Análisis de costos de un modelo de atención integral (MAI) en clínica de heridas para lesiones por presión a partir de evidencia de la vida real en una IPS de atención domiciliaria en Bucaramanga

Abstract

RESUMEN: Introduction: Ulcers pressure increase in home care due to patients' functional dependency and prolonged immobilization. This, combined with multimorbidity and frailty, contributes to the development of these injuries. Furthermore, pressure injuries represent high costs for the health system, both direct and indirect, significantly affecting the economics of health care systems and the patient's quality of life. Objectives: Conduct an analysis of the costs associated with the implementation of a comprehensive home care model in a wound clinic focused on pressure injuries from the perspective of the health service provider in Bucaramanga and its metropolitan area. Methodology: A retrospective partial economic evaluation was carried out from the perspective of the service provider, for patients with pressure injuries treated between October 2022 and October 2023. Sociodemographic and clinical data, input and labor costs were analyzed, using micro-processing methodologies. and macro-costing. Results were presented by level of wound complexity, and a statistical and sensitivity analysis was performed by calculating the confidence interval of the median total cost by a resampling method.10 Results: During the period from October 2022 to October 2023, the IPS wound clinic program treated a total of 1,067 patients, distributed as 29% low complexity, 68% medium complexity, and 3% high complexity. Significant differences were identified in age between groups, but not in the distribution by municipalities or in care regimes. Strong positive correlations were found between the total cost of the intervention and the cost of the dermal product, while no significant association was observed between wound assessment scale scores and estimated costs for care. The distribution of total costs showed variability between groups, with bimodal patterns in medium complexity and unimodal patterns in low complexity, and the confidence intervals for the median costs were wider for the high complexity group and more precise for medium and low complexity. complexity, with variations of less than $ 100.000 COP. Conclusions: The treatment of wounds and ostomies is complex and expensive, especially in the home setting, requiring efficient cost management to ensure the viability of the health system.

ABSTRACT: Introduction: Ulcers pressure increase in home care due to patients' functional dependency and prolonged immobilization. This, combined with multimorbidity and frailty, contributes to the development of these injuries. Furthermore, pressure injuries represent high costs for the health system, both direct and indirect, significantly affecting the economics of health care systems and the patient's quality of life. Objectives: Conduct an analysis of the costs associated with the implementation of a comprehensive home care model in a wound clinic focused on pressure injuries from the perspective of the health service provider in Bucaramanga and its metropolitan area. Methodology: A retrospective partial economic evaluation was carried out from the perspective of the service provider, for patients with pressure injuries treated between October 2022 and October 2023. Sociodemographic and clinical data, input and labor costs were analyzed, using micro-processing methodologies. and macro-costing. Results were presented by level of wound complexity, and a statistical and sensitivity analysis was performed by calculating the confidence interval of the median total cost by a resampling method.10 Results: During the period from October 2022 to October 2023, the IPS wound clinic program treated a total of 1,067 patients, distributed as 29% low complexity, 68% medium complexity, and 3% high complexity. Significant differences were identified in age between groups, but not in the distribution by municipalities or in care regimes. Strong positive correlations were found between the total cost of the intervention and the cost of the dermal product, while no significant association was observed between wound assessment scale scores and estimated costs for care. The distribution of total costs showed variability between groups, with bimodal patterns in medium complexity and unimodal patterns in low complexity, and the confidence intervals for the median costs were wider for the high complexity group and more precise for medium and low complexity. complexity, with variations of less than $ 100.000 COP. Conclusions: The treatment of wounds and ostomies is complex and expensive, especially in the home setting, requiring efficient cost management to ensure the viability of the health system.