Health care costs of copd in Colombia

Describe the average age of sexual life onset from young people and adolescents, the prevalence of contraceptive methods and explore determinants of pregnancy. A retrospective cohort (2014-2018) was followed by a health insurer of the subsidized regime in Colombia. The study sample consisted of 35,214 young people aged 10-24 years living in 21 municipalities of the Colombian Caribbean region. For the social determinants of pregnancy, a multivariate probit model was estimated using as explanatory variables, housing area, education, family functionality and sexual behavior. 10.3% of women and 14.1% of men had their first sexual encounter before age 14 and 43.5% of women and 37.4% of men began their sex life after age 17. From the young people who claimed to have started their sexual life, 70.9% of the men made use of the condom as a contraceptive method, while the women divided on average 27.2% for the pills and / or injections followed by 16 , 1% in the use of the subdermal implant. As determinants of pregnancy in young people under 20, it was found that variables such as suspending school years [Yes (β = 0.6, p = 0.006)], being planned with hormonal method [Yes (β = 0.5, p = 0.000)] or start sexual life [Between 10 to 14 years (β = 0.14, p = 0.000)], increase the likelihood of young women becoming pregnant at some time in their life. These results also showed that the schooling of the young [University (β = -0.4, p = 0.038)] and always use condoms in sexual intercourse [Yes (β = -0.5, p = 0.042)] help prevent the pregnancy event from occurring. The age of sexual onset establishes a basis on which decision makers should intervene for promote a safe sex life, from use of anticonceptives in young people and thus avoiding unplanned pregnancy

Direct medical costs related to COVID-19 in Colombia

We studied 113 patients hospitalized by COVID-19, 51.3% men. On average, the hospital length of stay for COVID-19 hospitalized patient was 7,3 (± 6,2) days with a median cost of $1,688 (IQR 788-2,523). In women, the median direct medical cost of hospitalization was$1,328 (IQR $463-$2,098), while in men was 1.4 times greater. Being 60 years of age or older triggers hospitalization costs almost twice as high as those under this age ($1,813 vs.$2,994), and when the cost is compared by type of hospitalization, this difference is more than three times (ICU: 4,118; general ward: $1,312)

Supervivencia de pacientes con diabetes mellitus por área residencial en Colombia, 2008-2017

Objectives To estimate the survival in a dynamic cohort of patients with diabetes mellitus (DM) affiliated to a public health insurer in Colombia. Methods Retrospective cohort study (2008 - 2017) of 29,286 patients diagnosed with DM affiliated to a public health insurer, grouped by residence area (urban and rural). Sociodemographic variables and mortality incidence were analyzed. Survival curves were estimated using Kaplan-Meier (KM), Log-Rank significance test and Cox regression models to identify risk factors mortality. Results The average annual mortality rate was 2.2 / 100persons-year [CI95% = 2.1-2.3]. In the fourth year of the study, the probability of survival in the urban area was 88.7% [CI95% = 87.8-89.6%] and in the rural area it was 83.9% [CI95% = 81.1% -86.3 %]. For the last year the gap tends to increase; in the urban area the probability of survival was 43.4% [CI95% = 37.8% -48.8%], while in the rural area it was 19.83% [CI95% = 9.9% -32.2%]. The Logan-Rank test shows a higher diabetic death risk in patients living in rural areas (Chi2 = 27.23, p-value = 0.00 and NS = 5%). The Cox regression indicate that a diabetic patient from the rural area, presents a death risk of 26.3% [CI95% = 17.2% -34.5%] greater than the urban patients. In both areas, death probability increases with age (1048) [CI95% = 1.04-1.05]. Conclusions The survival probability remained high during the first two years and then decreases at a higher rate in the rural area. There is a significant gap in services access and / or medicines for the control of DM at the urban-rural level. A medium-term policy would be the implementation of DM risk management programs and the timely supply of medicines to patients in rural areas.Los objetivos Estimar la supervivencia en una cohorte dinámica de pacientes con diabetes mellitus (DM) afiliada a una aseguradora de salud pública en Colombia. Los metodos Estudio de cohorte retrospectivo (2008 - 2017) de 29,286 pacientes diagnosticados con DM afiliados a una aseguradora de salud pública, agrupados por área de residencia (urbana y rural). Se analizaron las variables sociodemográficas y la incidencia de mortalidad. Las curvas de supervivencia se calcularon utilizando Kaplan-Meier (KM), la prueba de significación de Log-Rank y los modelos de regresión de Cox para identificar los factores de riesgo de mortalidad. Resultados La tasa de mortalidad anual promedio fue de 2.2 / 100 personas-año [IC95% = 2.1-2.3]. En el cuarto año del estudio, la probabilidad de supervivencia en el área urbana fue de 88.7% [CI95% = 87.8-89.6%] y en el área rural fue de 83.9% [CI95% = 81.1% -86.3%]. En el último año la brecha tiende a aumentar; en el área urbana, la probabilidad de supervivencia fue de 43.4% [CI95% = 37.8% -48.8%], mientras que en el área rural fue de 19.83% [CI95% = 9.9% -32.2%]. La prueba de Logan-Rank muestra un mayor riesgo de muerte por diabetes en pacientes que viven en áreas rurales (Chi2 = 27.23, valor de p = 0.00 y NS = 5%). La regresión de Cox indica que un paciente diabético del área rural presenta un riesgo de muerte de 26.3% [IC95% = 17.2% -34.5%] mayor que los pacientes urbanos. En ambas áreas, la probabilidad de muerte aumenta con la edad (1048) [CI95% = 1.04-1.05]. Conclusiones La probabilidad de supervivencia se mantuvo alta durante los primeros dos años y luego disminuye a una tasa mayor en el área rural. Existe una brecha significativa en el acceso a los servicios y / o medicamentos para el control de la DM a nivel urbano-rural. Una política a medio plazo sería la implementación de programas de gestión de riesgos de DM y el suministro oportuno de medicamentos a pacientes en áreas rurales