Análisis de costo efectividad del tratamiento de la parálisis facial en adultos, comparando acupuntura convencional con corticosteroides

Ilustraciones, diagramas algunas a color

Autores:: Veloza Romero, Ana Jannet

Tipo de recurso:

Fecha de publicación:: 2023

Institución:: Universidad Nacional de Colombia

Repositorio:: Universidad Nacional de Colombia

Idioma:: spa

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network_acronym_str	UNACIONAL2
network_name_str	Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv	Análisis de costo efectividad del tratamiento de la parálisis facial en adultos, comparando acupuntura convencional con corticosteroides
dc.title.translated.eng.fl_str_mv	Acupuncture versus corticosteroids for Bell´s palsy treatment: a cost-effectiveness analysis
title	Análisis de costo efectividad del tratamiento de la parálisis facial en adultos, comparando acupuntura convencional con corticosteroides
spellingShingle	Análisis de costo efectividad del tratamiento de la parálisis facial en adultos, comparando acupuntura convencional con corticosteroides 616.84 Manifestations of nervous system diseases 610 - Medicina y salud::615 - Farmacología y terapéutica 610 - Medicina y salud::616 - Enfermedades 330 - Economía::339 - Macroeconomía y temas relacionados Acupuntura Parálisis facial Análisis económico Acupuncture Adulto Parálisis de Bell Acupuntura Corticoesteroides Evaluación económica Análisis de costos Parálisis facial Análisis de costo efectividad Adult Facial paralysis Bell’s palsy Acupuncture Corticosteroids Cost effectiveness analisis Economic evaluation Costs analisis
title_short	Análisis de costo efectividad del tratamiento de la parálisis facial en adultos, comparando acupuntura convencional con corticosteroides
title_full	Análisis de costo efectividad del tratamiento de la parálisis facial en adultos, comparando acupuntura convencional con corticosteroides
title_fullStr	Análisis de costo efectividad del tratamiento de la parálisis facial en adultos, comparando acupuntura convencional con corticosteroides
title_full_unstemmed	Análisis de costo efectividad del tratamiento de la parálisis facial en adultos, comparando acupuntura convencional con corticosteroides
title_sort	Análisis de costo efectividad del tratamiento de la parálisis facial en adultos, comparando acupuntura convencional con corticosteroides
dc.creator.fl_str_mv	Veloza Romero, Ana Jannet
dc.contributor.advisor.none.fl_str_mv	Díaz Rojas, Jorge Augusto
dc.contributor.author.none.fl_str_mv	Veloza Romero, Ana Jannet
dc.contributor.researchgroup.spa.fl_str_mv	Evaluacion de Tecnologias y Politicas en Salud
dc.contributor.orcid.spa.fl_str_mv	0009-0009-7846-1548
dc.contributor.cvlac.spa.fl_str_mv	VELOZA-ROMERO, AJ
dc.subject.ddc.spa.fl_str_mv	616.84 Manifestations of nervous system diseases 610 - Medicina y salud::615 - Farmacología y terapéutica 610 - Medicina y salud::616 - Enfermedades 330 - Economía::339 - Macroeconomía y temas relacionados
topic	616.84 Manifestations of nervous system diseases 610 - Medicina y salud::615 - Farmacología y terapéutica 610 - Medicina y salud::616 - Enfermedades 330 - Economía::339 - Macroeconomía y temas relacionados Acupuntura Parálisis facial Análisis económico Acupuncture Adulto Parálisis de Bell Acupuntura Corticoesteroides Evaluación económica Análisis de costos Parálisis facial Análisis de costo efectividad Adult Facial paralysis Bell’s palsy Acupuncture Corticosteroids Cost effectiveness analisis Economic evaluation Costs analisis
dc.subject.lemb.spa.fl_str_mv	Acupuntura Parálisis facial Análisis económico
dc.subject.lemb.eng.fl_str_mv	Acupuncture
dc.subject.proposal.spa.fl_str_mv	Adulto Parálisis de Bell Acupuntura Corticoesteroides Evaluación económica Análisis de costos Parálisis facial Análisis de costo efectividad
dc.subject.proposal.eng.fl_str_mv	Adult Facial paralysis Bell’s palsy Acupuncture Corticosteroids Cost effectiveness analisis Economic evaluation Costs analisis
description	Ilustraciones, diagramas algunas a color
publishDate	2023
dc.date.accessioned.none.fl_str_mv	2023-08-04T14:40:28Z
dc.date.available.none.fl_str_mv	2023-08-04T14:40:28Z
dc.date.issued.none.fl_str_mv	2023-06
dc.type.spa.fl_str_mv	Trabajo de grado - Maestría
dc.type.driver.spa.fl_str_mv	info:eu-repo/semantics/masterThesis
dc.type.version.spa.fl_str_mv	info:eu-repo/semantics/acceptedVersion
dc.type.content.spa.fl_str_mv	Text
dc.type.redcol.spa.fl_str_mv	http://purl.org/redcol/resource_type/TM
status_str	acceptedVersion
dc.identifier.uri.none.fl_str_mv	https://repositorio.unal.edu.co/handle/unal/84453
dc.identifier.instname.spa.fl_str_mv	Universidad Nacional de Colombia
dc.identifier.reponame.spa.fl_str_mv	Repositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourl.spa.fl_str_mv	https://repositorio.unal.edu.co/
url	https://repositorio.unal.edu.co/handle/unal/84453 https://repositorio.unal.edu.co/
identifier_str_mv	Universidad Nacional de Colombia Repositorio Institucional Universidad Nacional de Colombia
dc.language.iso.spa.fl_str_mv	spa
language	spa
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spelling	Atribución-NoComercial 4.0 Internacionalinfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Díaz Rojas, Jorge Augustoec3d060d221609e5088d2b55505c5f5cVeloza Romero, Ana Jannetcd59c84fc50d0649cc234668b9d8df72Evaluacion de Tecnologias y Politicas en Salud0009-0009-7846-1548VELOZA-ROMERO, AJ2023-08-04T14:40:28Z2023-08-04T14:40:28Z2023-06https://repositorio.unal.edu.co/handle/unal/84453Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/Ilustraciones, diagramas algunas a colorLa parálisis facial idiopática o parálisis de Bell es una neuropatía periférica facial de presentación aguda y es la causa más común de parálisis de moto neurona facial. La máxima severidad de los síntomas ocurre en las primeras 48 a 72 horas, y los pacientes con déficit funcional considerable sufren consecuencias psicológicas, sociales y problemas profesionales. Recientemente ha cobrado importancia esta entidad ya que se ha vinculado con casos reportados de eventos adversos asociados a la vacunación contra el virus SARS CoV2. En la recuperación de los pacientes con parálisis de Bell se han utilizado diferentes terapias tales como corticosteroides, antivirales, fisioterapia y acupuntura. Este trabajo se propuso evaluar la costo-efectividad de la acupuntura convencional en el tratamiento de la parálisis de Bell en pacientes adultos, desde la perspectiva del sistema de salud colombiano, comparada con los Corticosteroides, en el tratamiento del episodio agudo de los pacientes con la misma patología, a través de un diseño tipo análisis de costo efectividad que incluyó todos los costos médicos directos asociados al uso de las tecnologías en salud bajo evaluación, así como los beneficios en salud percibidos directamente por los pacientes, con un horizonte temporal de tres semanas. Se siguieron las recomendaciones contenidas en el Manual Metodológico IETS para Evaluaciones Económicas (2014). El desenlace primario propuesto es la tasa de efectividad total al final del tratamiento (definida en el modelo como “Curación”), evaluada por la escala de House-Brackman. Como desenlace secundario se contempló la seguridad expresada como frecuencia de eventos adversos serios. Para lograr la Curación de la parálisis de Bell en la fase aguda de esa enfermedad, sin que se presenten eventos adversos serios, al comparar Acupuntura con Corticosteroides, se genera un ahorro para el sistema de salud de $ 16.024.257,23. Para un valor de disponibilidad a pagar por el tratamiento de la fase aguda de pacientes adultos con parálisis de Bell de $2.500.000,00, la Acupuntura frente a los Corticosteroides en el análisis de sensibilidad probabilístico evidencia ser más efectiva (68,2% de los puntos en el diagrama de dispersión en el plano de costo efectividad), más costo efectiva (20,4% en el cuadrante II, manteniendo su característica como opción terapéutica dominante), con una RCEI que se mantiene por debajo del umbral de disponibilidad a pagar fijado en un 10% de las iteraciones (cuadrante III), aunque con menor efectividad, también. (Texto tomado de la fuente)Bell's palsy (diopathic facial paralysis) is a peripheral facial neuropathy, with acute onset, being the most common facial motoneuron palsy. The highest severity is seen during the first 48 to 72 hours, and, if the patients has sequealae, he will face social, psichological al professional consequences. It has been mentioned this pathology recently due to it has been describes as an adverse event related to some SARS CoV2 vaccines. Tryiing to get full recovery of Bell's palsy clinical manifestations in patients, thera have been used several therapies, including corticosteroids, antiviral meds, physical therapy and acupuncture. This study proposal was to evaluate the acupuncture vs. corticosteroids cost effectiveness associated to the treatment of Bell's palsy acute onset, under Colombian health system perspective, through a cost effectveness analysis, covering not only all the medical direct costs, but also the health benefits perceived directly by the patients, within a three-weeeks time frame. The study followed the Economic Evaluation Handbook recommendations (IETS, 2014) for methodological issues. The main outcome was "Healing" (effectiveness global rate) at hte end of the acute onset treatment, assesed by House-Brackman scale. As a secondary outcome the serious adverse events proportion was included. To get the Bell's palsy acte onset healing , without suffering serious adverse events, comparing acupuncture to corticosteroids, the Colombian Health system will save COP $ 16.024.257,23. Moreover, considering a willingness to pay for a Bell's palsy acute onset's treatment fixed in COP $2.500.000,00, acupuncture against corticosteroids in a probabilistic sentivity analysis showed more effectiveness (68,2% in proportion in cost-effectiveness plane scatter plot), also the most cost-effective option (20,4% of points places in quadrant II of the same plane, keeping its dominant feature as therapeutic option), with an ICER which stays under the willingness-to-pay threshold stablished for a 10% of iterations (quadrant III), eventhough less effectiveness, also.Notas generales de interés al público relacionadas con el recursoMaestríaMagíster en Ciencias - FarmacologíaEn una evaluación económica de tipo análisis de costo efectividad (ACE) se calculan primero los costos y los efectos de una intervención y de una o más alternativas, y se calculan luego las diferencias entre los costos y los efectos, y se presentan tales diferencias en forma de razón, la cual corresponde al costo por cada unidad del efecto o del beneficio en salud considerado (unidad de eficiencia). Como el enfoque es en las diferencias entre dos o más opciones o tratamientos, los analistas se refieren a estos típicamente como costos incrementales, y a la razón de costo efectividad incremental (RCEI). Los efectos de cada intervención se calculan usando muchos tipos de unidades de medida, y en todo caso, los tomadores de decisiones se hallarán interesados en la asignación de recursos entre las diversas áreas de atención en salud, y por la misma razón la medición de un desenlace en salud puede ser útil para ser usada en el análisis para diferentes áreas; los años de vida ajustados por calidad (AVACs) son una medida de resultados en salud ampliamente utilizada. El ACE exige que se identifiquen, cuantifiquen y contrasten todos los costos relevantes y las consecuencias deseables de entre diferentes alternativas que puedan aplicarse a un determinado problema, pues uno de sus objetivos es la estructuración y el análisis de la información que permita informar a quienes toman las decisiones o elaboran las políticas públicas, ayudándolos así en su labor.Farmacoeconomíaapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Ciencias - Maestría en Ciencias - FarmacologíaFacultad de CienciasBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá616.84 Manifestations of nervous system diseases610 - Medicina y salud::615 - Farmacología y terapéutica610 - Medicina y salud::616 - Enfermedades330 - Economía::339 - Macroeconomía y temas relacionadosAcupunturaParálisis facialAnálisis económicoAcupunctureAdultoParálisis de BellAcupunturaCorticoesteroidesEvaluación económicaAnálisis de costosParálisis facialAnálisis de costo efectividadAdultFacial paralysisBell’s palsyAcupunctureCorticosteroidsCost effectiveness analisisEconomic evaluationCosts analisisAnálisis de costo efectividad del tratamiento de la parálisis facial en adultos, comparando acupuntura convencional con corticosteroidesAcupuncture versus corticosteroids for Bell´s palsy treatment: a cost-effectiveness analysisTrabajo de grado - Maestríainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMAmerican Academy of Neurology. 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Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association, 122(7), 406–415.EstudiantesInvestigadoresPúblico generalResponsables políticosLICENSElicense.txtlicense.txttext/plain; charset=utf-85879https://repositorio.unal.edu.co/bitstream/unal/84453/1/license.txteb34b1cf90b7e1103fc9dfd26be24b4aMD51ORIGINAL52318908.2023.pdf52318908.2023.pdfTesis de Maestría en Ciencias - Farmacologíaapplication/pdf1713515https://repositorio.unal.edu.co/bitstream/unal/84453/2/52318908.2023.pdf2fa3a6f230ac61ae765fc68d3658aa72MD52THUMBNAIL52318908.2023.pdf.jpg52318908.2023.pdf.jpgGenerated Thumbnailimage/jpeg4915https://repositorio.unal.edu.co/bitstream/unal/84453/3/52318908.2023.pdf.jpgbd7b62466ba6f2737ffe78625c90ccc4MD53unal/84453oai:repositorio.unal.edu.co:unal/844532023-08-16 23:04:31.083Repositorio Institucional Universidad Nacional de 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