Understanding the quality, costs and outcomes of healthcare services requires precise determination of the morbidity in a population. Measurement of morbidity in a population and its association with the services provided remains to be performed. The aim of this article was to present our experience of using clinical risk groups (CRGs) to measure morbidity in an integrated healthcare organization (IHO). We studied the population attended by an IHO in a county (approximately 120,000 patients) from 2002 to 2005. CRGs were used to measure morbidity. A descriptive analysis was performed of the population's distribution in CRG categories and utilization rates. One or more chronic diseases was found in 15.5% of the population, significant acute illness was found in 9%, minor chronic diseases was found in 7% and very severe diseases was found in 0.5%. Between 2002 and 2005, the number of individuals with chronic disease increased by 8%. The burden of illness increased with age. However, at all ages, at least 40% of the population remained healthy. Comorbidity in chronic illnesses was a crucial factor in explaining healthcare resource utilization. The CRG grouping system aids analysis at different levels for clinical administration. Due to its composition, this system allows better understanding of the use, costs and quality of the set of services received by a population.

A number of health economics studies require patient cost estimates as basic information input. However, the accuracy of cost estimates remains generally unspecified. We propose to investigate how the allocation of indirect costs or overheads can affect the estimation of patient costs and lead to improvements in the analysis of patient cost estimates. Instead of focussing on the costing method, this paper will highlight observed changes in variation explained by a methodology choice. We compare four overhead allocation methods for a specific Spanish population adjusted using the Clinical Risk Groups model. Our main conclusion is that the amount of global variation explained by the risk adjustment model depends mainly on direct costs, regardless of the cost allocation methodology used. Furthermore, the variation explained can be slightly increased, depending on the cost allocation methodology, and is independent of the level of aggregation in the classification system.

Objectives To analyse the prevalence of sexual violence (SV) and associated factors in Spanish young adults in the last year and before, during and after the COVID-19 lockdown. Design Cross-sectional study based on the online ‘SV in Young People Survey’ (2020). Setting Non-institutionalised population residing in Spain. Participants 2515 men and women aged 18–35 years old. The participants were obtained from a probability based, online closed panel of adults aged 16 or older that is representative of the non-institutionalised population. The sample designed includes quotas by sex, age, region and country of origin. Outcomes measures and analyses SV victimisation by sociodemographics, sexual attraction and couple-related characteristics during the past year and before, during and after the COVID-19 lockdown (March–June 2020). Prevalence ratios were calculated using robust Poisson regression models. Results In Spain, 8.5% of young people experienced SV during the past year. The greatest prevalence was observed in women with bisexual attraction (17.5%) and in men with homosexual attraction (14.2%). During the COVID-19 lockdown, the prevalence of SV victimisation was lower (1.9%), but unwanted intercourses increased, affecting 64.4% of those exposed to SV during the period. People with homosexual or bisexual attraction were more likely to experience SV in all of the studied periods (PRbefore: 2.01; p<0.001; PRduring: 2.63 p=0.002; PRafter: 2.67; p<0.001). Women were more likely than men to experience SV prior to the lockdown, while no cohabitation increased the likelihood to experience SV after this period Conclusions SV victimisation in Spanish youth is high. During COVID-19, there were changes in the magnitude of factors associated with SV. It seems that SV events decreased in people who did not live with their partners, but unwanted intercourses increased. The development of prevention strategies to address SV in youth should take into account social inequalities by sex, sexual orientation and origin.

Purpose: Entrepreneurship requires the attitudes and capabilities needed to begin new and innovative projects able to create positive impacts in the economy of a society. Given that it forms the basis from which new companies, products and innovations emerge, it is a very relevant term in business. With the aim of strengthening these capabilities, many universities are incorporating new educational strategies into their curricula to boost entrepreneurial intention and business skills among their students. This study aims to determine the factors that intervene in the entrepreneurial spirit of students in Spanish universities by examining areas of study, different personal and contextual characteristics, and the type of training students receive in entrepreneurship.Design/methodology/approach: Data collected from 33,182 students in 77 Spanish universities in the 2018 edition of the Global University Entrepreneurial Spirit Students' Survey (GUESSS) is examined in an exhaustive univariate and bivariate descriptive and inferential analysis. Furthermore, the relationship between the entrepreneurial index and the different explicative variables is modelled, and a basic random effect for the area of study is introduced to detect differences at this level.Findings: Economics, engineering and health sciences presented higher than average entrepreneurial indices. Regarding the type of training, only voluntary education in entrepreneurship influenced entrepreneurial spirit, albeit not equally in all areas of study.Originality/value: This study’s results can help universities to incorporate new educational strategies into their curricula to boost entrepreneurial intention and business skills among students by focusing resources where they are most efficient.

Background: Sexual harassment is a type of coercion, including social pressure, intimidation, physical force, and verbal acts, in addition to other forms such as cyber-harassment, recognized as a major important public health problem. Methods: This cross-sectional study, based on a survey administered online to men and women aged 18 to 35 years and living in Spain throughout 15th and 28th October 2020, aims to analyze the prevalence and factors associated with sexual harassment among young people in Spain within the last 12 months, particularly according to the COVID-19 lockdown period. It has been conducted by bivariate analysis and robust Poisson regression models. The final sample includes 2.515 participants. Results: The results indicate that women were almost twice as likely as men to experience sexual harassment (49% vs 22.2%). Also, among heterosexual men and women, the estimated prevalence was lower concerning that observed among bisexuals, gays, and lesbians (31.5% vs 53, 39.2, and 34.6% respectively). The prevalence percentage in the 18–24 age group was twice high as that observed in the 30–35 age group. Finally, during the lockdown period, the harassment through electronic channels increased (32.6% vs 16.5 and 17.8% before and after this period, respectively) and decreased on public roads (22.9% vs 63.4 and 54.4% pre-lockdown and post-lockdown periods, respectively). Conclusion: These findings highlight that sexual harassment presents a high prevalence among young people, especially cyber-harassment, and workplace harassment and it is important to be aware that young women are more likely to suffer harassment and even more if they do not have a partner or have LGB orientation. During the lockdown sexual harassment has moved from public spaces to the social network.