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Efectividad de un programa de atención integral del paciente con asma sobre la frecuencia de exacerbaciones en una institución de cuarto nivel de la ciudad de Bogotá (Colombia)

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dc.contributor.advisorGiraldo Cadavid, Luis Fernando
dc.creatorMolina Castro, Diego
dc.creator.degreeEspecialista en Medicina Internaspa
dc.creator.degreetypeFull timespa
dc.date.accessioned2019-01-29T15:42:49Z
dc.date.available2019-01-29T15:42:49Z
dc.date.created2019-01-28
dc.date.issued2019
dc.descriptionEl asma es una patología pulmonar de etiología multifactorial con grandes repercusiones en los sistemas de salud mundial, lo que ha llevado a la creación de programas de atención integral como una estrategia dirigida al mejoramiento de los estándares de atención en salud especialmente en los países en vía de desarrollo, logrando una disminución de los gastos en salud y un mejor tratamiento para los pacientes. Este estudio busca evaluar la efectividad del programa ASMAIRE de la Fundación Neumológica Colombiana, para disminuir el número de exacerbaciones durante el primer año de seguimiento, mediante una cohorte histórica de todos aquellos pacientes incluidos en el programa ASMAIRE adultos, con un diseño del estudio de “antes después” en el cual cada sujeto actuó como su propio control. Se realizó la comparación de las variables previas al ingreso y durante el primer año posterior a este. Se utilizaron densidades de incidencias y modelos uni y multivariados de regresión de Poisson. Se analizaron 715 pacientes encontrando que posterior al ingreso a ASMAIRE se presentó una disminución en las consultas a EPS (RR 0,44 IC95%:0,32;0,61 p=0,0001), urgencias (RR 0,83 IC95%:0,71;0,98 p=0,029) así como la necesidad de hospitalizaciones (RR 0,31 IC95%:0,23;0,42 p=0,0001) e ingreso a UCI (RR 0,07 IC95%:0,03;0,14 p=0,0001). En conclusión el ingreso al programa ASMAIRE, logró disminuir la presencia de exacerbaciones que requirieron consultar a EPS o urgencias así como la necesidad de hospitalizaciones e ingreso a UCI en el primer año de seguimiento.spa
dc.description.abstractAsthma is a pulmonary disease of multifactorial cause with big burden to all health systems around the world which led to the creation of integral attention programs as an strategy aimed to improving the standards of attention especially in developing countries, reaching a decrease in health expenditures and a improved treatment for patients based on guidelines. This study aims to evaluate the effectivity of the Fundación neumológica's ASMAIRE program to reduce the severe exacerbations during the first year of follow up through a historic cohort of those patient included in the program with a before and after cohort, where every subjects acts as its own control. We did a comparation of the different variables before and after the entry of every patient to the program and one year later. Incidence densities and uni and multivariate Poisson regression models were used. 715 patients were analyzed, finding that after admission to ASMAIRE there was a decrease in EPS consultations (RR 0.44 IC95%: 0.32, 0.61 p = 0.0001), emergencies (RR 0.83 IC95% 0.71, 0.98 p = 0.029) as well as the need for hospitalizations (RR 0.31 IC95%: 0.23, 0.42 p = 0.0001) and admission to the ICU (RR 0.07 IC 95%: 0.03; 0.14 p = 0.0001). In conclusion the admission to the ASMAIRE program, managed to reduce the presence of exacerbations that required consulting EPS or emergencies as well as the need for hospitalizations and admission to the ICU in the first year of follow-up.spa
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_18952
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/18952
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Medicinaspa
dc.publisher.programEspecialización en Medicina Internaspa
dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
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.subjectAsmaspa
dc.subjectCalidad de vidaspa
dc.subjectTratamientospa
dc.subjectAtención ambulatoriaspa
dc.subjectRecurrenciaspa
dc.subject.ddcEnfermedadesspa
dc.subject.keywordAsthmaspa
dc.subject.keywordQuality of lifespa
dc.subject.keywordTreatmentspa
dc.subject.keywordAmbulatory follow upspa
dc.subject.keywordRecurrencespa
dc.subject.keywordChronic programspa
dc.subject.lembAsmaspa
dc.subject.lembAtención médica ambulatoriaspa
dc.titleEfectividad de un programa de atención integral del paciente con asma sobre la frecuencia de exacerbaciones en una institución de cuarto nivel de la ciudad de Bogotá (Colombia)spa
dc.typemasterThesiseng
dc.type.documentAnálisis de casospa
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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