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The factors that predispose an individual to a higher risk of death from COVID-19 are poorly understood. The goal of the study was to identify factors associated with risk of death among patients with COVID-19. This is a retrospective cohort study of people with laboratory-confirmed SARS-CoV-2 infection from February to May 22, 2020. Data retrieved for this study included patient sociodemographic data, baseline comorbidities, baseline treatments, other background data on care provided in hospital or primary care settings, and vital status. Main outcome was deaths until June 29, 2020. In the multivariable model based on nursing home residents, predictors of mortality were being male, older than 80 years, admitted to a hospital for COVID-19, and having cardiovascular disease, kidney disease or dementia while taking anticoagulants or lipid-lowering drugs at baseline was protective. The AUC was 0.754 for the risk score based on this model and 0.717 in the validation subsample. Predictors of death among people from the general population were being male and/or older than 60 years, having been hospitalized in the month before admission for COVID-19, being admitted to a hospital for COVID-19, having cardiovascular disease, dementia, respiratory disease, liver disease, diabetes with organ damage, or cancer while being on anticoagulants was protective. The AUC was 0.941 for this model’s risk score and 0.938 in the validation subsample. Our risk scores could help physicians identify high-risk groups and establish preventive measures and better follow-up for patients at high risk of dying.ClinicalTrials.gov Identifier: NCT04463706

Introduction:  Pain is defined by the International Association for the Study of Pain (IASP) as an \"unpleasant, unpleasant, and unpleasant sensory and emotional experience of pain. (IASP) as an \"unpleasant sensory and emotional experience, associated with or similar to that associated with actual or potential tissue damage\". In Spain, it is estimated that 1 in 6 Spaniards (17%) suffers from chronic pain and that this disease represents the second cause of consultation in primary care (PC) and more than 50% of these interventions are related to it.  Of the 10 most prevalent pathologies, half of them are related to pain, with a notably higher impact on women. Aims And Objectives: - To know the approach to pain, with special emphasis on chronic pain, in the Basque public health system. - To carry out an analysis of the results obtained in the survey and in the interviews with key clinical and management professionals. - Design and implement a pain strategy in Osakidetza. Material And Method: Design of an online survey with the different key areas of a strategy for pain management in a healthcare organization. 31 questions in 8 blocks. 1.Pain management strategy or plan 2.Resources allocated by the organization 3.Assessment tools 4.Pain management 5.Training activities for professionals 6.Information/sensitization and empowerment of the patients and families 7.Coordination and continuity of care 8.Evaluation indicators Results: All organizations have strategies or plans. 67% of the Integrated care Organisation (ICO) have a Pain commission 100% of the ICO has a Pain Unit. 25% have specific resources for primary care. 100% has medical protocols for referrals and 75% in infirmary. 100% of ICO use the analog visual scale (AVS), among others. 83% of the ICOs have drug management reconciliation activities and safety criteria in drug management, and 75% refer to non-pharmacological approach methodologies, mainly related to the neurosciences. 58% of the OSIs consider that there are activities such as specific courses on pain and  in 75% of them encourage an interdisciplinary approach with specific pain care plans such as musculoskeletal pain. 67% believe that it promotes empowerment interventions, such as community interventions, patient empowerment, group approaches, and health education for both patients and caregivers. regarding continuity of care 75% have  face-to-face activities and 100% have non-face-to-face activities. Realted to evaluation 60% uses AVS instrument and there is a high use of opioids Conclussion: Although there are a multitude of interventions and many agents involved in pain management, the truth is that there is great heterogeneity in the availability of the same resources in the different ICO. Pprimary care still has a residual role in the management of these patients as well as non-pharmacological treatments. the lack of psychological care for these patients is striking. Also noteworthy is the almost non-existent difference in care according to the patient's gender. Implications For Applicability And Limitations: A strategic plan is therefore necessary for the corporation

Background To determine whether there is greater employee satisfaction in organisations that have made more progress in implementation of the European Foundation for Quality Management (EFQM) model. Methods A series of cross-sectional studies (one for each assessment cycle) comparing staff satisfaction survey results between groups of healthcare organisations by degree of implementation of the EFQM model (assessed in terms of external recognition of management quality in each organisation). Setting: 30 healthcare organisations including hospitals, primary care and mental health providers in Osakidetza, the Basque public health service. Participants: Employees of 30 Osakidetza organisations. Intervention: Progress in implementation of EFQM model. Main outcome measures: Scores in 9 dimensions of employee satisfaction from questionnaires administered in healthcare organisations in 4 assessment cycles between 2001 and 2010. Results Comparing satisfaction results in organisations granted Gold or Silver Q Awards and those without this type of external recognition, we found statistically significant differences in the dimensions of training and internal communication. Then, comparing recipients of Gold Q Awards with those with no Q Certification, differences in leadership style and in policy and strategy also emerged as significant. Conclusions Progress of healthcare organisations in the implementation of the EFQM Excellence Model is associated with increases in their employee satisfaction in dimensions that can be managed at the level of each organisation, while dimensions in which no statistically significant differences were found represent common organisational elements with little scope for self-management.

The Basque Country Public Health Service has moved in the last years from considering quality as an attribute of patient care to thinking that all management can be subject to improvement. Consequently, its general management team has promoted and supported a self-assessment experience of all their centres by means of the European Quality Model. This strategy has been facilitated by the Basque Country Government, which has strongly encouraged total quality management in companies, and has created the Basque Foundation for Quality Promotion, a key institution in this whole process. A total of 26 centres of the Public Health Service concluded a self-assessment process. As the main result of this, different improvement areas were detected, and various necessary actions were implemented in the centres assessed. Advantages, troubles and future work lines to extend and improve the use of the EFQM model in the health sector are discussed.