masterThesis
Costo efectividad del programa de atención domiciliaria de pacientes con bronquiolitis - instituto Roosevelt de Bogotá
Autor
López-Cabra, Claudia Alejandra
Suárez-Garzón, Omar Enrique
Institución
Resumen
Home health care includes a wide range of home health care services for acute and chronic diseases, in adults and children. In acute pathologies, such as bronchiolitis, it has been historically less used; however, the economic evidence reveals that home care can lead to lower costs than in-hospital medical care in patients whose health condition allows it to be received. Objective: To establish the incremental cost effectiveness ratio (RCEI) of the home care program versus in-hospital care in patients with Bronchiolitis at the Roosevelt Institute in Bogotá. Methodology: Cost-effectiveness economic evaluation study, in which real-life data from pediatric patients diagnosed with bronchiolitis from the Roosevelt Institute were evaluated, who were treated by home or in-hospital program. The effectiveness outcome was the days of medical care stay and the costs were evaluated using the macro costing technique and the bottom-down methodology. Results: A total of n = 1,172 patients treated at the Roosevelt Institute in 2018 with a diagnosis of bronchiolitis were included, distributed n = 915 treated in-hospital and n = 257 treated at home. The average age of the patients in the home group was 8.07 months, while in the in-hospital group it was 1.97 years (p=0,05) and in the case of insurance, 93% of the hospitalized patients belonged to the contributory regime and 100% to home care. The costs per patient in the case of in-hospital care were COP $528.409 vs COP $509.408 in home care. Regarding the effectiveness outcome, the average days of hospital stay were 4.5 days vs. 3.9 days in home care. Conclusions: Home care is a dominant alternative to in-hospital care since it is an alternative with greater effectiveness and lower costs.