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[Economic evaluation of healthcare interventions during more than 25 years in Spain (1983-2008)].

BACKGROUND
Economic evaluation has been promoted as a tool to guide decision-making processes regarding healthcare resources' allocation and in the adoption of healthcare technologies. We analyzed the evolution and the main characteristics of economic evaluations of healthcare interventions done during the period 1983-2008 in Spain.


METHODS
Observational descriptive study. We performed a systematic review in the main bibliographic databases (PubMed/ MEDLINE, SCOPUS, ISI Web of Knowledge, CRD, IME, IBECS) and manually through Internet in journals and public reports. There were predefined inclusion and exclusion criteria, and a set of variables to analyze the characteristics of the selected reports.


RESULTS
In total, 477 studies fulfilled the inclusion criteria. Some of the studies characteristics were: cost-effectiveness analysis (62.5%), decision analysis techniques (34.0%), healthcare system perspective (42.1%), therapeutic interventions (70.0%) and non explicit financing (44.0%). The geographical distribution for Spanish regions of the first authors was: Catalonia (29.3%), Community of Madrid (23.7%), Andalusia (6,7%) and Region of Valencia (6.3%). A total of 50.9% of the principal authors were employed at hospital centers. The most common disease conditions were: cardiovascular diseases (15.7%), infectious and parasitic diseases (15.3%) and malignant neoplasms (13.2%). A total of 82.2 % of the reports provided recommendations for decision making.


CONCLUSIONS
An increasing number of studies was observed. Identified reports combined heterogeneity in the quality of the information brought with regard to analysis methods, data sources, type of interventions, or disease conditions. It is suggested to do more efforts for improving the quantity and quality of reports in public health interventions.