582 research outputs found
Correction: clinical inertia in newly diagnosed type 2 diabetes mellitus among patients attendingselected healthcare institutions in Colombia
No full textCorrection: Diabetology & Metabolic Syndrome (2024) 16:42 https://doi.org/10.1186/s13098-023-01245-0 The copyright holder for this article was incorrectly given as “Battelle Memorial Institute, under exclusive licence to Springer Nature Switzerland AG 2024” but should have been “© Merck & Co., Inc., Rahway, NJ, USA and its affiliates and Nelson Alvis- Guzman, Martín Romero
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
Economic impact of infections and antibiotics
No full textIn this chapter, we review several aspects with respect to the burden of infectious diseases, its impact in morbidity and mortality, and its economic burden. Furthermore, we referenced the actual situation with relation to the use of antimicrobial, the resistance problem and misuse of antibiotic, and the economic impact in the health systems.Alvis Guzman, Nelson Rafael-0000-0001-9458-864X-600De La Hoz Restrepo, Fernando-e374ad59-e159-4dc6-906d-773d4be3e0b1-0Pinzón Redondo, Hernando Samuel-3a6cb4b3-6b3c-4c49-9107-64f6b1764192-
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
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,
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
Global, Regional, And National Cancer Incidence, Mortality, Years Of Life Lost, Years Lived With Disability, And Disability-Adjusted Life-Years For 29 Cancer Groups, 1990 To 2016: A Systematic Analysis For The Global Burden Of Disease Study
No full textImportance: The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. Objective: To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. Evidence Review: Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. Findings: In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, -1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined.Alvis Guzman, Nelson Rafael-0000-0001-9458-864X-600Additional Authors-c2a53f46-b116-4602-9638-94e960da2989-
Characteristics and monetary compensation of caregivers for patients with rheumatic conditions
No full textMusculoskeletal disorders (MD) are highly prevalent conditions that affect quality of life. MD cause physical and psychological dependence. Usually, the care of a patient with MD is assumed by a caregiver. The aim of this study was to describe the sociodemographic characteristics and the monetary remuneration associated to the care of a patient with MD. A cross sectional study was carried out in order to estimate the monetary remuneration related to the health care of patients with MD. A survey was applied to caregivers of patients with MD. Demographic data was collected. We asked about the relationship with the patient, the time as a caregiver and all data related to the monetary compensation. Descriptive epidemiology was done. We reported monetary data in American Dollars (USD) using the average exchange rate for 2018. We surveyed 132 caregivers. Mean age was 52 years [standard deviation 19], 72% were women, 78% were taking care of a patient with rheumatoid arthritis, 12% osteoarthrosis 2% lupus, and 2% osteoporosis. The remaining 6% were caregivers of patients with ankylosing spondylitis, fibromyalgia and Sjogren syndrome. Regarding the time as a caregiver, 48% had less than a year, 16% between two and three years, 18% more than three years, 13% more than four years, and 5% were temporarily caregivers. In our study, 85% of caregivers were a family member, while 15% a nurse or a non-related person. Regarding the compensation, 97% did not receive any salary or payment for being caregiver, the remaining 3% received between 265 and 530 USD per month. Our study demonstrated that the care for patients with MD is mainly assumed by family members. Our results agree with other studies in chronic conditions where only a small proportion of caregivers is paid. Caregivers should be considered for the health system.Santos-Moreno, PBuitriago-Garcia, DVillareal Peralta, LALVIS-ZAKZUK, NELSON J.-will be generated-orcid-0000-0001-9382-214X-600Alvis-Guzman,
A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia
No full textManagement of rheumatoid arthritis (RA) in many Latin-American countries is impaired by fragmentation and scarce healthcare provision, resulting in obstacles to access, diagnosis, and treatment, and consequently in poor health outcomes. The aim of this study is to propose a comprehensive care program as a model to provide healthcare to RA patients receiving synthetic DMARDs in a Colombian setting by describing the model and its results. Health outcomes were prospectively collected in all patients entering the program. By protocol, patients are followed up during 24 months using a treat-to-target strategy with a patient-centered care (PCC) model, meaning that a patient should be seen by rheumatologist, physical and occupational therapist, physiatrist, nutritionist and psychologist, at least three times a year according to disease activity by DAS28. Otherwise, patients receive standard therapy. The incidence of remission and low disease activity (LDA) was calculated by periods of follow-up. A total of 968 patients entered the program from January 2015 to December 2016; 80.2% were women. At baseline, 41% of patients were in remission, 17% in LDA and 42% in MDS/SDA. At 24 months of follow-up, 66% were in remission, 18% in LDA and only 16% in MDS/SDA. Regarding DAS28, the mean at the beginning of the time analysis was 3.1 (SD 1.0) and after 24 months it was 2.4 (SD 0.7), showing a statistically significant improvement (p < 0.001). In all patients, the reduction of disease activity was 65% (95% CI, 58–71). Patients entering the PCC program benefited from a global improvement in disease activity in terms of DAS28.Santos Moreno, Pedro Ivan-d95f55ab-f918-450f-94af-4f16a32e4e96-0Alvis Zakzuk, Nelson Jose-0000-0001-9382-214X-600Villarreal Peralta, Laura-df969345-dcd4-4f9c-9616-26e89e3055ca-0Carrasquilla Sotomayor, María-e72d670c-8bc2-4f8a-b7a5-a893020ecbf7-0Paternina Caicedo, Angel Jose-a500674c-e3af-4e7a-b798-fea708e10f12-0Alvis Guzman, Nelson Rafael-0000-0001-9458-864X-60
Factores socioeconómicas y calidad de vida: un análisis multinivel
No full textObjetivo: Evaluar, mediante la construcción de un modelo de análisis multinivel, las variaciones en la percepción de CVRS por diferencias demográficas, socioeconómicas, ambientales y culturales de las personas. Metodología: Mediante un estudio transversal en una muestra representativa para Colombia, estratificada por pobreza y no pobreza, tipo de municipios de habitación y región geográfica (continental y costero). Los individuos fueron caracterizados y cada uno valoró diferentes estados de salud asignados aleatoriamente de un paquete de estados simulados con descripciones construidas a partir de dimensiones priorizadas en un estudio preliminar y que estaban agrupados en tres categorías (leves, moderadas y graves). La valoración fue desarrollada mediante una escala visual análoga(VAS) con valores entre 0 y 100, siendo 100 el mejor estado de salud imaginable y 0 equivalente a la muerte. Con el uso de STATA se exploraron diferentes modelos explicativos de la CVRS valorada incluyendo las variables de cada individuo y su calidad de vida actual. Los resultados del modelo fueron analizados con el objetivo de encontrar el modelo que mejor explique la CVRS, y buscando probar un modelo multinivel teórico de explicación a tres niveles: individual, habitacional y cultural. El modelo construido fue comparado con los resultados que se puedan obtener con un modelo multivariado y aplicadas pruebas de significancia. Resultados: en el análisis se incluyeron 16.550 valoraciones, correspondientes a 1636 personas distribuidas en tres tipos de municipios (grandes, medianos y pequeños) y en región costera o continental. El 23% de los encuestados fueron clasificados como pobres, similar a lo reportado por el DANE para Colombia. El nivel de ingreso, dependencia económica, gravedad de la enfermedad, tipo de municipio, región e interacción edad-sexo fueron significativos en el modelo. El análisis demostró que un modelo a tres niveles explica mejor la valoración de CVRS que un modelo a un solo nivel, y que en el primer nivel un individuo a mayor estrato, con seguro privado, valora mejor la CVRS y, dependiendo del sexo, cambia su valoración con la edad. En los otros niveles las covarianzas muestran cómo los grandes municipios tienden a mayor valoración, al igual que los que habitan en regiones costeras. Los resultados obtenidos fueron organizados en tablas de valor en las que se presentan los valores correspondientes a las variables con las que se muestra como las variaciones de las características de los individuos pueden modificar el valor obtenido. Conclusión: La CVRS sí es un reflejo de la situación de salud pero la medida de percepción se encuentra afectada por condiciones del individuo que pueden ser afectadas por el sitio de residencia y estas por sus condiciones culturales y esto se puede explicar mediante un modelo multinivel. De tal manera, que el uso generalizado de tablas de valoración para aplicación en poblaciones específicas podría estar sesgado en su valor obtenido sino se incluyen en estos los ajustes específicos que se generarían por las condiciones de vida de los individuos sobre los que se van a tomar las decisiones.Abstract. Objective: Evaluate through the construction of a multilevel analysis model the variations of the perception of HRQoL for the demographic, socioeconomic, environmental and cultural differences at the population. Methods: Using a cross-sectional study on a representative sample for the Colombian population, poverty and no poverty, states and geographic regions (continental and coast) were stratify. Each participant were categorized and they randomly value the different stages of health from a group of simulated stages with constructed descriptions from a priority list of dimensions determinate on a previous research that were grouped into three categories (mild, moderate, severe). The assessment was developed using an analog visual scale (AVS) with values from 0 to 100, where 100 is the best possible health state and 0 is equal to death. With the help of STATA tools, it was explored different explicative model for the analyzed HRQoL including variables of each participant and its actual quality of life. The results were analyzed to determine which was the best model, that could explain, the HRQoL, and looking after a theoretical multilevel model assay that explain three levels: individual, environmental and cultural. The developed model was compared to the results that could appear in a multilevel model and significance test were apply. Results: 16,550 valuations were included at the present analysis, which corresponds to 1636 participants distributed on three types of states (big, middle and small ones) and those from the coast or continental regions. 23 % of surveyed population were classified as poor, which is similar to what has been reported to the DANE for Colombia. The level of income, economic dependency, and severity of disease, type of state, region and interaction of age-sex had a high level of significance in the model. The analysis show that a model of three levels could better explain the value of HRQoL than a model of just one level, it also show that a person with higher socioeconomic state and private health insurance will give a better value to HRQoL, and according to the sex the values could chance by aging. At other level the co-variance shows how the bigger states have a better value as those that live at coast regions. The results were organized in tables where the different variables and it corresponding values that represent significant variations if the value is modify as an individual characteristic. Conclusions: HRQoL is a reflex of the health situation but the perception measure could be affected by the conditions of the subject of analysis that could be affected by the place it lives and the cultural conditions and this could be explain by multilevel model. In a way the general use of the value tables used to be apply in specific populations could have bias at the value content if specific life conditions adjustments are not included at the populations that are going to be value and over whom the decisions are going to be make.Doctorad
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