC del 95&#37;&#44; 2&#44;7-3&#44;9&#37;&#41;&#46; La estimaci&#243;n de la tasa de incidencia acumulada fue de 1&#44;1 casos nuevos&#47;1&#46;000 habitantes&#47;a&#241;o&#46; Por grupos de estudio&#44; 2&#46;142 &#40;68&#44;4&#37;&#41; presentaron 1-2 ataques agudos y 988 &#40;31&#44;6&#37;&#41; 3 o m&#225;s recurrencias&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#46; La media &#177; DE de edad fue de 55&#44;8 &#177; 12&#44;2 a&#241;os y el 81&#44;1&#37; fueron varones&#46; Del conjunto de pacientes&#44; el 43&#44;6&#37; fueron hipertensos&#44; el 43&#44;1&#37; obesos y el 40&#44;5&#37; con dislipidemia&#46; La prevalencia del SM fue del 28&#44;8&#37; &#40;IC del 95&#37;&#44; 27&#44;2-30&#44;4&#37;&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se describen las caracter&#237;sticas generales de la serie y las comorbilidades asociadas a los pacientes con gota seg&#250;n los 2 grupos de estudio&#46; Los sujetos con &#8805; 3 ataques agudos&#47;recurrencias mostraron una media de edad superior &#40;57&#44;2 frente a 55&#44;2 a&#241;os&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; y una mayor proporci&#243;n de varones &#40;84&#44;1&#37; frente a 79&#44;7&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46; Estos sujetos presentaron una mayor proporci&#243;n de comorbilidades&#58; BUR &#40;3&#44;1 frente a 2&#44;9&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e &#237;ndice de Charlson &#40;1&#44;1 frente a 0&#44;9&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; En el modelo de regresi&#243;n log&#237;stica corregido&#44; los sujetos con &#8805; 3 ataques agudos&#47;recurrencias se asociaron con el SM <span class="elsevierStyleItalic">&#40;odds ratio</span> &#91;OR&#93;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44;2&#59; IC del 95&#37;&#44; 4&#44;6-8&#44;3&#41;&#44; la obesidad &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;1&#59; IC del 95&#37;&#58; 1&#44;7-2&#44;5&#41; y la hipertensi&#243;n arterial &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;6&#59; IC del 95&#37;&#58; 1&#44;3-1&#44;9&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#46; El SM tuvo una moderada correlaci&#243;n lineal con el n&#250;mero de ataques agudos &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;517&#41;&#44; los a&#241;os de evoluci&#243;n de la enfermedad &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;321&#41; y los niveles iniciales de &#225;cido &#250;rico &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;278&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#46; Las caracter&#237;sticas basales de la artropat&#237;a gotosa se detallan en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#59; el 89&#44;1&#37; de los sujetos presentaron hiperuricemia y el 84&#44;7&#37; de los casos procedieron de AP&#46; Los sujetos con &#8805; 3 ataques agudos&#47;recurrencias mostraron un mayor seguimiento en las consultas de reumatolog&#237;a &#40;el 3&#44;6 frente al 0&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Cabe destacar que &#250;nicamente en el 16&#44;9&#37; de los pacientes existi&#243; un diagn&#243;stico de certeza de gota &#40;visualizaci&#243;n de cristales de urato monos&#243;dico en el microscopio&#41;&#46; Por grupos de estudio&#44; en sujetos con &#8805; 3 ataques agudos&#47;recurrencias fue del 29&#44;0 frente al 11&#44;3&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">El modelo de costes brutos y corregidos prospectivos &#40;seguimiento de 24 meses&#41; asociados a la gota seg&#250;n los grupos de estudio se describe en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#46; El coste total de los pacientes incluidos en el estudio ascendi&#243; a 7 millones de euros&#44; de los cuales el 96&#44;9&#37; correspondi&#243; a costes sanitarios directos y el 3&#44;1&#37; a costes no sanitarios &#40;p&#233;rdidas de productividad&#41;&#44; con un promedio&#47;unitario total de 2&#46;228&#44;6 &#8364;&#46; Por grupos&#44; los costes totales &#40;sanitarios&#44; no sanitarios&#41; de los sujetos con 1-2 ataques de gota fueron inferiores en comparaci&#243;n con los que presentaron &#8805; 3 ataques &#40;2&#46;028&#44;6 &#8364; frente a 2&#46;662&#44;2 &#8364;&#41;&#46; La distribuci&#243;n porcentual del coste representa el 90&#44;8&#37; en AP y el 6&#44;2&#37; en atenci&#243;n especializada&#59; de estos&#44; el 23&#44;5&#37; en visitas en AP y el 57&#44;7&#37; en prescripci&#243;n farmac&#233;utica&#46; En el modelo multivariante corregido&#44; los costes fueron inferiores en el grupo de 1-2 ataques&#44; en especial los costes sanitarios totales &#40;2&#46;101&#44;5 &#8364; frente a 2&#46;517&#44;4 &#8364;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y en AP &#40;1&#46;987&#44;6 &#8364; frente a 2&#46;331&#44;3 &#8364;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; El promedio&#47;unitario corregido de los costes totales por paciente fue de 2&#46;130&#44;6 &#8364; frente a 2&#46;605&#44;4 &#8364;&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; En todos los componentes del coste los resultados fueron mayores en el grupo con &#8805; 3 ataques&#46; Durante el periodo de estudio&#44; los pacientes con &#8805; 3 ataques agudos&#47;recurrencias mostraron un mayor promedio de n&#250;mero de bajas laborales &#40;2&#44;3 frente a 1&#44;2&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41; y d&#237;as de incapacidad laboral &#40;0&#44;6 frente a 2&#44;6 d&#237;as&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">El subgrupo de pacientes diab&#233;ticos &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>641&#59; 20&#44;5&#37;&#59; IC del 95&#37;&#44; 19&#44;1-21&#44;9&#37;&#41;&#44; en comparaci&#243;n con los no diab&#233;ticos&#44; present&#243; un mayor promedio unitario del coste total &#40;3&#46;124&#44;8 &#8364; frente a 1&#46;997&#44;8 &#8364;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#59; estos pacientes mostraron mayor edad &#40;61&#44;9 frente a 54&#44;2 a&#241;os&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; carga de morbilidad &#40;3&#44;1 frente a 2&#44;8 BUR&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y SM &#40;63&#44;2 frente a 20&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p id="par0090" class="elsevierStylePara elsevierViewall">Los resultados generales del estudio muestran una prevalencia de gota del 3&#44;3&#37;&#59; con un mayor predominio en varones y con 1-2 ataques agudos&#46; Estas caracter&#237;sticas son similares a la mayor&#237;a de los estudios revisados de &#225;mbito poblacional<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; Aunque cabe destacar que la propia historia natural de la enfermedad puede dificultar su diagn&#243;stico&#44; especialmente en AP y en los servicios de urgencias&#44; donde la presencia del ataque agudo articular puede enmascarar otras entidades nosol&#243;gicas dificultando el diagn&#243;stico diferencial<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;6-8</span></a>&#46; Seg&#250;n los criterios del NCEP<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#44; la prevalencia del SM fue del 28&#44;8&#37;&#44; destacando su asociaci&#243;n con la obesidad&#44; la hipertensi&#243;n arterial y los niveles basales elevados de &#225;cido &#250;rico&#46; Nuestros resultados son similares a los datos de otros estudios revisados<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8&#44;11-13</span></a>&#46; Cabe considerar que en nuestro pa&#237;s la prevalencia del SM y su asociaci&#243;n con la gota podr&#237;an ser m&#225;s altas&#46; Algunos autores la sit&#250;an en cifras alrededor del 50&#37; en pacientes mayores de 60 a&#241;os y del 35&#37; en pacientes con gota en poblaci&#243;n general<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En el estudio&#44; el promedio&#47;unitario del coste fue de 2&#46;228&#44;6 &#8364;&#46; En el modelo corregido el promedio&#47;unitario de los costes totales por paciente fueron de 2&#46;130&#44;6 &#8364; &#40;1-2 ataques&#41; frente a 2&#46;605&#44;4 &#8364; &#40;&#8805; 3 ataques&#41;&#46; En todos los componentes del coste los resultados fueron mayores en el grupo con &#8805; 3 ataques y en el subgrupo de pacientes diab&#233;ticos&#46; En este aspecto&#44; para Brook et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> el coste total anual en una cohorte de empleados con gota fue de &#36; 6&#46;870&#44; 2 veces superior a los pacientes en ausencia de gota&#59; destacando que solo el 1&#37; de los empleados con gota generaron el 20&#37; de los costes&#46; Wu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> en un excelente trabajo realizado en pacientes ancianos&#44; en el que relacionan los niveles de &#225;cido &#250;rico s&#233;rico con el coste de los pacientes con gota fue de &#36; 2&#44;555&#46; En el estudio realizado por Mould-Quevedo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#44; sobre las principales enfermedades reum&#225;ticas inflamatorias desde la perspectiva del paciente en M&#233;xico&#44; el coste&#47;anual fue de &#36; 1&#46;006&#44; mayoritariamente en los costes ambulatorios&#46; Nuestros resultados estar&#237;an en consonancia con los aportados por Wu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&#44; donde la metodolog&#237;a empleada fue similar a la descrita en el presente trabajo&#44; aun teniendo presente que sus pacientes eran mayores y seguramente con mayor comorbilidad&#46; Los otros 2 estudios mencionados con anterioridad &#40;Wu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> y Mould-Quevedo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#41; son de dif&#237;cil comparaci&#243;n&#44; puesto que est&#225;n realizados con pacientes de mayor edad y&#44; adem&#225;s&#44; con metodolog&#237;as de trabajo distintas&#46; Todos los estudios son coincidentes en el peso de los costes ambulatorios&#46; En nuestro estudio&#44; el 96&#44;9&#37; fueron costes sanitarios directos y los mayores costes fueron debidos a las visitas de seguimiento y a la medicaci&#243;n&#46; En este aspecto&#44; un mayor seguimiento de estos pacientes en la AP podr&#237;a reducir los costes de la enfermedad&#59; aunque es indudable que la morbilidad asociada&#44; la falta de cumplimiento y los posibles factores predisponentes pueden repercutir en el uso de los recursos y del coste de estos pacientes<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Cabe destacar los escasos costes en p&#233;rdida de productividad laboral &#40;bajas laborales&#41; que genera la gota&#46; Una posible explicaci&#243;n se debe a que se utiliz&#243; una fuente de informaci&#243;n conservadora &#40;el salario m&#237;nimo interprofesional en lugar del coste salarial medio&#44; lo que ya en s&#237; mismo es una limitaci&#243;n del estudio&#41;&#59; adem&#225;s&#44; es posible que se produzcan bajas de corta duraci&#243;n &#40;inicios de tratamiento o descompensaciones&#41; que no se registren en los partes de incapacidad laboral&#46; Las evidencias disponibles en este terreno de los costes estar&#237;an en consonancia con Ferraz<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> y Joish<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a>&#44; donde evidencian que los pacientes con ataques agudos de artritis gotosa pierden un promedio de 3-5 d&#237;as de trabajo al a&#241;o&#44; ocasionando importantes repercusiones econ&#243;micas por p&#233;rdidas de productividad laboral en algunos casos poco cuantificadas&#46; Aunque&#44; en general&#44; los pacientes con 1-2 ataques son m&#225;s j&#243;venes y&#44; por tanto&#44; tienen menor frecuencia de la mayor&#237;a de las enfermedades asociadas&#44; ello por s&#237; solo puede ser lo que determina el menor coste de la enfermedad en esos pacientes&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Las posibles limitaciones del estudio inciden en la categorizaci&#243;n de la enfermedad&#44; el posible sesgo de clasificaci&#243;n de los pacientes &#40;por exceso&#41; y en la medida operativa de los costes&#44; atribuibles al sistema de informaci&#243;n desarrollado&#46; Por tanto&#44; en el art&#237;culo se muestran las limitaciones propias de los estudios retrospectivos&#59; como por ejemplo&#44; el infrarregistro de los datos o la posible variabilidad de los profesionales y de los pacientes al ser un dise&#241;o observacional&#46; Adem&#225;s&#44; el n&#250;mero de ataques agudos atendidos puede verse comprometido debido a la posible automedicaci&#243;n de los pacientes&#46; El estudio detalla el uso de los recursos y los costes asociados a los pacientes con artritis gotosa en situaci&#243;n de pr&#225;ctica cl&#237;nica habitual&#46; No obstante&#44; cabe destacar que sin una adecuada estandarizaci&#243;n de las metodolog&#237;as en cuanto a las caracter&#237;sticas de los pacientes&#44; as&#237; como en el n&#250;mero y la medida de las variables estudiadas&#44; los resultados obtenidos deben de interpretarse con prudencia oblig&#225;ndonos a ser cautelosos en la validez externa de los resultados&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Futuras investigaciones hacen necesario disponer de estudios de coste&#47;efectividad y de eficacia diagn&#243;stica y de tratamiento&#44; adem&#225;s de replicar el estudio en otras organizaciones sanitarias&#46; Por otra parte&#44; la propiedad inflamatoria de los cristales no est&#225; a&#250;n completamente aclarada&#59; podr&#237;a estar vinculada a la habilidad de ligar inmunoglobulinas&#44; complemento y l&#237;pidos&#46; Se necesitan ensayos cl&#237;nicos a largo plazo para probar la hip&#243;tesis de que la terapia hipouricemiante puede reducir el riesgo cardiovascular en estos pacientes&#46; Tampoco se ha establecido una pauta terap&#233;utica derivada de ensayos cl&#237;nicos en el tratamiento de la inflamaci&#243;n articular aguda&#46; El &#233;xito de la atenci&#243;n a los pacientes con enfermedades cr&#243;nicas como la gota deber&#237;a de basarse en intervenciones de equipos pluridisciplinarios que promuevan intervenciones efectivas en las que los pacientes est&#233;n altamente comprometidos en su autocuidado&#46; Es indudable que el diagn&#243;stico y el tratamiento de la gota deben exigir una mayor estrategia de intervenci&#243;n y de seguimiento por parte de nuestros profesionales sanitarios&#46; En conclusi&#243;n&#44; la gota est&#225; asociada a una elevada morbilidad&#44; SM y consumo de recursos sanitarios&#46; El estudio proporciona datos &#250;tiles sobre el coste de la gota en Espa&#241;a&#46; Los costes m&#225;s destacados corresponden al seguimiento ambulatorio de los pacientes&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Responsabilidades &#233;ticas</span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Protecci&#243;n de personas y animales</span><p id="par0115" class="elsevierStylePara elsevierViewall">Los autores declaran que para esta investigaci&#243;n no se han realizado experimentos en seres humanos ni en animales&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Confidencialidad de los datos</span><p id="par0120" class="elsevierStylePara elsevierViewall">Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicaci&#243;n de datos de pacientes y que todos los pacientes incluidos en el estudio han recibido informaci&#243;n suficiente y han dado su consentimiento informado por escrito para participar en dicho estudio&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Derecho a la privacidad y consentimiento informado</span><p id="par0125" class="elsevierStylePara elsevierViewall">Los autores han obtenido el consentimiento informado de los pacientes y&#47;o sujetos referidos en el art&#237;culo&#46; Este documento obra en poder del autor de correspondencia&#46;</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Autor&#237;a</span><p id="par0130" class="elsevierStylePara elsevierViewall">A&#46; Sicras y R&#46; Navarro realizaron la b&#250;squeda bibliogr&#225;fica&#44; obtuvieron los datos&#44; realizaron el an&#225;lisis y la interpretaci&#243;n de los resultados iniciales&#46; Todos los autores aportaron ideas&#44; interpretaron los hallazgos y revisaron los borradores del manuscrito&#46; Todos los autores aprobaron la versi&#243;n final del art&#237;culo&#46; A&#46; Sicras es el responsable principal del estudio&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicto de intereses</span><p id="par0135" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "identificador" => "xres124274"
          "titulo" => array:5 [
            0 => "Resumen"
            1 => "Objetivo"
            2 => "Pacientes y m&#233;todos"
            3 => "Resultados"
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          "titulo" => "Palabras clave"
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          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Objective"
            2 => "Patients and methods"
            3 => "Results"
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        3 => array:2 [
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        4 => array:2 [
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          "titulo" => "Introducci&#243;n"
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        5 => array:3 [
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            0 => array:2 [
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              "titulo" => "Poblaci&#243;n de estudio"
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            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Criterios de inclusi&#243;n y exclusi&#243;n"
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            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Medidas relacionadas con la gota"
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            3 => array:2 [
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              "titulo" => "Variables sociodemogr&#225;ficas y de morbilidad"
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              "titulo" => "Uso de recursos y modelo de costes"
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              "titulo" => "Confidencialidad de la informaci&#243;n"
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              "titulo" => "An&#225;lisis estad&#237;stico"
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              "titulo" => "Confidencialidad de los datos"
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            2 => array:2 [
              "identificador" => "sec0075"
              "titulo" => "Derecho a la privacidad y consentimiento informado"
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          "identificador" => "sec0080"
          "titulo" => "Autor&#237;a"
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        10 => array:2 [
          "identificador" => "sec0085"
          "titulo" => "Conflicto de intereses"
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        11 => array:2 [
          "identificador" => "xack38004"
          "titulo" => "Agradecimientos"
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        12 => array:1 [
          "titulo" => "Bibliograf&#237;a"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-05-19"
    "fechaAceptado" => "2012-06-27"
    "PalabrasClave" => array:2 [
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec111558"
          "palabras" => array:4 [
            0 => "Gota"
            1 => "Uso de recursos"
            2 => "Costes"
            3 => "S&#237;ndrome metab&#243;lico"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec111557"
          "palabras" => array:4 [
            0 => "Gout"
            1 => "Resources use"
            2 => "Cost"
            3 => "Metabolic syndrome"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar el uso de recursos y el impacto econ&#243;mico de los pacientes con gota en un &#225;mbito poblacional&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dise&#241;o observacional &#40;multic&#233;ntrico&#41; realizado a partir de registros pertenecientes a 6 centros de atenci&#243;n primaria y 2 hospitales&#46; Se incluy&#243; a pacientes &#8805; 18 a&#241;os con un episodio agudo de gota durante los a&#241;os 2003-2007&#46; El seguimiento de los pacientes fue de 2 a&#241;os&#46; Se confeccionaron 2 grupos de estudio&#58; pacientes con 1-2 ataques&#47;recurrencias agudas y con 3 o m&#225;s&#46; Principales variables&#58; sociodemogr&#225;ficas&#44; comorbilidad&#44; s&#237;ndrome metab&#243;lico &#40;SM&#41;&#44; y uso de recursos y costes sanitarios&#47;no sanitarios&#46; An&#225;lisis estad&#237;stico&#58; regresi&#243;n-log&#237;stica&#44; modelo de ANCOVA&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 3&#46;130 pacientes con gota&#46; Prevalencia&#58; 3&#44;3&#37;&#59; edad media&#58; 55&#44;8 a&#241;os&#59; varones&#58; 81&#44;1&#37;&#46; Por grupos&#58; el 68&#44;4&#37; present&#243; 1-2 ataques agudos y el 31&#44;6&#37;&#44; 3 o m&#225;s&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#46; La prevalencia del SM fue del 28&#44;8&#37; &#40;intervalo de confianza &#91;IC&#93; del 95&#37;&#44; 27&#44;2-30&#44;4&#37;&#41;&#46; El promedio&#47;unitario del coste fue de 2&#46;228&#44;6 &#8364; &#40;costes directos&#58; 96&#44;9&#37;&#41;&#44; el 90&#44;8&#37; en AP &#40;visitas&#58; 23&#44;5&#37;&#59; medicamentos&#58; 57&#44;7&#37;&#41;&#46; Por grupos&#44; en el modelo corregido el promedio&#47;unitario de los costes totales por paciente fue de 2&#46;130&#44;6 &#8364; frente a 2&#46;605&#44;4 &#8364;&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; En todos los componentes del coste los resultados fueron mayores en el grupo con &#8805; 3 ataques&#46; El subgrupo de pacientes diab&#233;ticos &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>641&#59; 20&#44;5&#37;&#41; present&#243; un mayor coste &#40;3&#46;124&#44;8 &#8364; frente a 1&#46;997&#44;8 &#8364;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La gota se asocia a una elevada morbilidad&#44; presencia de SM y consumo de recursos&#46; El estudio proporciona datos &#250;tiles sobre el coste de la enfermedad&#59; siendo los costes de seguimiento ambulatorio los m&#225;s elevados&#46;</p>"
      ]
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine the use of resources and economic impact of patients with gout at the population level&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Observational design analysing records belonging to 6 primary care centers and 2 hospitals&#46; We included patients&#8217; &#8805;18 years with an acute episode of gout over the years 2003-2007&#46; Patient follow-up was 2 years&#46; It produced two study groups&#58; patients with 1-2 attacks&#47;acute recurrences and 3 or more events&#46; Main variables were&#58; demographic&#44; co-morbidity&#44; metabolic syndrome &#40;MS&#41;&#44; and resource use and health&#47;non-health costs&#46; Statistical analysis&#58; logistic regression-model ANCOVA&#44; <span class="elsevierStyleItalic">P</span>&#60;&#46;05&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">3&#44;130 patients with gout were included&#46; Prevalence&#58; 3&#46;3&#37;&#44; mean age&#58; 55&#46;8 years male&#58; 81&#46;1&#37;&#46; Groups were distributed as follows&#58; 68&#46;4&#37; had 1-2 acute attacks and 31&#46;6&#37; with 3 or more&#44; <span class="elsevierStyleItalic">P</span>&#60;&#46;001&#46; The prevalence of MS was 28&#46;8&#37; &#40;confidence interval &#91;CI&#93; 95&#37; CI 27&#46;2 to 30&#46;4&#37;&#41;&#46; The average&#47;unit cost was &#8364; 2&#44;228&#46;6 &#40;direct costs&#58; 96&#46;9&#37;&#41;&#44; 90&#46;8&#37; in primary care &#40;visits&#58; 23&#46;5&#37;&#59; drugs&#58; 57&#46;7&#37;&#41;&#46; For groups&#44; the average corrected model&#47;unit total cost per patient was &#8364; 2&#44;130&#46;6 vs&#46; &#8364; 2&#44;605&#46;4&#44; respectively &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;001&#41;&#46; In all cost components&#44; the results were higher in the group with &#8805; 3 attacks&#46; The subgroup of diabetic patients &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>641&#44; 20&#46;5&#37;&#41; had a higher cost &#40;&#8364; 3&#44;124&#46;8&#8364; vs&#46; &#8364; 1&#44;997&#46;8&#44; <span class="elsevierStyleItalic">P</span>&#60;&#46;001&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Gout is associated with substantial morbidity&#44; presence of MS and resource consumption&#46; The study provides useful data on the cost of the disease&#59; the costs of outpatient follow up is the highest&#46;</p>"
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                  \t\t\t\t">58&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">43&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Diabetes mellitus</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">15&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">31&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Dislipidemia</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">32&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">58&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">40&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Obesidad</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">33&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">63&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">43&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Fumadores activos</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">17&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">35&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">23&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Alcoholismo</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">4&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">11&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Cardiopat&#237;a isqu&#233;mica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">11&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">23&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">15&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Accidente vasculocerebral</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Insuficiencia renal</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Asma bronquial</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">4&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">4&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">EPOC</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">9&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">12&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">10&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Neuropat&#237;as</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">S&#237;ndrome depresivo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">12&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">15&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">13&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Neoplasias malignas</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">9&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;040&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">S&#237;ndrome metab&#243;lico</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Consultas hospitalarias&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  """
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          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">IC&#58; intervalo de confianza&#59; NS&#58; no significativo&#59; p<span class="elsevierStyleSup">a</span>&#58; significaci&#243;n estad&#237;stica entre el coste de los 2 grupos de estudio&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Valores expresados en porcentaje o media &#177; desviaci&#243;n est&#225;ndar&#46;</p>"
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Grupos de artropat&#237;a&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Uso &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PU&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1-2 ataques&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Uso &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805; 3 ataques&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Uso &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">P<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coste total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">N&#250;mero de pacientes&#44; &#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">N &#61; 2&#46;142 &#40;68&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">N &#61; 988 &#40;31&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">N &#61; 3&#46;130 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="13" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Modelo de costes sin corregir</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes sanitarios</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;993&#44;6 &#177; 1&#46;538&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;522&#44;4 &#177; 1&#46;773&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;160&#44;5 &#177; 1&#46;634&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;762&#46;332&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Costes en atenci&#243;n primaria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;881&#44;3 &#177; 1&#46;390&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;328&#44;6 &#177; 1&#46;628&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;022&#44;5 &#177; 1&#46;484&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;330&#46;381&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Visitas m&#233;dicas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">499 &#177; 383&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">576&#44;7 &#177; 374&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">523&#44;7 &#177; 382&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;639&#46;281&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Pruebas de laboratorio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130&#44;3 &#177; 92&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">160&#44;5 &#177; 91&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">139&#44;8 &#177; 93&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">437&#46;571&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Radiolog&#237;a convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#44;6 &#177; 38&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">46&#44;1 &#177; 41&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">83&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#44;0 &#177; 39&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">128&#46;267&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Pruebas complementarias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">29&#44;2 &#177; 47&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">55&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;5 &#177; 52&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;5 &#177; 49&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&#46;586&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Prescripci&#243;n farmac&#233;utica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;183&#44;9 &#177; 1&#46;166&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;505&#44;9 &#177; 1&#46;421&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;285&#44;5 &#177; 1&#46;261&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;023&#46;674&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Costes en atenci&#243;n especializada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">112&#44;3 &#177; 501&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">193&#44;8 &#177; 545&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138&#44;0 &#177; 517&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">431&#46;951&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Visitas m&#233;dicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">53&#44;9 &#177; 186&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">97&#44;4 &#177; 249&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">67&#44;6 &#177; 209&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>D&#237;as de hospitalizaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">81&#44;2 &#177; 436&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">55&#44;0 &#177; 429&#44;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Urgencias&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">15&#44;5 &#177; 49&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15&#44;4 &#177; 47&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">48&#46;281&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes no sanitarios</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">5&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;1 &#177; 550&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">139&#44;8 &#177; 1&#46;116&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#44;1 &#177; 775&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">213&#46;189&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes totales &#40;sanitarios&#47;no sanitarios&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;028&#44;6 &#177; 1&#46;661&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;662&#44;2 &#177; 2&#46;143&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;228&#44;6 &#177; 1&#46;850&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;975&#46;521&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="13" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Modelo de costes corregidos</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Diferencia</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes sanitarios totales</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;101&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;517&#44;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;415&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;024&#44;1-2&#46;179&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;391&#44;2-2&#46;643&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes en atenci&#243;n primaria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">1&#46;987&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;343&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">1&#46;917&#44;5-2&#46;057&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;217&#44;3-2&#46;445&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes en atenci&#243;n especializada</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">113&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">186&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;72&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">141&#44;9-230&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Costes no sanitarios</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>IC del 95&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;459&#44;9-2&#46;750&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara">Modelo de ANCOVA&#58; cada prueba F contrasta el efecto simple de la presencia en cada combinaci&#243;n de dosis del resto de los efectos mostrados&#46; Estos contrastes se basan en las comparaciones por pares&#44; linealmente independientes&#44; entre las medias marginales estimadas&#46; Covariables&#58; edad&#44; BUR e &#237;ndice de Charlson&#46; Componente fijo&#58; sexo&#46; Uso&#58; porcentaje de uso de recursos entre todos los pacientes&#46; PU&#58; promedio&#47;unitario del uso recursos&#46; Los costes no sanitarios se refieren a los d&#237;as de p&#233;rdida de productividad laboral&#46;</p>"
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        "descripcion" => array:1 [
          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Modelo de costes brutos y corregidos</p>"
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      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
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            0 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of gout and hyperuricemia in Taiwan&#58; a hospital-based&#44; cross-sectional study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;W&#46; Lai"
                            1 => "C&#46;S&#46; Liu"
                            2 => "T&#46; Lin"
                            3 => "C&#46;C&#46; Lin"
                            4 => "H&#46;C&#46; Lai"
                            5 => "K&#46;F&#46; Liao"
                          ]
                        ]
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                    0 => array:2 [
                      "doi" => "10.1097/SMJ.0b013e3181a8cab9"
                      "Revista" => array:6 [
                        "tituloSerie" => "South Med J"
                        "fecha" => "2009"
                        "volumen" => "102"
                        "paginaInicial" => "772"
                        "paginaFinal" => "773"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19488006"
                            "web" => "Medline"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology&#58; gout-bad for the heart as well as the joint"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; So"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/nrrheum.2010.78"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Rev Rheumatol"
                        "fecha" => "2010"
                        "volumen" => "6"
                        "paginaInicial" => "386"
                        "paginaFinal" => "387"
                        "link" => array:1 [
                          0 => array:2 [
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