ABSTRACT
OBJECTIVES: Type 2 diabetes mellitus (T2DM) represents an increasing public health problem in Peru. This study aims to estimate the national economic burden of this disease for the public funder, the social security, and private sector insurers. METHODS: Direct healthcare costs were estimated for a cohort of 45-to-75-year-old adults diagnosed with T2DM in 2019, over a 20-year period. Disease progression was modeled using PROSIT Models and literature, including acute and chronic microvascular and macrovascular complications. Three scenarios of glycemic control were considered: current levels of 35.8% of the population controlled (HbA1c < 7%) (S1); 100% controlled (S2) and; 100% uncontrolled (S3). The impact of diabetes prevalence on overall costs was evaluated in sensitivity analysis. RESULTS: Total national economic burden was estimated at $15,405,448,731; an annual average per patient of $2,158. Total costs would decrease to $12,853,113,596 (-16.6%) in S2 and increase to $16,828,713,495 (+9.2%) in S3. Treating patients with complications and risk factors could cost 6.5 times more, being stroke the complication with the highest impact. Up to a 67.6% increase in total costs was found when increasing T2DM prevalence. CONCLUSIONS: T2DM places a heavy burden on the Peruvian healthcare budget that will be even greater if poor glycemic control is maintained.
Subject(s)
Cost of Illness , Diabetes Mellitus, Type 2 , Glycemic Control , Health Care Costs , Humans , Diabetes Mellitus, Type 2/economics , Peru , Middle Aged , Health Care Costs/statistics & numerical data , Aged , Female , Male , Glycemic Control/economics , Disease Progression , Prevalence , Cohort Studies , Glycated Hemoglobin/metabolism , Risk Factors , Diabetes Complications/economics , Diabetes Complications/epidemiologyABSTRACT
Se analiza prospectivamente el manejo de 21 pacientes portadores de una supuración pancreática secundaria a pancreatitis aguda necrohemorrágica grave, con drenaje retroperitoneal abierto (pancreatostomía). La cirugía incluyó procedimientos sobre la vía biliar, ostomías digestivas y el mencionado drenaje. Las complicaciones más frecuentes fueron las fístulas intestinales (23,8%), las lesiones isquémicas de intestino (19%) y los abscesos residuales (14,2%). La mortalidad fue del 9,5%, lo que representa un descenso importante en relación a series nacionales y extranjeras
