ABSTRACT
OBJETIVOS: Determinar los costos directos e indirectos asociados con la atención de los casos de dengue y de dengue hemorrágico o síndrome de choque por dengue (DH/SCD) entre los años 1997 y 2003 en el Estado de Zulia, Venezuela. MÉTODOS: El número total de pacientes con dengue y DH/SCD se obtuvo de los registros de la Dirección Regional de Epidemiología del Estado de Zulia y de los informes de casos confirmados en la Sección de Virología del Instituto de Investigaciones Clínicas Dr. Américo Negrette, de la Facultad de Medicina, Universidad del Zulia, Maracaibo, entre el 1.° de enero de 1997 y el 31 de diciembre de 2003. Como costos directos se consideraron el costo de la atención médica de urgencia de todos los casos y los costos de hospitalización de los casos con DH/SCD (costo por día-cama y costos de laboratorio). Los costos asociados con la ausencia laboral de los enfermos mayores de 15 años y de las madres acompañantes de los enfermos menores de 15 años conformaron los costos indirectos, ajustados según la proporción de hombres y mujeres en la fuerza laboral activa del país. Para el cálculo se utilizó el salario mínimo anual y los resultados se expresaron en dólares estadounidenses, según la tasa de cambio promedio de cada año. RESULTADOS: En el período estudiado se atendieron 33 857 casos de dengue y de DH/SCD; de ellos, 30 251 (89,35 por ciento) fueron de dengue y 3 606 (10,65 por ciento) de DH/SCD. Seis de estos fallecieron (letalidad 0,2 por 100 casos de DH/SCD). Los costos directos fueron US$ 474 251,70; de esa suma, US$ 132 042,30 correspondieron a la atención en los servicios de urgencia y US$ 342 209,40 a los gastos de hospitalización de los casos con DH/SCD. Los costos indirectos ascendieron a US$ 873 825,84 y representaron 64,8 por ciento del gasto total (US$ 1 348 077,54) relacionado con esta enfermedad en los años estudiados. CONCLUSIONES: Este es el primer estudio acerca del impacto económico del dengue en el Estado de Zulia y en Venezuela. A pesar de que el estudio tuvo algunas limitaciones, los resultados demuestran que el dengue constituye un importante problema de salud pública que ocasiona grandes gastos por ausentismo laboral temporal y que afecta considerablemente al desarrollo de la economía regional y nacional.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Severe Dengue/economics , Severe Dengue/epidemiology , Dengue/economics , Dengue/epidemiology , Health Care Costs , Health Services/economics , Catchment Area, Health , Health Expenditures , Venezuela/epidemiologyABSTRACT
Se diagnosticaron 3 012 casos, confirmados serológicamente, en una epidemia producida por el serotipo 2 del virus dengue en el municipio de Santiago de Cuba de la República de Cuba; 205 se clasificaron como casos de fiebre hemorrágica de dengue (FHD) y 12 fallecieron. Se estimaron las afectaciones económicas incurridas durante la epidemia de dengue en este municipio y para ello se analizaron los costos por hospitalización y control clínico-terapéutico de los pacientes, lucha antivectorial y vigilancia de laboratorio. Se estimó un costo total de 10 251 539 USD, de los que 76 porciento se empleó en la lucha antivectorial y 18 porciento en costos hospitalarios. Se discutió el costo-beneficio de los programas de prevención y control comparándolos con los costos necesarios para el control de la epidemia
Subject(s)
Humans , Costs and Cost Analysis , Dengue , Severe Dengue/economics , Health Care Costs , Dengue , Disease Outbreaks , Severe Dengue/epidemiologyABSTRACT
This study assesses the burden of dengue hemorrhagic fever (DHF) and effectiveness of an intervention package in Myanmar. Disability adjusted life years (DALYs) lost for fatal and non-fatal DHF cases and DALYs averted due to intervention for DHF from 1970-1997 were estimated. The data are based on reported cases and deaths from DHF extracted from annual reports of the Myanmar vector borne disease control program. Sensitivity analyses were performed for robustness of conclusions. DALYs lost from both fatal and non-fatal DHF cases in Myanmar were estimated as 83.83 DALYs per year per million population (range = 83.33-86.32) for the period 1970-1997. DALYs averted from DHF due to intervention were estimated as 134 DALYs per year per million population (range = 47-159). The burden of DHF in Myanmar for the selected year 1990 was 91.3 DALYs per year per million population (range = 90.1-96.5). A comparison was made with China, India and other Asian countries based on information provided by a World Bank study.
Subject(s)
Cost of Illness , Severe Dengue/economics , Humans , Myanmar/epidemiology , Quality-Adjusted Life YearsABSTRACT
The economic burden of DHF patients and of the Thai government in providing treatment and prevention and control of dengue hemorrhagic fever were assessed. Patient burden was reported by caretakers who stayed with the patients when they were admitted to three hospitals: Children's Hospital in Bangkok; Suphan Buri Provincial Hospital and Don Chedi Community Hospital, Don Chedi District in Suphan Buri Province. The hospital costs--medicine and laboratory costs--were collected from the treatment forms and the routine service cost was estimated by the staff of the hospitals. Cost of prevention and control were compiled from the budget report of Departments of the Ministry of Public Health and the Ministry of Interior. Based on 184 DHF patients admitted at the three hospitals, the direct patient costs--treatment cost and the costs of travel, food and lodging--was 66.99 US$ and 61.02 US$ per patient for one episode of DHF in Bangkok and Suphan Buri, respectively. The total patient costs--direct patient costs and opportunity costs were 118.29 US$ for a child patient and 161.49 US$ for an adult patient in Bangkok, 102.82 US$ for a child patient and 138.02 US$ for an adult patient in Suphan Buri. The net hospital cost in providing treatment for each DHF patient was 54.6 US$ and 38.65 US$ in Bangkok and Suphan Buri, respectively. The total cost of prevention and control of DHF in Thailand from government agencies in 1994 was 4.8724 million US$. Based on these findings, the whole expenditure of Thailand for DHF in 1994, would be at least 12.596 million US$, of which 54.8% was from the government budget, the rest, 45.2%, was the expenses paid by 51,688 patients and their families. The study concluded that in recording the economic-loss of DHF both the expenditures of the government and also the patient costs--direct and indirect--should be taken into account.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Cost of Illness , Costs and Cost Analysis , Severe Dengue/economics , Female , Health Care Costs/statistics & numerical data , Health Promotion/economics , Hospital Costs/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , ThailandABSTRACT
A study on treatment seeking behavior of dengue hemorrhagic fever (DHF) patients was made from 184 clinically diagnosed patients in three hospitals: Children's Hospital, Bangkok; Suphan Buri Provincial Hospital, Suphan Buri Province and Don Chedi Community Hospital in the district of Don Chedi, Suphan Buri Province. The information was collected by interviewing the patients' caretakers while they were attending the patients in the hospitals, using a series of closed- and open-ended questions. Based on the first place of treatment, five patterns of treatment seeking behavior were identified, the most common one was using the clinic as the first step. Different patterns of treatment seeking behavior had the impact on the duration of illness, the number of steps in seeking treatment and the direct patient costs. The socio-demographic characteristics of the patient's caretaker that influenced the decision making to take treatment alternatives included the level of education, occupation, residential area and lay symptom assessment. In addition, economic factors: the capability to reimburse the cost of treatment, the family income and the financial sources, were also important for caretakers to take into consideration when making treatment choices.