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Evaluación de la efectividad en salud pública: Fundamentos conceptuales y metodológicos
Effectiveness assessment in public health: conceptual and methodological foundations
Manel Nebota,b,c,d,
Corresponding author
mnebot@aspb.cat

Autor para correspondencia.
, Mª José Lópeza,b,d, Carles Arizaa,b,d, Joan R. Villalbía,b,c,d, Anna García-Altésb,d,e
a Agencia de Salud Pública de Barcelona, Barcelona, España
b CIBER de Epidemiología y Salud Pública (CIBERESP), España
c Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, España
d Institut d’Investigacions Biomèdiques Sant Pau (IIB Sant Pau), Barcelona, España
e Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS), Barcelona, España
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En los &#250;ltimos a&#241;os ha aumentado de forma notable el inter&#233;s por la evaluaci&#243;n de las intervenciones en salud&#44; especialmente en relaci&#243;n a su utilidad social y su eficiencia econ&#243;mica&#46; Sin embargo&#44; todav&#237;a estamos lejos de tener un grado suficiente de consenso en los aspectos b&#225;sicos de la evaluaci&#243;n&#44; como son la terminolog&#237;a&#44; la finalidad y la metodolog&#237;a de trabajo&#46; En este marco se revisan las principales definiciones y clasificaciones de la evaluaci&#243;n aplicada a los programas y pol&#237;ticas en salud p&#250;blica&#46; En relaci&#243;n a la evaluaci&#243;n de resultados&#44; se presentan los principales dise&#241;os evaluativos y sus componentes&#44; y se revisan las amenazas a la validez interna de los resultados de los dise&#241;os evaluativos d&#233;biles&#46; Se analizan y discuten las caracter&#237;sticas de las intervenciones de salud p&#250;blica que limitan las opciones de evaluaci&#243;n con dise&#241;os tradicionales&#46; Entre estas limitaciones destacan la complejidad de las intervenciones&#44; que habitualmente tienen m&#250;ltiples componentes&#44; y la dificultad de establecer un grupo de comparaci&#243;n sin intervenci&#243;n&#44; en especial mediante asignaci&#243;n aleatoria&#46; Para finalizar&#44; se describe una propuesta de evaluaci&#243;n a partir de dise&#241;os evaluativos d&#233;biles&#44; consistente en la valoraci&#243;n de la adecuaci&#243;n y la plausibilidad&#46; La adecuaci&#243;n estar&#237;a determinada por la existencia de un cambio observable en los indicadores de resultados&#44; y podr&#237;a ser suficiente para tomar decisiones bajo determinadas condiciones&#59; otras veces ser&#237;a necesario analizar la plausibilidad&#44; o atribuci&#243;n de los resultados observados al programa&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In the last few years&#44; interest has markedly increased in evaluating health programs&#44; especially their social utility and economic efficiency&#46; However&#44; consensus on key issues in evaluation&#44; such as terminology&#44; goals and methods is still a long way off&#46; In this context&#44; we review the main definitions and classifications of evaluation applied to public health programs and policies&#46; We describe the main evaluation designs and their components&#44; focusing on outcome evaluation&#46; Threats to the internal validity of the results of weak evaluation designs are also discussed&#46; The characteristics of public health interventions that limit evaluation with traditional designs are also analyzed&#46; These limitations include the complexity of interventions&#44; usually with multiple components&#44; and the difficulty of forming an equivalent control group with no intervention&#44; especially through random assignment&#46; Finally&#44; a two-step approach to evaluation through weak designs&#44; which takes into account adequacy and plausibility&#44; is described&#46; Adequacy consists of the observation of a change in the selected indicators after the intervention&#44; and would be sufficient to take decisions under certain conditions&#59; at other times&#44; plausibility would need to be analyzed&#44; defined as attribution of the results to the program or intervention&#46;</p>"
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Article information
ISSN: 02139111
Original language: Spanish
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?