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El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones.

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dc.contributor.advisorAnaya, Juan-Manuel
dc.contributor.advisorMolano González, Nicolás
dc.creatorCalixto, Omar-Javier
dc.creatorVargas-Zambrano, Juan-Camilo
dc.creatorFranco, Juan-Sebastian
dc.creatorMolano González, Nicolás
dc.creatorSalazar, Juan-Carlos
dc.creatorRodríguez Jiménez, Mónica María del Pilar
dc.creatorVicente-Celis, Zayhro
dc.creatorRojas-Villarraga, Adriana
dc.creator.degreeEspecialista en Epidemiología (en Convenio con el CES)
dc.date.accessioned2015-06-09T18:50:37Z
dc.date.available2015-06-09T18:50:37Z
dc.date.created2015-05-01
dc.date.issued2015
dc.descriptionIntroducción: el lupus eritematoso sistémico (LES) es considerado una enfermedad de alto costo. La expresión clínica de la enfermedad depende de la ubicación geografía y la etnicidad. El objetivo de este estudio fue el calcular los costos ambulatorios relacionado al LES en una cohorte colombiana, identificar los predictores de costos y comparar nuestro resultados con otras poblaciones. Métodos: Se realizó una aproximación de tipo prevalencia en 100 pacientes LES en quienes se evaluaron los costos directos médicos, directos no médicos, indirectos e intangibles. Todos los costos médicos fueron evaluados usando una metodología abajo hacia arriba. Los costos directos fueron valorados desde una perspectiva social usando una metodología de micro-costeo. Los costos indirectos se evaluaron mediante una aproximación de capital humano, y los costos intangibles calculados a partir de los años de vida ajustados por calidad (AVAC). Se analizaron los datos por medio de un análisis multivariado. Para comparaciones con otras poblaciones todos los costos fueron expresados como la razón entre los costos y producto interno bruto nacional per cápita. Resultados: La media de costos totales fue 13.031±9.215 USD (ajustados por el factor de conversión de paridad del poder adquisitivo), lo cual representa el 1,66 del PIB per capita de Colombia. Los costos directos son el 64% de los costos totales. Los costos médicos representan el 80% de los costos directos,. Los costos indirectos fueron el 10% y los costos intangibles el 25% de los costos totales. Los medicamentos representaron el 45% de los costos directos. Mayores costos se relacionaron con el estrato socioeconómico, seguro médico privado, AVAC, alopecia, micofenolato mofetilo, y terapia anticoagulante. Los costos directos ajustados de los pacientes con LES en Colombia fueron mayores que en Norte América y en Europa. Conclusiones: el LES impone una carga económica importante para la sociedad. Los costos relacionados con la atención médica y AVAC fueron los principales contribuyentes al alto costo de la enfermedad. Estos resultados pueden ser referencia para determinar políticas en salud pública así como comparar el gasto en salud de forma internacional.spa
dc.description.abstractBackground: Systemic lupus erythematosus (SLE) is considered a high cost disease. The clinical expression of the disease varies depending upon geography and ethnicity. The aim of this study was to calculate ambulatory cost related to SLE in a Colombian cohort, to identify cost predictors and to compare our results with those of other populations. Methods: A prevalence-based approach was done in 100 SLE patients in whom information related to direct medical, direct non-medical, indirect, and intangible costs was assessed. All medical costs were evaluated using a bottom-up methodology. The direct medical costs were assessed from a society perspective using a micro-costing method. Indirect costs were estimated using human capital approach, and intangible costs were calculated from Quality-Adjusted Life Years (QALY). Multivariate analysis were used to analyse data. For comparisons with other populations, all costs were expressed as the ratio between the costs and the country gross domestic product (GDP) per capita. Results: The mean of total ambulatory costs was 13,031 ± 9,215 USD (adjusted by the World Bank purchasing power parity conversion factor), which is 1.66 times Colombia’s GDP per capita. Direct costs explained 64% of total costs. Medical costs accounted for 80% of direct costs. Indirect costs constituted 10% of total costs, and intangible costs were 25% of total costs. Medications represented 45% of direct costs. Higher total costs were associated with socioeconomic status, private insurance, QALY, alopecia, mycophenolate mofetil use, and anticoagulation therapy. Total adjusted direct costs of SLE in Colombia were higher than in North America and Europe. Conclusion: SLE imposes a substantial economic burden on Colombian society. The costs associated with medical care and QALY were major contributors to the high cost-of-illness. These results may assist in defining public health policies as well as in comparing health expenditure internationally.eng
dc.description.sponsorshipCentro de estudios de enfermedades autoinmunes CREAspa
dc.description.sponsorshipUniversidad nuestra señora del Rosariospa
dc.description.sponsorshipUniversidad CES de Medellinspa
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_10533
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/10533
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de medicinaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto completo)spa
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectLupus eritematoso sistemicospa
dc.subjectCosto de la enfermedadspa
dc.subjectCalidad de vidaspa
dc.subjectPredictores de costosspa
dc.subject.ddcEnfermedades
dc.subject.decsLupus eritematoso sistémicospa
dc.subject.decsAdministración de servicios de saludspa
dc.subject.decsEpidemiologíaspa
dc.subject.keywordSystemic lupus erythematosuseng
dc.subject.keywordCost of illnesseng
dc.subject.keywordQuality of lifeeng
dc.titleEl costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones.spa
dc.typebachelorThesiseng
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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