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Neumonía de la comunidad en niños: impacto sanitario y costos del tratamiento en el primer nivel de atención público de la Argentina / Health impact and treatment costs of community-acquired pneumoniai in children in the first level of public attention in Argentina
Berneztein, Ricardo; Drake, Ignacio.
  • Berneztein, Ricardo; Hospital Nacional de Pediatría "Prof. Dr.Juan P. Garrahan". Buenos Aires. AR
  • Drake, Ignacio; Ministerio de Salud. Programa Remediar. AR
Arch. argent. pediatr ; 107(2): 101-110, abr. 2009. tab, graf
Article in Spanish | LILACS | ID: lil-516041
RESUMEN
La neumonía de la comunidad infantil causa muertes evitables con atención médica y antibióticos. La Argentina sufrió desde 2001 una grave crisis queprobablemente aumentó el riesgo de mortalidad. Objetivos. Evaluar el impacto sanitario y los costos de la provisión gratuita de medicamentos en el primer nivel de atención público para la neumonía infantil. Métodos. Diseños 1. Estudio ecológico cruce de diagnósticos, prescripciones, beneficiarios, por provincia, de las recetas del Programa Remediar. Población

objetivo:

menores de 15 años atendidos en 6.000 centros de salud de la Argentina, desde marzo de 2005 hasta febrero de 2006. 2. Evaluación ex post sobre un enfoque contrafáctico. 3. Cálculo de costos de medicamentos por resultado. Resultados. En 15 millones de recetas se identificaron 2.420 niños menores de 1 año, 19.205 de 1-4 añosy 15.977 de 5-14 años con neumonía. Un 90% recibió antibióticos, frecuentemente amoxicilina. La cobertura de Remediar, 27,8% en menores de 5 años, fue mayor en provincias más pobres. Probable impacto 4.322 vidas salvadas o 310.325 años de vida perdidos evitados si la mortalidad sin antibióticos fuerade 20%. Los hogares indigentes ahorraron por los medicamentos el 14,3% de sus ingresos. Cada vida salvada pudo haber costado, US$ 6,46 y cada año de vida perdido evitado, 0,09 US$. Conclusiones. Se destaca el impacto de un programa sanitario de bajo costo para el tratamiento de población vulnerable con neumonía infantil en la Argentina.
ABSTRACT
Community acquired pneumonia in children remains an important cause of childhood deaths throughout the world that can be prevented by the use of antibiotics and access to medical care. Both were reduced in 2001 when Argentina suffered a severe social crisis. Among the responses to the crisis, the Remediar Program provided free essential medicines to the socially vulnerable population. Objectives. Assess the health impact and costs ofthe provision of free medicines at the first level of public attention for childhood pneumonia. Materials and methods. Three designs 1. Ecologicalstudy with cross comparisons of diagnoses, prescriptions, beneficiaries by individual provinces of Remediar forms. Target population children under 15 years old attended at 6 thousand health centres in Argentina, encompassing 24 Argentine provinces from March 2005 until February 2006. 2. Counterfactual approach. 3. Calculation of drug costs per unit ofoutcome. Results. Over 15 million prescriptions were identified, 2,420 children under 1 year, 19,205 of 1 to 4years and 15,977 from 5 to 14 years old with pneumonia. 90% of beneficiaries received antibiotics, most often amoxicillin. In children’s under 5 years of age, Remediar coverage was 27.8%, with greater impact in the poorest provinces. The likely impactwas 4,322 lives saved or 310,325 years of life lost avoided if mortality without antibiotics was 20%. Indigents who had children with pneumonia savedby medicines 14.3% of their income. Each life saved could have cost US$ 6.46 and each year of life lost averted US$ 0.09. Conclusion. This work highlights the impact of a low-cost health program for the treatment of vulnerable populations with childhood pneumonia in Argentina.
Subject(s)
Full text: Available Index: LILACS (Americas) Main subject: Pneumonia / Primary Health Care / Public Assistance / Cost of Illness / Drugs, Essential Type of study: Evaluation studies / Health economic evaluation Limits: Adolescent / Child / Child, preschool / Infant Country/Region as subject: South America / Argentina Language: Spanish Journal: Arch. argent. pediatr Journal subject: Pediatrics Year: 2009 Type: Article Affiliation country: Argentina Institution/Affiliation country: Hospital Nacional de Pediatría "Prof. Dr.Juan P. Garrahan"/AR / Ministerio de Salud/AR

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Full text: Available Index: LILACS (Americas) Main subject: Pneumonia / Primary Health Care / Public Assistance / Cost of Illness / Drugs, Essential Type of study: Evaluation studies / Health economic evaluation Limits: Adolescent / Child / Child, preschool / Infant Country/Region as subject: South America / Argentina Language: Spanish Journal: Arch. argent. pediatr Journal subject: Pediatrics Year: 2009 Type: Article Affiliation country: Argentina Institution/Affiliation country: Hospital Nacional de Pediatría "Prof. Dr.Juan P. Garrahan"/AR / Ministerio de Salud/AR