<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112021000600525</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2020.07.006</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[La eficiencia no basta. Análisis ético y recomendaciones para la distribución de recursos escasos en situación de pandemia]]></article-title>
<article-title xml:lang="en"><![CDATA[Efficiency is not enough. Ethical analysis and recommendations for the allocation of scarce resources in a pandemic situation]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hortal-Carmona]]></surname>
<given-names><![CDATA[Joaquín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Padilla-Bernáldez]]></surname>
<given-names><![CDATA[Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Melguizo-Jiménez]]></surname>
<given-names><![CDATA[Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ausín]]></surname>
<given-names><![CDATA[Txetxu]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cruz-Piqueras]]></surname>
<given-names><![CDATA[Maite]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López de la Vieja]]></surname>
<given-names><![CDATA[María Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Puyol]]></surname>
<given-names><![CDATA[Àngel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez-Arias]]></surname>
<given-names><![CDATA[David]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tamayo-Velázquez]]></surname>
<given-names><![CDATA[María Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Triviño]]></surname>
<given-names><![CDATA[Rosana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A0"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Agencia Pública Sanitaria Hospital de Poniente Hospital de Guadix ]]></institution>
<addr-line><![CDATA[Granada ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Red de Ética Salubrista para la Acción, Cuidados y Observación Social (ESPACyOS)  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Servicio Madrileño de Salud Colectivo Silesia ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Servicio Andaluz de Salud Centro de Salud Almanjáyar ]]></institution>
<addr-line><![CDATA[Granada ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Centro Superior de Investigaciones Científicas (CSIC) Instituto de Filosofía ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Escuela Andaluza de Salud Pública  ]]></institution>
<addr-line><![CDATA[Granada ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Universidad de Salamanca Facultad de Filosofía Departamento de Historia del Derecho, Filosofía Jurídica, Moral y Política]]></institution>
<addr-line><![CDATA[Salamanca ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Universitat Autònoma de Barcelona Facultad de Filosofía y Letras Departamento de Filosofía]]></institution>
<addr-line><![CDATA[Barcelona ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,Universidad de Granada Facultad de Psicología, Unidad Científica de Excelencia FiloLab Departamento de Filosofía 1]]></institution>
<addr-line><![CDATA[Granada ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="A10">
<institution><![CDATA[,Universidad de Alcalá Facultad de Medicina y Ciencias de la Salud Departamento de Cirugía y Ciencias Médicas y Sociales]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>35</volume>
<numero>6</numero>
<fpage>525</fpage>
<lpage>533</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112021000600525&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112021000600525&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112021000600525&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo:  Elaborar una herramienta de apoyo que ayude a tomar decisiones en el marco de la pandemia de COVID19.  Método:  Se parte de una búsqueda de diferentes recomendaciones éticas surgidas en España sobre priorización de recursos sanitarios escasos en la pandemia de COVID19, así como de una revisión narrativa de modelos teóricos sobre distribución en pandemias para definir una fundamentación ética. Finalmente, se extraen recomendaciones para su posible aplicación en distintos ámbitos asistenciales.  Resultados:  Se identifican tres principios, igualdad estricta, equidad y eficiencia, que se sustancian en criterios de distribución específicos.  Conclusiones:  Se propone un modelo de distribución de recursos sanitarios escasos en situación de pandemia que parte de un procedimiento de toma de decisiones y adapta los criterios de distribución a los escenarios de la atención sanitaria: atención primaria, residencias sociosanitarias y atención hospitalaria.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective:  To develop a support tool to decision-making in the framework of the COVID19 pandemic.  Method:  Different ethical recommendations that emerged in Spain on prioritizing scarce health resources in the COVID19 pandemic first wave were searched; it was conducted a narrative review of theoretical models on distribution in pandemics to define an ethical foundation. Finally, recommendations are drawn to be applied in different healthcare settings.  Results:  Three principles are identified; strict equality, equity and efficiency, which are substantiated in specific distribution criteria.  Conclusions:  A model for the distribution of scarce health resources in a pandemic situation is proposed, starting with a decision-making procedure and adapting the distribution criteria to different healthcare scenarios: primary care settings, nursing homes and hospitals.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Ética de la salud pública]]></kwd>
<kwd lng="es"><![CDATA[Equidad en salud]]></kwd>
<kwd lng="es"><![CDATA[Racionamiento]]></kwd>
<kwd lng="es"><![CDATA[Eficiencia en salud]]></kwd>
<kwd lng="es"><![CDATA[Pandemia]]></kwd>
<kwd lng="en"><![CDATA[Public health ethics]]></kwd>
<kwd lng="en"><![CDATA[Health equity]]></kwd>
<kwd lng="en"><![CDATA[Rationing]]></kwd>
<kwd lng="en"><![CDATA[Health efficiency]]></kwd>
<kwd lng="en"><![CDATA[Pandemics]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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