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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We thank Velasco Montes et al&#46; for their interest in our article <span class="elsevierStyleItalic">Gasto sanitario p&#250;blico y mortalidad por COVID-19 en Espa&#241;a y en Europa</span> &#91;Public healthcare expenditure and COVID-19 mortality in Spain and in Europe&#93;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is true that we did not include models adjusted for other sociodemographic&#44; economic&#44; or other variables because our aim was to analyze whether the widespread and uncritically accepted relationship between the &#8220;scarcity&#8221; of resources and outcomes<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> was able to be verified empirically&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">It is possible&#44; but not probable&#44; that the lack of a relationship between public healthcare expenditure and mortality due to COVID-19 may change after adjusting for other variables&#46; After adjustment&#44; Medeiros et al&#46; did not find an association between healthcare expenditure and the mortality rate<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> whereas Khan et al&#46; paradoxically found that the higher healthcare expenditure is as a percentage of GDP &#40;&#37;HE&#47;GDP&#41;&#44; the higher the case fatality rate&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The development of adjusted models requires that the variables introduced have a clinical-epidemiological significance and show an independent association with robust outcome variables&#46; The case fatality rate is dependent on the efficacy of epidemiological surveillance and &#37;HE&#47;GDP does not indicate the real expenditure&#46; Nevertheless&#44; if we are able to develop suitable adjustment models&#44; we will attempt to take on the challenge proposed by Velasco Montes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p></span>"
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Correspondence
Public healthcare expenditure and COVID-19 mortality in Spain and in Europe. Response to the Letter from the Editor by Velasco Montes et al
Gasto sanitario público y mortalidad por COVID-19 en España y en Europa. Respuesta a la carta al editor de Velasco Montes et al.
F.J. Elola-Somozaa,
Corresponding author
fjelola@movistar.es

Corresponding author.
, M.C. Bas-Villalobosa,b, J. Pérez-Villacastína,b, C. Macaya-Miguela,c
a Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain
b Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
c Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We thank Velasco Montes et al&#46; for their interest in our article <span class="elsevierStyleItalic">Gasto sanitario p&#250;blico y mortalidad por COVID-19 en Espa&#241;a y en Europa</span> &#91;Public healthcare expenditure and COVID-19 mortality in Spain and in Europe&#93;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is true that we did not include models adjusted for other sociodemographic&#44; economic&#44; or other variables because our aim was to analyze whether the widespread and uncritically accepted relationship between the &#8220;scarcity&#8221; of resources and outcomes<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> was able to be verified empirically&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">It is possible&#44; but not probable&#44; that the lack of a relationship between public healthcare expenditure and mortality due to COVID-19 may change after adjusting for other variables&#46; After adjustment&#44; Medeiros et al&#46; did not find an association between healthcare expenditure and the mortality rate<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> whereas Khan et al&#46; paradoxically found that the higher healthcare expenditure is as a percentage of GDP &#40;&#37;HE&#47;GDP&#41;&#44; the higher the case fatality rate&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The development of adjusted models requires that the variables introduced have a clinical-epidemiological significance and show an independent association with robust outcome variables&#46; The case fatality rate is dependent on the efficacy of epidemiological surveillance and &#37;HE&#47;GDP does not indicate the real expenditure&#46; Nevertheless&#44; if we are able to develop suitable adjustment models&#44; we will attempt to take on the challenge proposed by Velasco Montes et al&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Elola-Somoza FJ&#44; Bas-Villalobos MC&#44; P&#233;rez-Villacast&#237;n J&#44; Macaya-Miguel C&#46; Gasto sanitario p&#250;blico y mortalidad por COVID-19 en Espa&#241;a y en Europa&#46; Respuesta a la carta al editor de Velasco Montes <span class="elsevierStyleItalic">et al</span>&#46; Rev Clin Esp&#46; 2022&#59;222&#58;56&#8211;57&#46;</p>"
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Article information
ISSN: 22548874
Original language: English
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