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dc.contributor.authorRodríguez-Martínez, Carlos E.
dc.contributor.authorSossa Briceño, Mónica P
dc.date.accessioned2020-05-14T19:33:59Z
dc.date.available2020-05-14T19:33:59Z
dc.identifier.issn1680-5348spa
dc.identifier.urihttp://hdl.handle.net/20.500.12495/2788
dc.descriptionObjetivo. Estimar el costo-efectividad de no realizar radiografía de tórax a ningún lactante con sospecha clínica de bronquiolitis viral versus realizarla en todos estos pacientes de manera rutinaria, que es la práctica más utilizada hoy en Colombia. Métodos. Se realizó un estudio de costo-efectividad en el que se compararon las estrategias consistentes en tomar radiografía a todos y no tomar radiografía de tórax a ningún lactante con sospecha clínica de bronquiolitis viral. El desenlace principal fue la proporción de diagnósticos correctos. El horizonte temporal fue la evolución de la bronquiolitis. La perspectiva fue la del tercer pagador y los costos se obtuvieron de las tarifas vigentes en una clínica en la ciudad de Bogotá. Se realizaron análisis de sensibilidad determinísticos y probabilísticos. Resultados. La estrategia de no realizar radiografía de tórax a ningún paciente fue dominante en relación con realizarla en todos los casos de manera rutinaria, con un costo promedio de US$ 111,0 y una tasa de diagnósticos correctos de 0,8020, comparados con los valores correspondientes de US$ 129,0 y 0,7873 para la estrategia de tomar radiografía rutinaria a todos estos pacientes. La variable más influyente fue el costo hospitalario de la neumonía. En el análisis de sensibilidad probabilístico, la estrategia de no radiografiar a ningún lactante fue dominante en 61,1% de las simulaciones. Conclusiones. Los resultados sugieren que no realizar radiografía de tórax de rutina a lactantes con sospecha clínica de bronquiolitis viral es una estrategia costo-efectiva respecto a la práctica común de realizarla en todos estos casos, dado que arroja una mayor proporción de diagnósticos correctos a un menor costo promedio por paciente. No obstante, harán falta nuevos estudios con muestras más representativas de todos los establecimientos de salud e incluir la estrategia de tomar radiografía de tórax únicamente a pacientes que tengan predictores de anormalidades radiológicas.spa
dc.format.mimetypeapplication/pdfspa
dc.language.isospaspa
dc.publisherOrganización Panamericana de la Saludspa
dc.relation.ispartofseriesRevista Panamericana de Salud Publica, 1680-5348, Vol. 29, Nro. 3, 2011, p. 155-161spa
dc.relation.urihttp://iris.paho.org/xmlui/handle/123456789/9558spa
dc.subjectBronquiolitisspa
dc.subjectNeumoníaspa
dc.subjectRadiografíaspa
dc.titleCosto-efectividad de la radiografía de tórax en lactantes con sospecha clínica de bronquiolitis viral en Colombiaspa
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dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.publisher.journalRevista Panamericana de Salud Publicaspa
dc.title.translatedCost-effectiveness of chest x-rays in infants with clinically suspected viral bronchiolitis in Colombiaspa
dc.description.abstractenglishOBJECTIVE: Estimate the cost-effectiveness of not taking chest x-rays of any infant with clinically suspected viral bronchiolitis versus routinely taking them of all such patients, the most common practice today in Colombia. METHODS: A cost-effectiveness study was conducted, comparing strategies of taking chest x-rays of all infants with clinically suspected viral bronchiolitis and not x-raying any of these infants. The principal outcome was the proportion of correct diagnoses. The time horizon was the clinical course of the bronchiolitis. The perspective was that of the third-party payer, and the costs were obtained from the rates in effect in a clinic in Bogotá. Deterministic and probabilistic sensitivity analyses were performed. RESULTS: The strategy of not taking a chest x-ray of any patient prevailed over that of routinely taking one in all cases, with an average cost of US$ 111.00 and a correct diagnosis rate of 0.8020, versus the respective values of US$ 129.00 and 0.7873 for the strategy of routinely x-raying all of these patients. The most influential variable was pneumonia-related hospital costs. In the probabilistic sensitivity analysis, the strategy of not x-raying any infant prevailed in 61.1 percent of the simulations. CONCLUSIONS: The results suggest that not taking routine chest x-rays of infants with clinically suspected viral bronchiolitis is a cost-effective strategy compared with the common practice of taking them in all cases, since the former yields a greater proportion of correct diagnoses at a lower average cost per patient. Nevertheless, new studies will be needed that have more representative samples from all of the health facilities and include the strategy of taking chest x-rays only of patients with predictors of radiologic abnormalities.(AU)spa
dc.rights.localAcceso cerradospa
dc.date.issued2011


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