1,034 research outputs found
Estado del arte del proyecto
No full textEl objetivo de este proyecto de investigación es realizar evaluaciones económicas de intervenciones
sanitarias y estudios de resultados en salud que permitan aumentar la evidencia científica que informa las decisiones en salud, tanto a nivel micro como macro en las áreas de economía de la salud, epidemiología, salud pública y la gestión sanitaria y de servicios de salud. Este proyecto de
investigación se sustenta en la medida que valora la intención de materializar en artículos científicos
diversas investigaciones que se vienen adelantando al interior de nuestros grupos de investigación de la Universidad de la Costa-CUC. Existen diferentes aproximaciones metodológicas desde donde se pueden diseñar y ejecutar las investigaciones que planteamos. Como grupos de análisis intentaremos abordar el mayor espectro posible de las enfermedades crónicas no transmisibles y las enfermedades infecciosas. Este proyecto será de gran utilidad para aumentar la cantidad y calidad de la evidencia en el área de las evaluaciones económicas de intervenciones sanitarias y los estudios de resultados en salud. El número de publicaciones que se esperan obtener con este proyecto impactarán positivamente en los estándares investigativos del programa al que pertenecemos, la facultad y la Universidad, así como en la clasificación de nosotros como investigadores y de los grupos de investigación en donde se articularán estos trabajos. Las publicaciones serán mayormente sometidas a revistas Q1, así también como a Q2 y Q3. Se espera que las investigaciones llevadas a cabo generen un número importante de artículos científicos, artículos cortos y presentaciones en congresos científicos.Alvis Zakzuk, NelsonAlvis Guzman, Nelso
Willingness to receive the COVID-19 vaccine in the population aged 80 years and older in Colombia 2021
No full textColombia diseñó y adoptó un plan de vacunación contra la COVID-19. El objetivo de esta investigación fue conocer la disposición para aceptar la vacunación contra esa enfermedad de personas de 80 y más anos. ˜ Métodos: Se realizó una encuesta telefónica a 11.721 personas de 80 y más anos, ˜ afiliadas a una aseguradora de salud, en la que se indagó sobre la intención a recibir la vacuna. Los respondientes fueron los afiliados o sus familiares o cuidadores. Resultados: El promedio de edad fue 85,0 anos ˜ (DE: 4,5), sin diferencias entre sexos; 3.344 participantes (28,5%) refirieron el antecedente de haberse realizado una prueba diagnóstica previa de COVID-19 y 73 resultaron positivos. La incidencia acumulada de infección por SARS-CoV-2 desde marzo de 2020 fue de 622,8 por 100.000 personas (IC95%: 491-778 por 100.000). Respecto a la actitud hacia la vacunación contra la COVID-19, uno de cada 4 respondientes se abstuvo de opinar o se manifestó neutro. Cuando el respondiente era un familiar, la aceptación de la vacuna era del 60,4% (IC95%: 59,5-61,3) con diferencias por sexo: entre los hombres era del 62,2% (IC95%: 60,8-63,6) y en mujeres del 59,2 (IC95%: 58,0-60,3), con p < 0,05. Cuando el respondiente fue el potencial receptor de la vacuna, la aceptación de la vacuna fue del 61,7% (IC95%: 59,4-64,0) y también difería por sexos: 70,2% en hombres (IC95%: 66,9-73,5) y 55,1% en mujeres (IC95%: 52,0-58,3), con p < 0,05.Alvis Guzman, N.Alvis Zakzuk, J.Paz Wilches, J.Fernandez Mercado, J.C.de la Hoz Restrepo, F
EPH48 evolution of polypharmacy and prescribed drug expenditure: the case of an insured poor population in the colombian caribbean during 2018-2021
No full textEVOLUTION OF POLYPHARMACY AND PRESCRIBED DRUG EXPENDITURE: THE CASE OF AN INSURED POOR POPULATION IN THE COLOMBIAN CARIBBEAN DURING 2018-2021 Gamero K,1 Alvis J,2 Mercado Fernandez JC,3 Paz Wilches J,4 Alvis Guzman N5 1 Distribuciones Pharmaser, Cali, VAC, Colombia, 2 Distribuciones Pharmaser, Cartagena, BOL, Colombia, 3 MUTUALSER EPS - University of Cartagena - Clínica Crecer, Cali, VAC, Colombia, 4 Mutual SER EPS, Cartagena, Colombia, 5 ALZAK Foundation- Universidad De La Costa, Barranquilla, Colombia Objectives: The aim of this study is to estimate the impact of the variation in the prevalence of polypharmacy rate in the prescribed drug expenditure (PDE). during 2018-2021. Methods: Cross sectional descriptive study of polymedicated patients (PP) during 2018-2021 was developed. Data was extracted from the individual outpatient dispense records from a health insurance company in Colombia. Polypharmacy and hypermedication were defined when patients consumed 10 medications in at least a continuous period. The number of patients attended, the number of medications per patient, defined daily doses (DDD) per patient (TI) and cost per DDD are calculated. Finally, a simulation of PDE of 2021 is developed in which the prevalence of polypharmacy is neutralized between 2018 and 2021 and keep the other variables constant. Results: Polypharmacy rate was 26,82% in 2018 and 31,17% in 2021. The PDE in 2015 constant US653,240 to 1,372,664, 110% higher than the PDE of 2018 due to the cost per DDD increased from 0.048, despite TI decreased from 333 to 286 but, lower than 2021 PDE because 2018 polypharmacy is lower. Conclusions: Polypharmacy has had a significant impact on the increase in PDE of the insurance company because in 2021 the cost per DDD increased as a consequence of the prescription of more expensive health technologies. The design of interventions and strict protocols need to be developed to mitigate the risk of non rational prescriptions in polymedicated patients and controlling the evolution of PDE
Factores asociados al parto por cesárea y su relación con el comportamiento de los nacidos vivos en Colombia 2008-2017
No full textObjective: The present research aims to estimate the risk factors associated with cesarean section in Colombia during the period 2008 - 2017. Materials and methods: The microdata of the DANE's vital statistics were used for the years between 2008 and 2017. Contingency tables were calculated to establish the existence of relationships between risk variables and cesarean section. Likewise, a probabilistic model was developed to establish the factors associated with a higher probability of evidencing a cesarean section in delivery care. Results: In Colombia, the cesarean rate has increased dramatically in the last decade. For 2008, the rate of cesarean section in the country was 35% while for 2017 the observed rate was 43%. The Caribbean region presents a significant difference in the evolution of the cesarean rate compared to the behavior of the country. The variables multiplicity of childbirth, weight at birth, the fact that the mother is primigestant and the marital status of married have an important association with the probability of showing a caesarean section in the delivery care. These factors should be used to effectively detect the high risk of the pregnant woman and concentrate in them, a greater vigilance during the prenatal control. The Caribbean region has a different behavior to the rest of the country, so it is important to deepen the determination of the explanatory factors of this difference.Objetivo: La presente investigación tiene como objetivo identificar los factores asociados al parto por cesárea y su relación con el comportamiento de los nacidos vivos en Colombia durante el periodo 2008 – 2017. Materiales y métodos: Estudio cuantitativo descriptivo y correlacional, donde se utilizó los micro datos de las estadísticas vitales del DANE revisión de literatura por los años entre 2008 y 2017 y anteriores al 2007. Se calcularon tablas de contingencias para establecer relación entre variables sociodemográficas, número de cesárea en el tiempo y su relación con el comportamiento de los nacidos vivos. Se elaboró un modelo probabilístico para establecer los factores asociado a una mayor probabilidad de optar por método quirúrgico, como la cesárea en la atención del parto. Resultados: En Colombia, latasa de cesárea se ha incrementado drásticamente en la última década. Para 2008 la tasa de cesárea en el país era de
35% mientras que para 2017 la tasa observada fue de 43%. La naturaleza pública y mixta de la IPS que atiende el parto disminuye el riesgo de cesárea mientras que la multiparidad, peso al nacer y nacimiento pretérmino aumenta el riesgo. Conclusiones: El presente estudio, evidenció que Colombia presenta un alarmante incremento de la proporción de cesáreas como forma de atención del parto, especialmente en los departamentos de la región caribe colombiana, generando la necesidad de incorporar políticas integrales para revertir esta tendencia, en la que se articulen todos los actores del sistema de salud (familia, médicos, prestadores, aseguradoras y estado).Díaz Arroyo, EsperanzaCampos De Ávila, Feyer Antoni
Direct medical costs related to COVID-19 in Colombia
No full textWe 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 1,328 (IQR 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 (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).ALVIS ZAKZUK, NELSON RAFAEL-will be generated-orcid-0000-0001-9136-9775-600Florez Tanus, ADiaz Jimenez, Diana FChaparro Narvaez, Pablo EnriqueCastaneda Orjuela, Carlos AndresDe La Hoz, Fernando PioCastell C, DuenasAlvis Guzman,
Therapeutic inertia in the treament of patients with type 2 diabetes in a cardiovascular risk management cohort from the caribbean region of Colombia
No full textSalazar Mejia, FernandoDe Los Angeles Carrasquilla, MariaParra Padilla, DALVIS-ZAKZUK, NELSON J.-will be generated-orcid-0000-0001-9382-214X-600Alvis Guzman, NDe La Hoz, Fernando Pi
Factors associated with the formation of inhibitors in patients with hemophilia of the subsidized regime in Colombia
No full textMarrugo, A. CNoriega, NancyElles, RosmerySimanca Fontalvo, R. MTanus, A FlorezAlvis Guzman,
Knowledeges and experiences of pregnant women on prenatal care programs of a subsidized health care company from the Caribbean region of Colombia: a qualitative analysis
No full textObjectives: Prenatal care programs have been conceived to reduce maternal and perinatal mortality risk. However, some pregnant women arrive late or do not attend the program, thus, health risks associated with pregnancy increases considerably. The objective of this study was to know pregnant women perceptions about a prenatal care program that include two components: health services and educational advice. Methods: A randomized sample of 33 women was chosen. Inclusion criteria considered women between 30 and 32 gestation weeks of pregnancy and living in the urban area. Data was collected using the focus group technique. For the analysis, we used the following protocol: Literal transcription of oral speech, information coding and integration, and data triangulation. Qualitative analysis with textual data was conducted with Quanteda package in R statistical software. Results: Important differences were found by geographic zones. In the city, pregnant women associate the program mainly with health services, while women living in town area associate the program with the educational component. Also, in the city the first contact with the program was by the prenatal care appointment, while in town was through the educational agents from the health care company. The program is valued in special form by women with high risk pregnancy and first-time mothers like a mechanism to guarantee their wellbeing and the baby’s. On the other hand, women that planned their pregnancy, began early prenatal check-ups than those who did not planned it. Conclusions: In the design of prenatal care programs sociocultural differences of communities to which they target as well as the perceptions, realities, and motivations of pregnant women must be considered. This would allow having better results in maternal and perinatal health and public health as a result of a more comprehensive intervention.Moyano Tamara, L.Alvis Zakzuk, N.Bustamante, L.Jerez Arias, M.Alvis Zakzuk, J.Alvis Guzman, N.Salcedo Mejía, F.E.Alvis-Zakzuk, N. J
Costos y tendencias en el uso de la terapia biológica para la artritis reumatoide: un estudio retrospectivo
No full textObjectives: The aim of this study was to identify the risk of depression and assess the relationship between comorbid depression, healthcare utilization and healthcare expenditures in patients with rheumatoid arthritis (RA).
Methods: We used 2015 Medical Expenditure Panel Survey (MEPS) to identify patients with RA and depression. The risk of being depressed was estimated using multiple logistic regression with survey weights. Generalized linear regression was employed to evaluate whether depression is statistically significantly associated with increased utilization and cost for office-based provider care, hospital outpatient care, hospital inpatient care, emergency room care and prescription medications. The results were adjusted for age, sex, race, marital status, education, health insurance, metropolitan area status, region, income level, and comorbidities.
Results: A total number of 6,290 RA patients were identified from 2015 MEPS data set, representing a population size of 244,515,143. Of all the RA patients in 2015, 1,163 were found to have medical records of comorbid depression. Patients with RA were 2.1 times more likely to be depressed after adjusting for confounding variables (95%CI 1.80-2.42). Depressed patients had more office-based visits (p emergency room visits (p=0.0136), hospital admissions (p=0.0330), filled more prescriptions (p spent more on outpatient care (p=0.001), prescription medications (p=0.0003) compared to their counterparts. The difference in total health care cost per person was around 4,000.
Conclusiones: la AR se asocia con un aumento en el costo y la utilización de la atención médica. El cuidado colaborativo podría estar indicado para futuros ahorros de costos.Santos-Moreno, P-4c8bf522-fd2f-4d0d-bd00-433bf39bccbf-0Buitrago-Garcia, D-f72f35bb-b832-4224-b846-95d3948c1509-0Villarreal, L-0e7db4bd-aaff-42eb-b6c7-f475dbb3fe50-0Alvis-Zakzuk, N-4ad43f03-69e9-4fe7-b60d-070645964218-0Carrasquilla, M-c777b5bf-3e08-468d-9bb7-9fdd4a8f5e28-0Alvis Guzman, N-2d13fafb-f99f-45da-90f0-c24f33bc4418-
HPR76 inequalities of the infant mortality and poverty in Colombia: analysis 1993 vs 2019
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