Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

Background: Asthma is one of the most common chronic respiratory conditions worldwide. Asthma-related economic burden has been reported in Latin America, but knowledge about its economic impact to the Colombian health care system and the influence of disease severity is lacking. This study estimated direct medical costs and health care resource utilization (HCRU) in patients with asthma according to severity in Colombia. Methods: This study identified all-age patients who had at least one medical event linked to an asthma diagnosis (CIE-10: J45-J46) between 2004 and 2014. Patients were selected if they had a continuous enrollment and uninterrupted insurance coverage between January 1–2015 and December 31–2015 and were categorized into 4 different severity levels using a modified algorithm based on Leidy criteria. Healthcare utilization and costs were estimated in a 1-year period after the identification period. A Generalized Linear Model (GLM) with gamma distribution and log link was used to analyze costs adjusting for patient demographics. Results: A total of 20,410 patients were included: 69.5% had mild intermittent, 18.0% mild persistent, 6.9% moderate persistent and 5.5% severe persistent asthma; with mean costs (SD) of $67 (134),$482 (1506), $1061 (1983),$2235 (3426) respectively (p < 0.001). The mean total direct cost was estimated at $331 (1278) per patient. Medication and hospitalization had the higher proportion in total costs (46% and 31% respectively). General physician visits was the most used service (57.2%) and short-acting β-2 agonists the most used medication (24%). Conclusions: Health services utilization and direct costs of asthma were highly related to disease severity. Nationwide health policies aimed at the effective control of asthma are necessary and would play an important role in reducing the associated economic impact

Determinantes económicos y sociales de la obesidad en niños y adolescentes: un análisis regional para Colombia

Tesis (Economista).--Universidad de Cartagena. Facultad de Ciencias Económicas. Programa de Economía, 2015La obesidad es uno de los problemas de salud pública más importante del siglo XXI, el problema es de escala mundial y está afectando no solo a los países desarrollados, sino también, a muchos países de bajo y medianos ingresos. El presente trabajo se propone analizar la complejidad de la asociación entre la obesidad en niños y adolescentes y algunos factores económicos, sociales y nutricionales, lo cual se considera fundamental para la implementación de medidas de intervención, encaminadas a la prevención del sobrepeso y la obesidad

Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

Abstract Background Asthma is one of the most common chronic respiratory conditions worldwide. Asthma-related economic burden has been reported in Latin America, but knowledge about its economic impact to the Colombian health care system and the influence of disease severity is lacking. This study estimated direct medical costs and health care resource utilization (HCRU) in patients with asthma according to severity in Colombia. Methods This study identified all-age patients who had at least one medical event linked to an asthma diagnosis (CIE-10: J45-J46) between 2004 and 2014. Patients were selected if they had a continuous enrollment and uninterrupted insurance coverage between January 1–2015 and December 31–2015 and were categorized into 4 different severity levels using a modified algorithm based on Leidy criteria. Healthcare utilization and costs were estimated in a 1-year period after the identification period. A Generalized Linear Model (GLM) with gamma distribution and log link was used to analyze costs adjusting for patient demographics. Results A total of 20,410 patients were included: 69.5% had mild intermittent, 18.0% mild persistent, 6.9% moderate persistent and 5.5% severe persistent asthma; with mean costs (SD) of $67 (134),$482 (1506), $1061 (1983),$2235 (3426) respectively (p < 0.001). The mean total direct cost was estimated at $331 (1278) per patient. Medication and hospitalization had the higher proportion in total costs (46% and 31% respectively). General physician visits was the most used service (57.2%) and short-acting β-2 agonists the most used medication (24%). Conclusions Health services utilization and direct costs of asthma were highly related to disease severity. Nationwide health policies aimed at the effective control of asthma are necessary and would play an important role in reducing the associated economic impact

Concentration of health spending in an insurer Colombian subsidized regime, 2014

Objetivo: Estimar la concentración del gasto sanitario según grupos de patologías y tipos de servicios en una aseguradora subsidiada que afilia personas pobres (estratos socioeconómicos 1 y 2) al Sistema de Salud de Colombia en 2014. Metodología: Se analizó el gasto sanitario en 1 666 477 afiliados, por grupos de patología y tipos de servicios, en el año 2014. Para la descripción de la concentración del gasto se utilizó el coeficiente de Gini y la curva de Lorenz. Resultados: El gasto sanitario de la aseguradora fue de usd 418 millones. De este, el 81 % se aplicó a servicios contenidos en el Plan Obligatorio de Salud (pos). Los grupos de patologías que concentraron el 43,4 % del gasto sanitario fueron cardiovascular (14,3 %), cáncer (7,8 %), enfermedades respiratorias (7,3 %), enfermedades urinarias (7 %) y traumatismos (6,9 %). Los servicios diagnósticos, curativos y de rehabilitación representaron el 77,8 % del gasto sanitario. La hospitalización fue el grupo de servicio que más impactó el costo (47 %), y las consultas, el más utilizado. Las curvas de Lorenz demostraron que el 70 % del gasto en salud se concentra en aproximadamente el 20 % de los afiliados, generando un coeficiente de Gini de 0,58. Conclusión: El diagnóstico y el tratamiento de las enfermedades crónicas no transmisibles concentran una alta proporción del gasto sanitario, lo cual genera una competencia de recursos para servicios preventivos y de promoción de la salud.Objective: to estimate the concentration of health spending depending on pathology groups and types of services in a subsidized insurance company which enrolled low-income people (social economic strata 1 and 2) in the Colombian Healthcare System in 2014. Methodology: Health spending was analyzed in 1 666 477 members, set up by pathologies and types of services during 2014. To describe the concentration of health spending, researchers used the Gini coefficient and the Lorenz curve. Results: the health spending of the insurance company was US$418 million. Out of this, 81 % was used in service contained in the mandatory Health Plan (in Spanish, Plan Obligatorio de Salud -POS). The pathology groups that concentrated 43.4% of health spending were cardiovascular (14.3%), cancer (7.8%), respiratory diseases (7.3%), urinary diseases (7%) and trauma (6.9%). Diagnostic, healing and rehabilitation services represented 77.8% of health spending. Hospitalization was the service group with the highest impact on costs (47%), and consultations, the most used. The Lorenz curves showed that 70% of the health spending is concentrated in approximately 20% the Affiliated people, resulting in a 0.58 Gini coefficient. Conclusion: Diagnostic and treatment of chronic non-transmittable diseases concentrate a vast part of health spending, which produces a competition of resources for preventive services and healthcare promotion

How expensive are hospitalizations by Covid-19? evidence from Colombia

Objectives This study aimed to estimate the direct medical costs due to hospitalizations by COVID-19 in Colombia and to identify their cost drivers in Colombia. Methods This is a retrospective cost-of-illness study of COVID-19 in Colombia. We estimated direct medical costs using data from patients insured to a Benefit Plan Administrator Company, between March 15, 2020 and May 29, 2020. Absolute and relative frequencies, averages, medians, and interquartile ranges (IQRs) were used to characterize the population and estimate the costs of hospitalized patients with COVID-19. We stratified the cost analysis by sex, age groups, comorbidities, and type of hospitalization (general ward and intensive care unit [ICU]). Cost drivers were calculated from a generalized linear model. Results We studied 113 confirmed patients, 51.3% men. On average, the hospital length of stay was 7.3 (± 6.2) days. A person hospitalized with COVID-19 reported median costs of $1688 (IQR 788-2523). In women, this cost was$1328 (IQR 463-2098); in men, this was 1.4 times greater. The median cost for ICU was $4118 (IQR 2069-5455), 3 times higher than those hospitalized only in the general ward. Admission to the ICU, having 1 comorbidity, length of stay, high blood pressure, having 5 comorbidities, and being treated in the city of Cartagena were statistically significant with direct medical costs. Conclusions Our study provides an idea of the magnitude of costs needed to hospitalize a COVID-19 case in Colombia. Other studies in Colombia have assessed the costs of hospitalization for infectious diseases such as influenza, costs significantly lower than those described here

Determinantes de estadia prolongada de neonatos em uma unidade de cuidados intensivos

Objetivo: determinar los factores asociados con estancias prolongadas en una unidad de cuidados intensivos (UCI) neonatal. Materiales y métodos: estudio de tipo retrospectivo, de corte transversal, descriptivo y analítico a partir de los registros individuales de prestación de servicios (RIPS) y la facturación de una Empresa Prestadora de Servicios de Salud (EPS) de Colombia. Se estimó un modelo logístico binomial tomando como variable dependiente estancias prolongadas. Resultados: la mediana de la duración en estancia en una UCI de los 947 neonatos incluidos en el análisis fue de 3 días y una estancia promedio de 4.8 días (amplitud intercuartílica de 1-5 días). Respecto a los determinantes, la edad gestacional, el peso al nacer y la edad de la madre mantienen una relación inversa con la probabilidad de generar días estancias, residir en zonas urbanas y contar con un buen control prenatal se convierten en factores protectores. Conclusión: el control prenatal es una intervención eficiente y efectiva para la gestión del riesgo de la salud, así como disminuir los embarazos en las mujeres jóvenes (35 años) cumplirían un papel fundamental en la reducción de estancias prolongadas en una UCI neonatal.Objective: To determine the factors associated with prolonged stays in neonatal ICU. Materials and methods: This is a retrospective, cross-sectional, descriptive and analytical study based on the Individual Service Delivery Registries (RIPS) and the billing of a Health Services Provider Company (EPS) of Colombia. A binomial logistic model was estimated using prolonged stays as a dependent variable. Results: The median length of stay in the ICU of the 947 neonates included in the analysis was three days with an average sojourn of 4.8 days (interquartile range of 1-5 days). Regarding the determinants: gestational age, birth weight and age of the mother, they have an inverse relationship with the probability of generating stays, while living in urban areas and having accurate prenatal control become protective factors. Conclusion: Prenatal control is an efficient and effective intervention for managing health risk, also reducing pregnancies in young ( 35 years) would play a key role in decreasing prolonged stays in neonatal ICU