El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones.
Introducción: 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, id...
- Autores:
- Tipo de recurso:
- Fecha de publicación:
- 2015
- Institución:
- Universidad del Rosario
- Repositorio:
- Repositorio EdocUR - U. Rosario
- Idioma:
- spa
- OAI Identifier:
- oai:repository.urosario.edu.co:10336/10533
- Acceso en línea:
- https://doi.org/10.48713/10336_10533
http://repository.urosario.edu.co/handle/10336/10533
- Palabra clave:
- Lupus eritematoso sistemico
Costo de la enfermedad
Calidad de vida
Predictores de costos
Enfermedades
Lupus eritematoso sistémico
Administración de servicios de salud
Epidemiología
Systemic lupus erythematosus
Cost of illness
Quality of life
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- Abierto (Texto completo)
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| dc.title.spa.fl_str_mv |
El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones. |
| title |
El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones. |
| spellingShingle |
El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones. Lupus eritematoso sistemico Costo de la enfermedad Calidad de vida Predictores de costos Enfermedades Lupus eritematoso sistémico Administración de servicios de salud Epidemiología Systemic lupus erythematosus Cost of illness Quality of life |
| title_short |
El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones. |
| title_full |
El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones. |
| title_fullStr |
El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones. |
| title_full_unstemmed |
El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones. |
| title_sort |
El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones. |
| dc.contributor.advisor.none.fl_str_mv |
Anaya, Juan-Manuel Molano González, Nicolás |
| dc.subject.spa.fl_str_mv |
Lupus eritematoso sistemico Costo de la enfermedad Calidad de vida Predictores de costos |
| topic |
Lupus eritematoso sistemico Costo de la enfermedad Calidad de vida Predictores de costos Enfermedades Lupus eritematoso sistémico Administración de servicios de salud Epidemiología Systemic lupus erythematosus Cost of illness Quality of life |
| dc.subject.ddc.none.fl_str_mv |
Enfermedades |
| dc.subject.decs.spa.fl_str_mv |
Lupus eritematoso sistémico Administración de servicios de salud Epidemiología |
| dc.subject.keyword.eng.fl_str_mv |
Systemic lupus erythematosus Cost of illness Quality of life |
| description |
Introducción: 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. |
| publishDate |
2015 |
| dc.date.accessioned.none.fl_str_mv |
2015-06-09T18:50:37Z |
| dc.date.available.none.fl_str_mv |
2015-06-09T18:50:37Z |
| dc.date.created.none.fl_str_mv |
2015-05-01 |
| dc.date.issued.none.fl_str_mv |
2015 |
| dc.type.eng.fl_str_mv |
bachelorThesis |
| dc.type.coar.fl_str_mv |
http://purl.org/coar/resource_type/c_7a1f |
| dc.type.spa.spa.fl_str_mv |
Trabajo de grado |
| dc.identifier.doi.none.fl_str_mv |
https://doi.org/10.48713/10336_10533 |
| dc.identifier.uri.none.fl_str_mv |
http://repository.urosario.edu.co/handle/10336/10533 |
| url |
https://doi.org/10.48713/10336_10533 http://repository.urosario.edu.co/handle/10336/10533 |
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spa |
| language |
spa |
| dc.rights.coar.fl_str_mv |
http://purl.org/coar/access_right/c_abf2 |
| dc.rights.acceso.spa.fl_str_mv |
Abierto (Texto completo) |
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Abierto (Texto completo) http://purl.org/coar/access_right/c_abf2 |
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application/pdf |
| dc.publisher.spa.fl_str_mv |
Universidad del Rosario |
| dc.publisher.department.spa.fl_str_mv |
Facultad de medicina |
| institution |
Universidad del Rosario |
| dc.source.bibliographicCitation.none.fl_str_mv |
Smith PP, Gordon C. Systemic lupus erythematosus: clinical presentations. Autoimmun Rev 2010;10:43–5. D’Cruz DP, Khamashta M a, Hughes GR V. Systemic lupus erythematosus. Lancet 2007;369:587–96. Doria A, Amoura Z, Cervera R, Khamastha M a, Schneider M, Richter J, et al. Annual direct medical cost of active systemic lupus erythematosus in five European countries. Ann Rheum Dis 2014;73:154–60. Amoura Z, Deligny C, Pennaforte J, Hamidou M, Blanco P, Hachulla E, et al. Coût du lupus systémique en France des patients adultes avec une maladie active et traitée (étude LUCIE). La Rev Med Interne 2014:1–9. Richter JG, Häckel B, Manger K, Riechers E, Schmeding A, Thies W, et al. [What factors determine the direct medical costs of patients with systemic lupus erythematosus in Germany? Subanalysis of the LUCIE study]. Gesundheitswesen 2014;76:41–3. Khamashta M a, Bruce IN, Gordon C, Isenberg D a, Ateka-Barrutia O, Gayed M, et al. The cost of care of systemic lupus erythematosus (SLE) in the UK: annual direct costs for adult SLE patients with active autoantibody-positive disease. Lupus 2014;23:273–83. Bexelius C, Wachtmeister K, Skare P, Jönsson L, Vollenhoven R Van. Drivers of cost and health-related quality of life in patients with systemic lupus erythematosus (SLE): a Swedish nationwide study based on patient reports. Lupus 2013;22:793–801. Narayanan S, Wilson K, Ogelsby A, Juneau P, Durden E. Economic burden of systemic lupus erythematosus flares and comorbidities in a commercially insured population in the United States. J Occup Environ Med 2013;55:1262–70. Furst DE, Clarke a, Fernandes a W, Bancroft T, Gajria K, Greth W, et al. Resource utilization and direct medical costs in adult systemic lupus erythematosus patients from a commercially insured population. Lupus 2013;22:268–78. Aghdassi E, Zhang W, St-pierre Y, Clarke ANNE, Peeva V, Landolt-marticorena C, et al. Healthcare cost and loss of productivity in a Canadian population of patients with and without lupus nephritis. J Rheumatol 2011;38:658–66. Zhu TY, Tam L, Lee VW-Y, Lee KK-C, Li EK. The impact of flare on disease costs of patients with systemic lupus erythematosus. Arthritis Rheum 2009;61:1159–67. Carls G, Li T, Panopalis P, Wang S, Mell AG, Gibson TB, et al. Direct and indirect costs to employers of patients with systemic lupus erythematosus with and without nephritis. J Occup Environ Med 2009;51:66–79. Panopalis P, Clarke AE, Yelin E. The economic burden of systemic lupus erythematosus. Best Pract Res Clin Rheumatol 2012;26:695–704. Lau CS, Mak A. The socioeconomic burden of SLE. Nat Rev Rheumatol 2009;5:400–4. Zhu TY, Tam LS, Li EK. Cost-of-illness studies in systemic lupus erythematosus: A systematic review. Arthritis Care Res (Hoboken) 2011;63:751–60. Turchetti G, Yazdany J, Palla I, Yelin E, Masca M, Mosca M. Systemic lupus erythematosus and the economic perspective: a systematic literature review and points to consider. Clin Exp Rheumatol 2012;30:S116–22. Meacock R, Dale N, Harrison MJ. The humanistic and economic burden of systemic lupus erythematosus : a systematic review. Pharmacoeconomics 2013;31:49–61. Birnbaum H, Pike C, Kaufman R, Marynchenko M, Kidolezi Y, Cifaldi M. Societal cost of rheumatoid arthritis patients in the US. Curr Med Res Opin 2010;26:77–90. Catay E, Del Cid CC, Narváez L, Velozo EJ, Rosa JE, Catoggio LJ, et al. Cost of rheumatoid arthritis in a selected population from Argentina in the prebiologic therapy era. Clinicoecon Outcomes Res 2012;4:219–25. Chermont GC, Kowalski SC, Ciconelli RM, Ferraz MB. Resource utilization and the cost of rheumatoid arthritis in Brazil. Clin Exp Rheumatol 2008;26:24–31. De Azevedo ABC, Ferraz MB, Ciconelli RM. Indirect costs of rheumatoid arthritis in Brazil. Value Health 2008;11:869–77. Mora C, González A, Díaz J, Quintana G. Costos directos de la artritis reumatoide temprana en el primer año de atención : simulación de tres situaciones clínicas en un hospital universitario de tercer nivel en Colombia. Biomedica 2009;29:43–50. Pineda-tamayo R, Arcila G, Restrepo P, Anaya JM. Impacto de la enfermedad cardiovascular en los costos de hospitalización de pacientes con artritis reumatoidea. Biomedica 2004;24:366–74. Romero M, Arango C, Alvis N, Suarez JC, Duque A. [The cost of treatment of multiple sclerosis in Colombia]. Value Health 2011;14:S48–50. Torres TM, Ferraz MB, Ciconelli RM. Resource utilisation and cost of ankylosing spondylitis in Brazil. Clin Exp Rheumatol n.d.;28:490–7. Ysrraelit C, Caceres F, Villa A, Marcilla MP, Blanche J, Burgos M, et al. ENCOMS: Argentinian survey in cost of illness and unmet needs in multiple sclerosis. Arq Neuropsiquiatr 2014;72:337–43. Huscher D, Merkesdal S, Thiele K, Zeidler H, Schneider M, Zink a. Cost of illness in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and systemic lupus erythematosus in Germany. Ann Rheum Dis 2006;65:1175–83. DeSanVicente-Celis Z, Salazar J, R P-T, Anaya J. Sobre la necesidad de la farmacoeconomía. Comenzar por los principios. Rev Colomb Reum 2011;18:187–201. Palfrey S. Daring to practice low-cost medicine in a high-tech era. N Engl J Med 2011;364:e21. Anaya J-M. The autoimmune tautology. Arthritis Res Ther 2010;12:147. Pons-Estel GJ, Alarcón GS, Scofield L, Reinlib L, Cooper GS. Understanding the Epidemiology and Progression of Systemic Lupus Erythematosus. Semin Arthritis Rheum 2010;39:257–68. Rovin BH, Zhang X. Biomarkers for lupus nephritis: The quest continues. Clin J Am Soc Nephrol 2009;4:1858–65. Ward MM. Access to care and the incidence of endstage renal disease due to systemic lupus erythematosus. J Rheumatol 2010;37:1158–63. Ward MM. Laboratory abnormalities at the onset of treatment of end-stage renal disease: are there racial or socioeconomic disparities in care? Arch Intern Med 2007;167:1083–91. Burling F, Ng J, Thein H, Ly J, Marshall MR, Gow P. Ethnic, clinical and immunological factors in systemic lupus erythematosus and the development of lupus nephritis: results from a multi-ethnic New Zealand cohort. Lupus 2007;16:830–7. Alarcón GS, Bastian HM, Beasley TM, Roseman JM, Tan FK, Fessler BJ, et al. Systemic lupus erythematosus in a multi-ethnic cohort (LUMINA): contributions of admixture and socioeconomic status to renal involvement. Lupus 2006;15:26–31. Davidson A, Diamond B. Autoimmune diseases. N Engl J Med 2001;345:340–50. Anaya J-M. The diagnosis and clinical significance of polyautoimmunity. Autoimmun Rev 2014;13:423–6. Anaya J-M, Rojas-Villarraga A, Shoenfeld Y. From the mosaic of autoimmunity to the autoimmune tautology. In: Anaya J-M, Rojas-Villarraga A, Shoenfeld Y, Levy R a, Cervera R, editors. Autoimunity. From bench to bedside, Bogotá: Editorial Universidad del rosario; 2013, p. 237–45. Rojas-Villarraga A, Castellanos-delahoz J, Perez-Fernandez O, Amaya-Amaya J, Franco J-S, Anaya J-M. Autoimmune Ecology. In: Anaya J-M, Shoenfeld Y, Rojas-Villarraga A, Levy R a, Cervera R, editors. Autoimunity. From bench to bedside, Bogotá: Editorial Universidad del rosario; 2013, p. 322–41. Cherepanov D, Palta M, Fryback DG, Robert SA, Hays RD, Kaplan RM. Gender differences in multiple underlying dimensions of health-related quality of life are associated with sociodemographic and socioeconomic status. Med Care 2011;49:1021–30. Aitsi-Selmi a, Batty GD, Barbieri M a, Silva a a M, Cardoso VC, Goldani MZ, et al. Childhood socioeconomic position, adult socioeconomic position and social mobility in relation to markers of adiposity in early adulthood: evidence of differential effects by gender in the 1978/79 Ribeirao Preto cohort study. Int J Obes (Lond) 2013;37:439–47. Moroni L, Bianchi I, Lleo A. Geoepidemiology, gender and autoimmune disease. Autoimmun Rev 2012;11:A386–92. Agmon-Levin N, Mosca M, Petri M, Shoenfeld Y. Systemic lupus erythematosus one disease or many? Autoimmun Rev 2012;11:593–5. Anaya J-M, Cañas C, Mantilla RD, Pineda-Tamayo R, Tobón GJ, et al. Lupus nephritis in Colombians: contrasts and comparisons with other populations. Clin Rev Allergy Immunol 2011;40:199–207. Borchers AT, Naguwa SM, Shoenfeld Y, Gershwin ME. The geoepidemiology of systemic lupus erythematosus. Autoimmun Rev 2010;9:A277–87. Mok CC, Chan PT, Ho LY, Yu KL, To CH. Prevalence of the antiphospholipid syndrome and its effect on survival in 679 Chinese patients with systemic lupus erythematosus: a cohort study. Medicine (Baltimore) 2013;92:217–22. Urowitz MB, Bookman AA, Koehler BE, Gordon DA, Smythe HA, Ogryzlo MA. The bimodal mortality pattern of systemic lupus erythematosus. Am J Med 1976;60:221–5. Frostegård J. SLE, atherosclerosis and cardiovascular disease. J Intern Med 2005;257:485–95. Haycoux A. What is health economics? Health economics 2009;1-8. Raftery J. Economic evaluation: an introduction. BMJ 1998;316:1013–4. Arrow K. Uncertainty and the welfare economics of medical care. Am Econ Rev 1963;53:942–73. Krieger N, Williams D. Measuring social class in US public health research: concepts, methodologies, and guidelines. Rev Public Heal 1997;18:341–78. Marmot MG. Improvement of social environment to improve health. Lancet 1998;351:57–60. Adler NE, Rehkopf DH. U.S. disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health 2008;29:235–52. DeSanVicente-Celis Z, Salazar J-C, Pineda-Tamayo R, Anaya J-M. On the need of pharmacoeconomics. Beginning by the principles. Rev Colomb Reumatol 2011;18:187–202. Tarricone R. Cost-of-illness analysis. What room in health economics? Health Policy 2006;77:51–63. Walley T. Pharmacoeconomics and Economic Evaluation of Drug Therapies, n.d., p. 67–75. Kobelt G, Berg J, Lindgren P, Fredrikson S, Jönsson B. Costs and quality of life of patients with multiple sclerosis in Europe. J Neurol Neurosurg Psychiatry 2006;77:918–26. Kobelt G, Berg J, Lindgren P, Jönsson B. Costs and quality of life in multiple sclerosis in Europe: method of assessment and analysis. Eur J Health Econ 2006;7 Suppl 2:S5–13. Byford S, Torgerson DJ, Raftery J. Economic note: cost of illness studies. BMJ 2000;320:1335. Segel J. Cost-of-Illness studies-A primer. RTI Int., RTI -UNC Center of Excellence in Health Promotion Economics. 2006, p. 1–39. Bootman J, Townsend R, McGhan W. Principles of pharmacoeconomics. 3th ed. Cincinnati: Whitney Harvey books; 2005. Conaghan PG, Durez P, Alten RE, Burmester G-R, Tak PP, Klareskog L, et al. Impact of intravenous abatacept on synovitis, osteitis and structural damage in patients with rheumatoid arthritis and an inadequate response to methotrexate: the ASSET randomised controlled trial. Ann Rheum Dis 2013;72:1287–94. Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet 2007;370:1929–38. Soto Álvarez J. Estudios de farmacoeconomía: ¿Por qué, cómo, cuándo y para qué? Medifam 2001;11:147–55. Charan J, Biswas T. How to Calculate Sample Size for Different Study Designs in Medical Research? Indian J Psychol Med 2013;35:121–6. Cárdenas-Roldán J, Rojas-Villarraga A, Anaya J-M. How do autoimmune diseases cluster in families? A systematic review and meta-analysis. BMC Med 2013;11:73. Sutcliffe N, Clarke a E, Taylor R, Frost C, Isenberg D a. Total costs and predictors of costs in patients with systemic lupus erythematosus. Rheumatology (Oxford) 2001;40:37–47. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725. Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A. Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D). Br J Rheumatol 1997;36:551–9. Wolfe F, Hawley DJ. Measurement of the quality of life in rheumatic disorders using the EuroQol. Br J Rheumatol 1997;36:786–93. Wolfe F, Michaud K, Li T, Katz RS. EQ-5D and SF-36 quality of life measures in systemic lupus erythematosus: comparisons with rheumatoid arthritis, noninflammatory rheumatic disorders, and fibromyalgia. J Rheumatol 2010;37:296–304. Congreso de la República de Colombia. Decreto 2423 de 1996, actualizado 2013. Por el cual se determina la nomenclatura y clasificación de los procedimientos médicos, quirúrgicos y hospitalarios del Manual Tarifario y se dictan otras disposiciones. Bogotá: 2013. Farmaprecios max. Guia de productos. PLM 2013:19–52. Congreso de la República de Colombia. Decreto 1406. Por el se dictan disposiciones para la puesta en operación del Registro Único de Aportantes al Sistema de Seguridad Social Integral, se establece el régimen de recaudación de aportes que financian dicho Sistema y se dictan otras disposicione. Bogotá: 1999. Congreso de la República de Colombia. Código sustantivo del trabajo. Articulo 227 auxilio monetario por enfermedad no profesional. Bogotá: VIII; 1950. Jia H, Zack MM, Moriarty DG, Fryback DG. Predicting the EuroQol Group’s EQ-5D index from CDC's “Healthy Days” in a US sample. Med Decis Making 2011;31:174–85. Augustovski FA, Irazola VE, Velazquez AP, Gibbons L, Craig BM. Argentine valuation of the EQ-5D health states. Value Heal 2009;12:587–96. Lebart L, Morineau A, Piron M. Statistique exploratoire multidimensionnelle. Paris: DUNOD; 1995. Team R. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing.; 2013. Panopalis P, Petri M, Manzi S, Isenberg D a, Gordon C, Senécal J-L, et al. The systemic lupus erythematosus Tri-Nation study: cumulative indirect costs. Arthritis Rheum 2007;57:64–70. Zhu TY, Tam L-S, Lee VWY, Lee KK, Li EK. Systemic lupus erythematosus with neuropsychiatric manifestation incurs high disease costs: a cost-of-illness study in Hong Kong. Rheumatology (Oxford) 2009;48:564–8. Cho J, Chang S, Shin N, Choi B, Oh H, Yoon M, et al. Costs of illness and quality of life in patients with systemic lupus erythematosus in South Korea. Lupus 2014. In press. Li T, Carls GS, Panopalis P, Wang S, Gibson TB, Squibb B, et al. Long-term medical costs and resource utilization in systemic lupus erythematosus and lupus nephritis: a five-year analysis of a large medicaid population. Arthritis Rheum 2009;61:755–63. Pelletier EM, Ogale S, Yu E, Brunetta P, Garg J. Economic Outcomes in Patients Diagnosed With Systemic Lupus Erythematosus With Versus Without Nephritis : Results From an Analysis of Data From a US Claims Database. Clin Ther 2009;31:2653–64. Clarke a E, Panopalis P, Petri M, Manzi S, Isenberg D a, Gordon C, et al. SLE patients with renal damage incur higher health care costs. Rheumatology (Oxford) 2008;47:329–33. World Health Organization. Cost-effectiveness threshold. Cost Eff Strateg Plan Geneva, Switzerland. World Health Organization. 2014. World Health Organization. WHO guide to identifying the economic consequences of disease and injury. Geneva, Switzerland. World Health Organization; 2009. Gironimi G, Clarke AE, Hamilton VH, Danoff DS, Bloch DA, Fries JF, et al. Why health care costs more in the US: comparing health care expenditures between systemic lupus erythematosus patients in Stanford and Montreal. Arthritis Rheum 1996;39:979–87. Quintana G, Bolivar HAH, Coral-Alvarado P. Economic Evaluations in Systemic Lupus Erythematosus. In: Harjacek M, editor. Challenges Rheumatol., InTech; 2011, p. 13–24. Comision nacional de precios de medicamentos y dispositivos medicos. Circular Numero 03 de 2013. Bogota: Comision Nacional de Precios de Medicamentos y Dispositivos Medicos; 2013. Consejo Nacional de Politica Economica y Social. Documento Conpes Social 155. Politica Farmaceutica Nacional. Bogota: 2012. Comision nacional de precios de medicamentos y dispositivos medicos. Circular numero 04 de 2013. Bogota: Comision Nacional de Precios de Medicamentos y Dispositivos Medicos;2013. Wilson ECF, Jayne DRW, Dellow E, Fordham RJ. The cost-effectiveness of mycophenolate mofetil as firstline therapy in active lupus nephritis. Rheumatology (Oxford) 2007;46:1096–101. |
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Anaya, Juan-Manuel19474778600Molano González, Nicolás80873475600Calixto, Omar-JavierVargas-Zambrano, Juan-CamiloFranco, Juan-SebastianMolano González, NicolásSalazar, Juan-CarlosRodríguez Jiménez, Mónica María del PilarVicente-Celis, ZayhroRojas-Villarraga, AdrianaEspecialista en Epidemiología (en Convenio con el CES)2af7274f-4228-4a32-9948-87516d4fe53965e9bd59-0de4-4119-876e-78afbfaa6f4475c89141-36d1-4ee5-bbb7-7dafb54791b380873475600d56aa6b0-0659-454e-992d-df5ee2c733a051799499600d42c270a-4e7b-4bac-88d0-0c76d74afb3e522497016002015-06-09T18:50:37Z2015-06-09T18:50:37Z2015-05-012015Introducción: 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.Background: 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.Centro de estudios de enfermedades autoinmunes CREAUniversidad nuestra señora del RosarioUniversidad CES de Medellinapplication/pdfhttps://doi.org/10.48713/10336_10533 http://repository.urosario.edu.co/handle/10336/10533spaUniversidad del RosarioFacultad de medicinaAbierto (Texto completo)EL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.http://purl.org/coar/access_right/c_abf2Smith PP, Gordon C. Systemic lupus erythematosus: clinical presentations. Autoimmun Rev 2010;10:43–5.D’Cruz DP, Khamashta M a, Hughes GR V. Systemic lupus erythematosus. Lancet 2007;369:587–96.Doria A, Amoura Z, Cervera R, Khamastha M a, Schneider M, Richter J, et al. Annual direct medical cost of active systemic lupus erythematosus in five European countries. Ann Rheum Dis 2014;73:154–60.Amoura Z, Deligny C, Pennaforte J, Hamidou M, Blanco P, Hachulla E, et al. Coût du lupus systémique en France des patients adultes avec une maladie active et traitée (étude LUCIE). La Rev Med Interne 2014:1–9.Richter JG, Häckel B, Manger K, Riechers E, Schmeding A, Thies W, et al. [What factors determine the direct medical costs of patients with systemic lupus erythematosus in Germany? Subanalysis of the LUCIE study]. Gesundheitswesen 2014;76:41–3.Khamashta M a, Bruce IN, Gordon C, Isenberg D a, Ateka-Barrutia O, Gayed M, et al. The cost of care of systemic lupus erythematosus (SLE) in the UK: annual direct costs for adult SLE patients with active autoantibody-positive disease. Lupus 2014;23:273–83.Bexelius C, Wachtmeister K, Skare P, Jönsson L, Vollenhoven R Van. Drivers of cost and health-related quality of life in patients with systemic lupus erythematosus (SLE): a Swedish nationwide study based on patient reports. Lupus 2013;22:793–801.Narayanan S, Wilson K, Ogelsby A, Juneau P, Durden E. Economic burden of systemic lupus erythematosus flares and comorbidities in a commercially insured population in the United States. J Occup Environ Med 2013;55:1262–70.Furst DE, Clarke a, Fernandes a W, Bancroft T, Gajria K, Greth W, et al. Resource utilization and direct medical costs in adult systemic lupus erythematosus patients from a commercially insured population. Lupus 2013;22:268–78.Aghdassi E, Zhang W, St-pierre Y, Clarke ANNE, Peeva V, Landolt-marticorena C, et al. Healthcare cost and loss of productivity in a Canadian population of patients with and without lupus nephritis. J Rheumatol 2011;38:658–66.Zhu TY, Tam L, Lee VW-Y, Lee KK-C, Li EK. The impact of flare on disease costs of patients with systemic lupus erythematosus. Arthritis Rheum 2009;61:1159–67.Carls G, Li T, Panopalis P, Wang S, Mell AG, Gibson TB, et al. Direct and indirect costs to employers of patients with systemic lupus erythematosus with and without nephritis. J Occup Environ Med 2009;51:66–79.Panopalis P, Clarke AE, Yelin E. The economic burden of systemic lupus erythematosus. Best Pract Res Clin Rheumatol 2012;26:695–704.Lau CS, Mak A. The socioeconomic burden of SLE. Nat Rev Rheumatol 2009;5:400–4.Zhu TY, Tam LS, Li EK. Cost-of-illness studies in systemic lupus erythematosus: A systematic review. Arthritis Care Res (Hoboken) 2011;63:751–60.Turchetti G, Yazdany J, Palla I, Yelin E, Masca M, Mosca M. Systemic lupus erythematosus and the economic perspective: a systematic literature review and points to consider. Clin Exp Rheumatol 2012;30:S116–22.Meacock R, Dale N, Harrison MJ. The humanistic and economic burden of systemic lupus erythematosus : a systematic review. Pharmacoeconomics 2013;31:49–61.Birnbaum H, Pike C, Kaufman R, Marynchenko M, Kidolezi Y, Cifaldi M. Societal cost of rheumatoid arthritis patients in the US. Curr Med Res Opin 2010;26:77–90.Catay E, Del Cid CC, Narváez L, Velozo EJ, Rosa JE, Catoggio LJ, et al. Cost of rheumatoid arthritis in a selected population from Argentina in the prebiologic therapy era. Clinicoecon Outcomes Res 2012;4:219–25.Chermont GC, Kowalski SC, Ciconelli RM, Ferraz MB. Resource utilization and the cost of rheumatoid arthritis in Brazil. Clin Exp Rheumatol 2008;26:24–31.De Azevedo ABC, Ferraz MB, Ciconelli RM. Indirect costs of rheumatoid arthritis in Brazil. Value Health 2008;11:869–77.Mora C, González A, Díaz J, Quintana G. Costos directos de la artritis reumatoide temprana en el primer año de atención : simulación de tres situaciones clínicas en un hospital universitario de tercer nivel en Colombia. Biomedica 2009;29:43–50.Pineda-tamayo R, Arcila G, Restrepo P, Anaya JM. Impacto de la enfermedad cardiovascular en los costos de hospitalización de pacientes con artritis reumatoidea. Biomedica 2004;24:366–74.Romero M, Arango C, Alvis N, Suarez JC, Duque A. [The cost of treatment of multiple sclerosis in Colombia]. Value Health 2011;14:S48–50.Torres TM, Ferraz MB, Ciconelli RM. Resource utilisation and cost of ankylosing spondylitis in Brazil. Clin Exp Rheumatol n.d.;28:490–7.Ysrraelit C, Caceres F, Villa A, Marcilla MP, Blanche J, Burgos M, et al. ENCOMS: Argentinian survey in cost of illness and unmet needs in multiple sclerosis. Arq Neuropsiquiatr 2014;72:337–43.Huscher D, Merkesdal S, Thiele K, Zeidler H, Schneider M, Zink a. Cost of illness in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and systemic lupus erythematosus in Germany. Ann Rheum Dis 2006;65:1175–83.DeSanVicente-Celis Z, Salazar J, R P-T, Anaya J. Sobre la necesidad de la farmacoeconomía. Comenzar por los principios. Rev Colomb Reum 2011;18:187–201.Palfrey S. Daring to practice low-cost medicine in a high-tech era. N Engl J Med 2011;364:e21.Anaya J-M. The autoimmune tautology. Arthritis Res Ther 2010;12:147.Pons-Estel GJ, Alarcón GS, Scofield L, Reinlib L, Cooper GS. Understanding the Epidemiology and Progression of Systemic Lupus Erythematosus. Semin Arthritis Rheum 2010;39:257–68.Rovin BH, Zhang X. Biomarkers for lupus nephritis: The quest continues. Clin J Am Soc Nephrol 2009;4:1858–65.Ward MM. Access to care and the incidence of endstage renal disease due to systemic lupus erythematosus. J Rheumatol 2010;37:1158–63.Ward MM. Laboratory abnormalities at the onset of treatment of end-stage renal disease: are there racial or socioeconomic disparities in care? Arch Intern Med 2007;167:1083–91.Burling F, Ng J, Thein H, Ly J, Marshall MR, Gow P. Ethnic, clinical and immunological factors in systemic lupus erythematosus and the development of lupus nephritis: results from a multi-ethnic New Zealand cohort. Lupus 2007;16:830–7.Alarcón GS, Bastian HM, Beasley TM, Roseman JM, Tan FK, Fessler BJ, et al. Systemic lupus erythematosus in a multi-ethnic cohort (LUMINA): contributions of admixture and socioeconomic status to renal involvement. Lupus 2006;15:26–31.Davidson A, Diamond B. Autoimmune diseases. N Engl J Med 2001;345:340–50.Anaya J-M. The diagnosis and clinical significance of polyautoimmunity. Autoimmun Rev 2014;13:423–6.Anaya J-M, Rojas-Villarraga A, Shoenfeld Y. From the mosaic of autoimmunity to the autoimmune tautology. In: Anaya J-M, Rojas-Villarraga A, Shoenfeld Y, Levy R a, Cervera R, editors. Autoimunity. From bench to bedside, Bogotá: Editorial Universidad del rosario; 2013, p. 237–45.Rojas-Villarraga A, Castellanos-delahoz J, Perez-Fernandez O, Amaya-Amaya J, Franco J-S, Anaya J-M. Autoimmune Ecology. In: Anaya J-M, Shoenfeld Y, Rojas-Villarraga A, Levy R a, Cervera R, editors. Autoimunity. From bench to bedside, Bogotá: Editorial Universidad del rosario; 2013, p. 322–41.Cherepanov D, Palta M, Fryback DG, Robert SA, Hays RD, Kaplan RM. Gender differences in multiple underlying dimensions of health-related quality of life are associated with sociodemographic and socioeconomic status. Med Care 2011;49:1021–30.Aitsi-Selmi a, Batty GD, Barbieri M a, Silva a a M, Cardoso VC, Goldani MZ, et al. Childhood socioeconomic position, adult socioeconomic position and social mobility in relation to markers of adiposity in early adulthood: evidence of differential effects by gender in the 1978/79 Ribeirao Preto cohort study. Int J Obes (Lond) 2013;37:439–47.Moroni L, Bianchi I, Lleo A. Geoepidemiology, gender and autoimmune disease. Autoimmun Rev 2012;11:A386–92.Agmon-Levin N, Mosca M, Petri M, Shoenfeld Y. Systemic lupus erythematosus one disease or many? Autoimmun Rev 2012;11:593–5.Anaya J-M, Cañas C, Mantilla RD, Pineda-Tamayo R, Tobón GJ, et al. Lupus nephritis in Colombians: contrasts and comparisons with other populations. Clin Rev Allergy Immunol 2011;40:199–207.Borchers AT, Naguwa SM, Shoenfeld Y, Gershwin ME. The geoepidemiology of systemic lupus erythematosus. Autoimmun Rev 2010;9:A277–87.Mok CC, Chan PT, Ho LY, Yu KL, To CH. Prevalence of the antiphospholipid syndrome and its effect on survival in 679 Chinese patients with systemic lupus erythematosus: a cohort study. Medicine (Baltimore) 2013;92:217–22.Urowitz MB, Bookman AA, Koehler BE, Gordon DA, Smythe HA, Ogryzlo MA. The bimodal mortality pattern of systemic lupus erythematosus. Am J Med 1976;60:221–5.Frostegård J. SLE, atherosclerosis and cardiovascular disease. J Intern Med 2005;257:485–95.Haycoux A. What is health economics? Health economics 2009;1-8.Raftery J. Economic evaluation: an introduction. BMJ 1998;316:1013–4.Arrow K. Uncertainty and the welfare economics of medical care. Am Econ Rev 1963;53:942–73.Krieger N, Williams D. Measuring social class in US public health research: concepts, methodologies, and guidelines. Rev Public Heal 1997;18:341–78.Marmot MG. Improvement of social environment to improve health. Lancet 1998;351:57–60.Adler NE, Rehkopf DH. U.S. disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health 2008;29:235–52.DeSanVicente-Celis Z, Salazar J-C, Pineda-Tamayo R, Anaya J-M. On the need of pharmacoeconomics. Beginning by the principles. Rev Colomb Reumatol 2011;18:187–202.Tarricone R. Cost-of-illness analysis. What room in health economics? Health Policy 2006;77:51–63.Walley T. Pharmacoeconomics and Economic Evaluation of Drug Therapies, n.d., p. 67–75.Kobelt G, Berg J, Lindgren P, Fredrikson S, Jönsson B. Costs and quality of life of patients with multiple sclerosis in Europe. J Neurol Neurosurg Psychiatry 2006;77:918–26.Kobelt G, Berg J, Lindgren P, Jönsson B. Costs and quality of life in multiple sclerosis in Europe: method of assessment and analysis. Eur J Health Econ 2006;7 Suppl 2:S5–13.Byford S, Torgerson DJ, Raftery J. Economic note: cost of illness studies. BMJ 2000;320:1335.Segel J. Cost-of-Illness studies-A primer. RTI Int., RTI -UNC Center of Excellence in Health Promotion Economics. 2006, p. 1–39.Bootman J, Townsend R, McGhan W. Principles of pharmacoeconomics. 3th ed. Cincinnati: Whitney Harvey books; 2005.Conaghan PG, Durez P, Alten RE, Burmester G-R, Tak PP, Klareskog L, et al. Impact of intravenous abatacept on synovitis, osteitis and structural damage in patients with rheumatoid arthritis and an inadequate response to methotrexate: the ASSET randomised controlled trial. Ann Rheum Dis 2013;72:1287–94.Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet 2007;370:1929–38.Soto Álvarez J. Estudios de farmacoeconomía: ¿Por qué, cómo, cuándo y para qué? Medifam 2001;11:147–55.Charan J, Biswas T. How to Calculate Sample Size for Different Study Designs in Medical Research? Indian J Psychol Med 2013;35:121–6.Cárdenas-Roldán J, Rojas-Villarraga A, Anaya J-M. How do autoimmune diseases cluster in families? A systematic review and meta-analysis. BMC Med 2013;11:73.Sutcliffe N, Clarke a E, Taylor R, Frost C, Isenberg D a. Total costs and predictors of costs in patients with systemic lupus erythematosus. Rheumatology (Oxford) 2001;40:37–47.Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725.Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A. Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D). Br J Rheumatol 1997;36:551–9.Wolfe F, Hawley DJ. Measurement of the quality of life in rheumatic disorders using the EuroQol. Br J Rheumatol 1997;36:786–93.Wolfe F, Michaud K, Li T, Katz RS. EQ-5D and SF-36 quality of life measures in systemic lupus erythematosus: comparisons with rheumatoid arthritis, noninflammatory rheumatic disorders, and fibromyalgia. J Rheumatol 2010;37:296–304.Congreso de la República de Colombia. Decreto 2423 de 1996, actualizado 2013. Por el cual se determina la nomenclatura y clasificación de los procedimientos médicos, quirúrgicos y hospitalarios del Manual Tarifario y se dictan otras disposiciones. Bogotá: 2013.Farmaprecios max. Guia de productos. PLM 2013:19–52.Congreso de la República de Colombia. Decreto 1406. Por el se dictan disposiciones para la puesta en operación del Registro Único de Aportantes al Sistema de Seguridad Social Integral, se establece el régimen de recaudación de aportes que financian dicho Sistema y se dictan otras disposicione. Bogotá: 1999.Congreso de la República de Colombia. Código sustantivo del trabajo. Articulo 227 auxilio monetario por enfermedad no profesional. Bogotá: VIII; 1950.Jia H, Zack MM, Moriarty DG, Fryback DG. Predicting the EuroQol Group’s EQ-5D index from CDC's “Healthy Days” in a US sample. Med Decis Making 2011;31:174–85.Augustovski FA, Irazola VE, Velazquez AP, Gibbons L, Craig BM. Argentine valuation of the EQ-5D health states. Value Heal 2009;12:587–96.Lebart L, Morineau A, Piron M. Statistique exploratoire multidimensionnelle. Paris: DUNOD; 1995.Team R. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing.; 2013.Panopalis P, Petri M, Manzi S, Isenberg D a, Gordon C, Senécal J-L, et al. The systemic lupus erythematosus Tri-Nation study: cumulative indirect costs. Arthritis Rheum 2007;57:64–70.Zhu TY, Tam L-S, Lee VWY, Lee KK, Li EK. Systemic lupus erythematosus with neuropsychiatric manifestation incurs high disease costs: a cost-of-illness study in Hong Kong. Rheumatology (Oxford) 2009;48:564–8.Cho J, Chang S, Shin N, Choi B, Oh H, Yoon M, et al. Costs of illness and quality of life in patients with systemic lupus erythematosus in South Korea. Lupus 2014. In press.Li T, Carls GS, Panopalis P, Wang S, Gibson TB, Squibb B, et al. Long-term medical costs and resource utilization in systemic lupus erythematosus and lupus nephritis: a five-year analysis of a large medicaid population. Arthritis Rheum 2009;61:755–63.Pelletier EM, Ogale S, Yu E, Brunetta P, Garg J. Economic Outcomes in Patients Diagnosed With Systemic Lupus Erythematosus With Versus Without Nephritis : Results From an Analysis of Data From a US Claims Database. Clin Ther 2009;31:2653–64.Clarke a E, Panopalis P, Petri M, Manzi S, Isenberg D a, Gordon C, et al. SLE patients with renal damage incur higher health care costs. Rheumatology (Oxford) 2008;47:329–33.World Health Organization. Cost-effectiveness threshold. Cost Eff Strateg Plan Geneva, Switzerland. World Health Organization. 2014.World Health Organization. WHO guide to identifying the economic consequences of disease and injury. Geneva, Switzerland. World Health Organization; 2009.Gironimi G, Clarke AE, Hamilton VH, Danoff DS, Bloch DA, Fries JF, et al. Why health care costs more in the US: comparing health care expenditures between systemic lupus erythematosus patients in Stanford and Montreal. Arthritis Rheum 1996;39:979–87.Quintana G, Bolivar HAH, Coral-Alvarado P. Economic Evaluations in Systemic Lupus Erythematosus. In: Harjacek M, editor. Challenges Rheumatol., InTech; 2011, p. 13–24.Comision nacional de precios de medicamentos y dispositivos medicos. Circular Numero 03 de 2013. Bogota: Comision Nacional de Precios de Medicamentos y Dispositivos Medicos; 2013.Consejo Nacional de Politica Economica y Social. Documento Conpes Social 155. Politica Farmaceutica Nacional. Bogota: 2012.Comision nacional de precios de medicamentos y dispositivos medicos. Circular numero 04 de 2013. Bogota: Comision Nacional de Precios de Medicamentos y Dispositivos Medicos;2013.Wilson ECF, Jayne DRW, Dellow E, Fordham RJ. The cost-effectiveness of mycophenolate mofetil as firstline therapy in active lupus nephritis. Rheumatology (Oxford) 2007;46:1096–101.instname:Universidad del Rosarioreponame:Repositorio Institucional EdocURLupus eritematoso sistemicoCosto de la enfermedadCalidad de vidaPredictores de costosEnfermedades616600Lupus eritematoso sistémicoAdministración de servicios de saludEpidemiologíaSystemic lupus erythematosusCost of illnessQuality of lifeEl costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. 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