Hospitalization costs due to severe acute respiratory infection (SARI) in three Central American countries

Objective: To estimate the direct medical costs of severe acute respiratory infection (SARI) in children and adults from three Central American countries with a bottom-up costing approach. Methods: The costs of inpatients treatment were estimated through the retrospective bottom-up costing in a rand...

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Autores:: Alvis-Guzmán, Nelson
Marín-Correa, Carlos
Castañeda-Orjuela, Carlos Andrés
Sánchez-Ruiz, Carolina
Carrasquilla-Sotomayor, María
Sanchez-Largaespada, Felix
Mena, Ricardo
Mejía, Homer

Tipo de recurso:: Article of journal

Fecha de publicación:: 2018

Institución:: Corporación Universidad de la Costa

Repositorio:: REDICUC - Repositorio CUC

Idioma:: eng

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repository_id_str
dc.title.spa.fl_str_mv	Hospitalization costs due to severe acute respiratory infection (SARI) in three Central American countries
dc.title.translated.spa.fl_str_mv	Costos de hospitalización por agudos severos. infección respiratoria en tres centrales países americanos
title	Hospitalization costs due to severe acute respiratory infection (SARI) in three Central American countries
spellingShingle	Hospitalization costs due to severe acute respiratory infection (SARI) in three Central American countries Cost and cost analysis Severe acute respiratory infection Guatemala Honduras Nicaragua Análisis de costos y costos Infección respiratoria aguda grave
title_short	Hospitalization costs due to severe acute respiratory infection (SARI) in three Central American countries
title_full	Hospitalization costs due to severe acute respiratory infection (SARI) in three Central American countries
title_fullStr	Hospitalization costs due to severe acute respiratory infection (SARI) in three Central American countries
title_full_unstemmed	Hospitalization costs due to severe acute respiratory infection (SARI) in three Central American countries
title_sort	Hospitalization costs due to severe acute respiratory infection (SARI) in three Central American countries
dc.creator.fl_str_mv	Alvis-Guzmán, Nelson Marín-Correa, Carlos Castañeda-Orjuela, Carlos Andrés Sánchez-Ruiz, Carolina Carrasquilla-Sotomayor, María Sanchez-Largaespada, Felix Mena, Ricardo Mejía, Homer
dc.contributor.author.spa.fl_str_mv	Alvis-Guzmán, Nelson Marín-Correa, Carlos Castañeda-Orjuela, Carlos Andrés Sánchez-Ruiz, Carolina Carrasquilla-Sotomayor, María Sanchez-Largaespada, Felix Mena, Ricardo Mejía, Homer
dc.subject.spa.fl_str_mv	Cost and cost analysis Severe acute respiratory infection Guatemala Honduras Nicaragua Análisis de costos y costos Infección respiratoria aguda grave
topic	Cost and cost analysis Severe acute respiratory infection Guatemala Honduras Nicaragua Análisis de costos y costos Infección respiratoria aguda grave
description	Objective: To estimate the direct medical costs of severe acute respiratory infection (SARI) in children and adults from three Central American countries with a bottom-up costing approach. Methods: The costs of inpatients treatment were estimated through the retrospective bottom-up costing in a randomized sample of clinical records from SARI patients treated in teaching tertiary hospitals during 2009 - 2011 period. Activities incurred per patient were registered and a setting-specific cost per activity was acquired. Average cost per patient in the group of children and elderly adults was estimated for each country. In Nicaragua, only the pediatric population was included. Costs were expressed in local currency (2011), American dollars, and international dollars (2005) for country comparison. Results: The care cost per case in children in Guatemala was the cheaper (I$971.95) compared to Nicaragua (I$1,431.96) and Honduras (I$1,761.29). In adults, the treatment cost for Guatemala was the more expensive: I$4,065.00 vs. I$2,707.91 in Honduras. Conclusion: Bottom-up costing of SARI cases allowed the mean estimates per treated case that could have external validity for the target population diagnosed in hospitals with similar epidemiological profiles and level of complexity for the study countries. This information is very relevant for the decision-making.
publishDate	2018
dc.date.issued.none.fl_str_mv	2018-01-11
dc.date.accessioned.none.fl_str_mv	2019-05-27T14:16:36Z
dc.date.available.none.fl_str_mv	2019-05-27T14:16:36Z
dc.type.spa.fl_str_mv	Artículo de revista
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dc.relation.ispartof.spa.fl_str_mv	DOI: http://dx.doi.org/10.22354/in.v22i3.728
dc.relation.references.spa.fl_str_mv	1. Cashat-Cruz M, Morales-Aguirre JJ, Mendoza-Azpiri M. Respiratory tract infections in children in developing countries. Semin Pediatr Infect Dis. 2005;16(2):84-92. Epub 2005/04/13. 2. Nair H, Simoes EA, Rudan I, Gessner BD, Azziz-Baumgartner E, Zhang JS, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013;381(9875):1380-90. Epub 2013/02/02. 3. Leowski J. Mortality from acute respiratory infections in children under 5 years of age: global estimates. World Health Stat Q. 1986;39(2):138-44. Epub 1986/01/01. 4. Abarca VK. Influenza: vacunación a nuevos grupos etarios. Rev Chilena Infectol. 2007;24(3):227-30. 5. Monto AS. Global burden of influenza: what we know and what we need to know. Int Congr Ser. 2004;1263:3-11. 6. Shek LP, Lee BW. Epidemiology and seasonality of respiratory tract virus infections in the tropics. Paediatr Respir Rev. 2003;4(2):105-11. Epub 2003/05/22. 7. Brooks WA, Alamgir AS, Sultana R, Islam MS, Rahman M, Fry AM, et al. Avian influenza virus A (H5N1), detected through routine surveillance, in child, Bangladesh. Emerg Infect Dis. 2009;15(8):1311-3. Epub 2009/09/16. 8. Zaman RU, Alamgir AS, Rahman M, Azziz-Baumgartner E, Gurley ES, Sharker MA, et al. Influenza in outpatient ILI case-patients in national hospital-based surveillance, Bangladesh, 2007-2008. PLoS One. 2009;4(12):e8452. Epub 2009/12/31. 9. Gordon A, Ortega O, Kuan G, Reingold A, Saborio S, Balmaseda A, et al. Prevalence and seasonality of influenza-like illness in children, Nicaragua, 2005-2007. Emerg Infect Dis. 2009;15(3):408-14. Epub 2009/02/26. 10. Lindblade KA, Arvelo W, Gray J, Estevez A, Frenkel G, Reyes L, et al. A comparison of the epidemiology and clinical presentation of seasonal influenza A and 2009 pandemic influenza A (H1N1) in Guatemala. PLoS One. 2010;5(12):e15826. Epub 2011/01/07. 11. Reyes L, Arvelo W, Estevez A, Gray J, Moir JC, Gordillo B, et al. Populationbased surveillance for 2009 pandemic influenza A (H1N1) virus in Guatemala, 2009. Influenza Other Respir Viruses. 2010;4(3):129-40. Epub 2010/04/23. 12. Molinari NA, Ortega-Sanchez IR, Messonnier ML, Thompson WW, Wortley PM, Weintraub E, et al. The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine. 2007;25(27):5086-96. Epub 2007/06/05. 13. Keech M, Beardsworth P. The impact of influenza on working days lost: a review of the literature. Pharmacoeconomics. 2008;26(11):911-24. Epub 2008/10/15. 14. Giachetto Larraz G, Telechea Ortiz H, Speranza Mourine N, Giglio N, Cane A, Pirez Garcia MC, et al. Costo-efectividad de la vacunación universal antineumocócica en Uruguay. [Cost-effectiveness of universal pneumococcal vaccination in Uruguay]. Rev Panam Salud Pública. 2010;28(2):92-9. Epub 2010/10/22. 15. Alvis-Guzman N, Orozco-Africano J, Paternina-Caicedo A, CoronellRodriguez W, Alvis-Estrada L, Jervis-Jalabe D, et al. Treatment costs of diarrheal disease and all-cause pneumonia among children under-5 years of age in Colombia. Vaccine. 2013;31(Suppl. 3):C58-62. Epub 2013/06/29. 16. Castaneda-Orjuela C, Alvis-Guzman N, Paternina AJ, De la HozRestrepo F. Cost-effectiveness of the introduction of the pneumococcal polysaccharide vaccine in elderly Colombian population. Vaccine. 2011;29(44):7644-50. Epub 2011/08/23. 17. Constenla DO. Economic impact of pneumococcal conjugate vaccination in Brazil, Chile, and Uruguay. Rev Panam Salud Pública. 2008;24(2):101-12. Epub 2008/12/10. 18. Uruena A, Pippo T, Betelu MS, Virgilio F, Giglio N, Gentile A, et al. Costeffectiveness analysis of the 10- a nd 13-valent pneumococcal conjugate vaccines in Argentina. Vaccine. 2011;29(31):4963-72. Epub 2011/05/31. 19. Castañeda-Orjuela C, Alvis-Guzman N, Velandia-Gonzalez M, De la HozRestrepo F. Cost-effectiveness of pneumococcal conjugate vaccines of 7, 10, and 13 valences in Colombian children. Vaccine. 2012;30(11):1936-43. Epub 2012/01/24. 20. Rodriguez Martinez CE, Sossa Briceno MP. Costo-efectividad de la radiografía de tórax en lactantes con sospecha clínica de bronquiolitis viral en Colombia. [Cost-effectiveness of chest x-rays in infants with clinically suspected viral bronchiolitis in Colombia]. Rev Panam Salud Pública. 2011;29(3):153-61. Epub 2011/04/13. 21. Diez Domingo J, Ridao Lopez M, Ubeda Sansano I, Ballester Sanz A. Incidencia y costes de la hospitalizacion por bronquiolitis y de las infecciones por virus respiratorio sincitial en la Comunidad Valenciana. Años 2001 y 2002. [Incidence and cost of hospitalizations for bronchiolitis and respiratory syncytial virus infections in the autonomous community of Valencia in Spain (2001 and 2002)]. An Pediatr (Barc). 2006;65(4):325-30. Epub 2006/10/06. 22. Becerril-Montekio V, Lopez-Davila L. Sistema de salud de Guatemala. [The health system of Guatemala]. Salud Pública Mex. 2011;53(Suppl.2):s197-208. Epub 2011/09/09. 23. Bermudez-Madriz JL, Saenz Mdel R, Muiser J, Acosta M. Sistema de salud de Honduras. [The health system of Honduras]. Salud Pública Mex. 2011;53(Suppl.2):s209-19. Epub 2011/09/09. 24. Muiser J, Saenz Mdel R, Bermudez JL. Sistema de salud de Nicaragua. [The health system of Nicaragua]. Salud Publica Mex. 2011;53(Suppl.2):s233-42. Epub 2011/09/09.
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spelling	Alvis-Guzmán, NelsonMarín-Correa, CarlosCastañeda-Orjuela, Carlos AndrésSánchez-Ruiz, CarolinaCarrasquilla-Sotomayor, MaríaSanchez-Largaespada, FelixMena, RicardoMejía, Homer2019-05-27T14:16:36Z2019-05-27T14:16:36Z2018-01-110123-9392https://hdl.handle.net/11323/4719Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Objective: To estimate the direct medical costs of severe acute respiratory infection (SARI) in children and adults from three Central American countries with a bottom-up costing approach. Methods: The costs of inpatients treatment were estimated through the retrospective bottom-up costing in a randomized sample of clinical records from SARI patients treated in teaching tertiary hospitals during 2009 - 2011 period. Activities incurred per patient were registered and a setting-specific cost per activity was acquired. Average cost per patient in the group of children and elderly adults was estimated for each country. In Nicaragua, only the pediatric population was included. Costs were expressed in local currency (2011), American dollars, and international dollars (2005) for country comparison. Results: The care cost per case in children in Guatemala was the cheaper (I$971.95) compared to Nicaragua (I$1,431.96) and Honduras (I$1,761.29). In adults, the treatment cost for Guatemala was the more expensive: I$4,065.00 vs. I$2,707.91 in Honduras. Conclusion: Bottom-up costing of SARI cases allowed the mean estimates per treated case that could have external validity for the target population diagnosed in hospitals with similar epidemiological profiles and level of complexity for the study countries. This information is very relevant for the decision-making.Objetivo: Estimar los costos médicos directos de la infección respiratoria aguda grave (IRAG) en niños y adultos de tres países de América Central con un enfoque de costos de abajo hacia arriba. Métodos: los costos del tratamiento de pacientes hospitalizados se calcularon mediante el cálculo retrospectivo de los costos ascendentes en una muestra aleatoria de registros clínicos de SARI. Pacientes tratados en hospitales terciarios docentes durante el periodo 2009 - 2011. Se registraron las actividades incurridas por paciente y se determinó un costo por actividad específico del entorno. adquirido. El costo promedio por paciente en el grupo de niños y adultos mayores se estimó para cada país. En Nicaragua, solo la población pediátrica era incluido. Los costos se expresaron en moneda local (2011), dólares estadounidenses y dólares internacionales (2005) para la comparación de países. Resultados: El costo de atención por caso en niños en Guatemala fue el más barato (I $ 971.95) en comparación con Nicaragua (I $ 1,431.96) y Honduras (I $ 1,761.29). En los adultos, el El costo del tratamiento para Guatemala fue el más caro: I $ 4,065.00 vs. I $ 2,707.91 en Honduras. Conclusión: el cálculo de costos ascendente de los casos de IRAG permitió las estimaciones medias por caso tratado que podrían tener validez externa para la población objetivo diagnosticada en Hospitales con perfiles epidemiológicos y nivel de complejidad similares para los países estudiados. Esta información es muy relevante para la toma de decisiones.Alvis-Guzmán, Nelson-db5718c5-8ade-4b65-b025-c11502d6b475-0Marín-Correa, Carlos-da63beea-5061-4bea-80e0-29eec74c4160-0Castañeda-Orjuela, Carlos Andrés-0a0c293e-94ff-494f-812c-a9de1a738c0e-0Sánchez-Ruiz, Carolina-39d9d859-c425-4261-86e5-d4fe2b6606d0-0Carrasquilla-Sotomayor, María-e72d670c-8bc2-4f8a-b7a5-a893020ecbf7-0Sanchez-Largaespada, Felix-5fd0aa5a-4701-4869-8247-30c18ba99d4c-0Mena, Ricardo-abffd535-74c9-4b4b-b2b7-640ba6c6804f-0Mejía, Homer-47652b2f-5a59-46a6-b409-13ce95349296-0engInfectioDOI: http://dx.doi.org/10.22354/in.v22i3.7281. Cashat-Cruz M, Morales-Aguirre JJ, Mendoza-Azpiri M. Respiratory tract infections in children in developing countries. Semin Pediatr Infect Dis. 2005;16(2):84-92. Epub 2005/04/13. 2. Nair H, Simoes EA, Rudan I, Gessner BD, Azziz-Baumgartner E, Zhang JS, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013;381(9875):1380-90. Epub 2013/02/02. 3. Leowski J. Mortality from acute respiratory infections in children under 5 years of age: global estimates. World Health Stat Q. 1986;39(2):138-44. Epub 1986/01/01. 4. Abarca VK. Influenza: vacunación a nuevos grupos etarios. Rev Chilena Infectol. 2007;24(3):227-30. 5. Monto AS. Global burden of influenza: what we know and what we need to know. Int Congr Ser. 2004;1263:3-11. 6. Shek LP, Lee BW. Epidemiology and seasonality of respiratory tract virus infections in the tropics. Paediatr Respir Rev. 2003;4(2):105-11. Epub 2003/05/22. 7. Brooks WA, Alamgir AS, Sultana R, Islam MS, Rahman M, Fry AM, et al. Avian influenza virus A (H5N1), detected through routine surveillance, in child, Bangladesh. Emerg Infect Dis. 2009;15(8):1311-3. Epub 2009/09/16. 8. Zaman RU, Alamgir AS, Rahman M, Azziz-Baumgartner E, Gurley ES, Sharker MA, et al. Influenza in outpatient ILI case-patients in national hospital-based surveillance, Bangladesh, 2007-2008. PLoS One. 2009;4(12):e8452. Epub 2009/12/31. 9. Gordon A, Ortega O, Kuan G, Reingold A, Saborio S, Balmaseda A, et al. Prevalence and seasonality of influenza-like illness in children, Nicaragua, 2005-2007. Emerg Infect Dis. 2009;15(3):408-14. Epub 2009/02/26. 10. Lindblade KA, Arvelo W, Gray J, Estevez A, Frenkel G, Reyes L, et al. A comparison of the epidemiology and clinical presentation of seasonal influenza A and 2009 pandemic influenza A (H1N1) in Guatemala. PLoS One. 2010;5(12):e15826. Epub 2011/01/07. 11. Reyes L, Arvelo W, Estevez A, Gray J, Moir JC, Gordillo B, et al. Populationbased surveillance for 2009 pandemic influenza A (H1N1) virus in Guatemala, 2009. Influenza Other Respir Viruses. 2010;4(3):129-40. Epub 2010/04/23. 12. Molinari NA, Ortega-Sanchez IR, Messonnier ML, Thompson WW, Wortley PM, Weintraub E, et al. The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine. 2007;25(27):5086-96. Epub 2007/06/05. 13. Keech M, Beardsworth P. The impact of influenza on working days lost: a review of the literature. Pharmacoeconomics. 2008;26(11):911-24. Epub 2008/10/15. 14. Giachetto Larraz G, Telechea Ortiz H, Speranza Mourine N, Giglio N, Cane A, Pirez Garcia MC, et al. Costo-efectividad de la vacunación universal antineumocócica en Uruguay. [Cost-effectiveness of universal pneumococcal vaccination in Uruguay]. Rev Panam Salud Pública. 2010;28(2):92-9. Epub 2010/10/22. 15. Alvis-Guzman N, Orozco-Africano J, Paternina-Caicedo A, CoronellRodriguez W, Alvis-Estrada L, Jervis-Jalabe D, et al. Treatment costs of diarrheal disease and all-cause pneumonia among children under-5 years of age in Colombia. Vaccine. 2013;31(Suppl. 3):C58-62. Epub 2013/06/29. 16. Castaneda-Orjuela C, Alvis-Guzman N, Paternina AJ, De la HozRestrepo F. Cost-effectiveness of the introduction of the pneumococcal polysaccharide vaccine in elderly Colombian population. Vaccine. 2011;29(44):7644-50. Epub 2011/08/23. 17. Constenla DO. Economic impact of pneumococcal conjugate vaccination in Brazil, Chile, and Uruguay. Rev Panam Salud Pública. 2008;24(2):101-12. Epub 2008/12/10. 18. Uruena A, Pippo T, Betelu MS, Virgilio F, Giglio N, Gentile A, et al. Costeffectiveness analysis of the 10- a nd 13-valent pneumococcal conjugate vaccines in Argentina. Vaccine. 2011;29(31):4963-72. Epub 2011/05/31. 19. Castañeda-Orjuela C, Alvis-Guzman N, Velandia-Gonzalez M, De la HozRestrepo F. Cost-effectiveness of pneumococcal conjugate vaccines of 7, 10, and 13 valences in Colombian children. Vaccine. 2012;30(11):1936-43. Epub 2012/01/24. 20. Rodriguez Martinez CE, Sossa Briceno MP. Costo-efectividad de la radiografía de tórax en lactantes con sospecha clínica de bronquiolitis viral en Colombia. [Cost-effectiveness of chest x-rays in infants with clinically suspected viral bronchiolitis in Colombia]. Rev Panam Salud Pública. 2011;29(3):153-61. Epub 2011/04/13. 21. Diez Domingo J, Ridao Lopez M, Ubeda Sansano I, Ballester Sanz A. Incidencia y costes de la hospitalizacion por bronquiolitis y de las infecciones por virus respiratorio sincitial en la Comunidad Valenciana. Años 2001 y 2002. [Incidence and cost of hospitalizations for bronchiolitis and respiratory syncytial virus infections in the autonomous community of Valencia in Spain (2001 and 2002)]. An Pediatr (Barc). 2006;65(4):325-30. Epub 2006/10/06. 22. Becerril-Montekio V, Lopez-Davila L. Sistema de salud de Guatemala. [The health system of Guatemala]. Salud Pública Mex. 2011;53(Suppl.2):s197-208. Epub 2011/09/09. 23. Bermudez-Madriz JL, Saenz Mdel R, Muiser J, Acosta M. Sistema de salud de Honduras. [The health system of Honduras]. Salud Pública Mex. 2011;53(Suppl.2):s209-19. Epub 2011/09/09. 24. Muiser J, Saenz Mdel R, Bermudez JL. Sistema de salud de Nicaragua. [The health system of Nicaragua]. Salud Publica Mex. 2011;53(Suppl.2):s233-42. Epub 2011/09/09.http://creativecommons.org/licenses/by-nc-sa/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Cost and cost analysisSevere acute respiratory infectionGuatemalaHondurasNicaraguaAnálisis de costos y costosInfección respiratoria aguda graveHospitalization costs due to severe acute respiratory infection (SARI) in three Central American countriesCostos de hospitalización por agudos severos. infección respiratoria en tres centrales países americanosArtículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/acceptedVersionPublicationORIGINALHospitalization costs due to severe acute.pdfHospitalization costs due to severe acute.pdfapplication/pdf532321https://repositorio.cuc.edu.co/bitstreams/c3fd7de2-c59f-4e1c-8aa8-c8891fc8a122/downloade7748363f7bfb5274a0f666dad96725eMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-81031https://repositorio.cuc.edu.co/bitstreams/0ef5357a-8046-4133-9b0b-730290bb4cfe/download934f4ca17e109e0a05eaeaba504d7ce4MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repositorio.cuc.edu.co/bitstreams/f8bbc2c0-c36f-46b6-853b-b70cff2c9dfa/download8a4605be74aa9ea9d79846c1fba20a33MD53THUMBNAILHospitalization costs due to severe acute.pdf.jpgHospitalization costs due to severe acute.pdf.jpgimage/jpeg53645https://repositorio.cuc.edu.co/bitstreams/99bc8df1-737d-4d48-9baf-41103a574563/downloadaae63818e6f2ce57b6e4c131995e4dc8MD55TEXTHospitalization costs due to severe acute.pdf.txtHospitalization costs due to severe acute.pdf.txttext/plain38966https://repositorio.cuc.edu.co/bitstreams/6c661bfe-186e-4a8f-82d8-b469d14add66/downloadaabba0a6629a7f0265826d6cd0f12363MD5611323/4719oai:repositorio.cuc.edu.co:11323/47192024-09-17 14:24:32.206http://creativecommons.org/licenses/by-nc-sa/4.0/open.accesshttps://repositorio.cuc.edu.coRepositorio de la Universidad de la Costa CUCrepdigital@cuc.edu.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

Hospitalization costs due to severe acute respiratory infection (SARI) in three Central American countries

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