Cost-opportunity analysis of the use of fecal screening test in acute diarrhea in children under 5 years old

Objective : To analyze the use of routine fecal screening test in children under 5 years old, with acute diarrheal dis­ease in a primary care level hospital in Bogotá and evaluate how best the resources used in this intervention can be allocated to an alternative one, that produces greater benefit ....

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Autores Principales: López Barón, Eliana, Morales Jiménez, Juan Carlos, Rodríguez Morales, Fabio
Formato: Artículo (Article)
Lenguaje:Español (Spanish)
Publicado: Universidad Militar Nueva Granada 2016
Materias:
Acceso en línea:http://hdl.handle.net/10654/34487
id ir-10654-34487
recordtype dspace
institution Universidad Militar Nueva Granada
collection DSpace
language Español (Spanish)
topic Diarrhea
fecal test
stool analysis
Diarrea
leucocitos fecales
coproscópico
Diarrea
exame fecal
análise de fezes
spellingShingle Diarrhea
fecal test
stool analysis
Diarrea
leucocitos fecales
coproscópico
Diarrea
exame fecal
análise de fezes
López Barón, Eliana
Morales Jiménez, Juan Carlos
Rodríguez Morales, Fabio
Cost-opportunity analysis of the use of fecal screening test in acute diarrhea in children under 5 years old
description Objective : To analyze the use of routine fecal screening test in children under 5 years old, with acute diarrheal dis­ease in a primary care level hospital in Bogotá and evaluate how best the resources used in this intervention can be allocated to an alternative one, that produces greater benefit .Methods: Review of the literature on acute diarrhea and utility of fecal screening test. Data collection of diarrhea consultations in children under 5 years old and fecal screening test done between October 2011 and February 2012 in a Bogota´s Hospital. Selecting those one, which diagnoses enteroinvasive diarrhea and costing of routine use, and estimated opportunity-cost in programs to reduce morbi-mortality in children under 5 years old.Results: The main etiology of diarrhea is viral. More than 5 WBCs / field has adequate sensitivity and specificity, but the clinical assessment is better on detection of enteroinvasive disease. Fecal screening test was requested in 44.8 %; 14.6 % was suggested enteroinvasive disease. The resources used in 30.2 % of patients did not require the test match to US$2.633.Conclusions: The utility of Fecal screening test is low and does not imprve the pretest probability of enteroinvasive diarrhea. Is necessary to address the cost-opportunity analysis for the proper distribution of resources in intervetions that reduce the morbi-mortality.
format Artículo (Article)
author López Barón, Eliana
Morales Jiménez, Juan Carlos
Rodríguez Morales, Fabio
author_facet López Barón, Eliana
Morales Jiménez, Juan Carlos
Rodríguez Morales, Fabio
author_sort López Barón, Eliana
title Cost-opportunity analysis of the use of fecal screening test in acute diarrhea in children under 5 years old
title_short Cost-opportunity analysis of the use of fecal screening test in acute diarrhea in children under 5 years old
title_full Cost-opportunity analysis of the use of fecal screening test in acute diarrhea in children under 5 years old
title_fullStr Cost-opportunity analysis of the use of fecal screening test in acute diarrhea in children under 5 years old
title_full_unstemmed Cost-opportunity analysis of the use of fecal screening test in acute diarrhea in children under 5 years old
title_sort cost-opportunity analysis of the use of fecal screening test in acute diarrhea in children under 5 years old
publisher Universidad Militar Nueva Granada
publishDate 2016
url http://hdl.handle.net/10654/34487
_version_ 1712101817407504384
spelling ir-10654-344872020-01-08T19:36:24Z Cost-opportunity analysis of the use of fecal screening test in acute diarrhea in children under 5 years old Análisis de costo oportunidad del uso de coproscópico en diarrea aguda en menores de 5 años. Análise custo-oportunidade do uso do teste de verificação fecal na diarreia aguda em crianças menores de 5 anos López Barón, Eliana Morales Jiménez, Juan Carlos Rodríguez Morales, Fabio Diarrhea fecal test stool analysis Diarrea leucocitos fecales coproscópico Diarrea exame fecal análise de fezes Objective : To analyze the use of routine fecal screening test in children under 5 years old, with acute diarrheal dis­ease in a primary care level hospital in Bogotá and evaluate how best the resources used in this intervention can be allocated to an alternative one, that produces greater benefit .Methods: Review of the literature on acute diarrhea and utility of fecal screening test. Data collection of diarrhea consultations in children under 5 years old and fecal screening test done between October 2011 and February 2012 in a Bogota´s Hospital. Selecting those one, which diagnoses enteroinvasive diarrhea and costing of routine use, and estimated opportunity-cost in programs to reduce morbi-mortality in children under 5 years old.Results: The main etiology of diarrhea is viral. More than 5 WBCs / field has adequate sensitivity and specificity, but the clinical assessment is better on detection of enteroinvasive disease. Fecal screening test was requested in 44.8 %; 14.6 % was suggested enteroinvasive disease. The resources used in 30.2 % of patients did not require the test match to US$2.633.Conclusions: The utility of Fecal screening test is low and does not imprve the pretest probability of enteroinvasive diarrhea. Is necessary to address the cost-opportunity analysis for the proper distribution of resources in intervetions that reduce the morbi-mortality. Objetivo: Analizar el uso de coproscópico de rutina menores de 5 años con diarrea aguda, en hospital de primer nivel de Bogotá y evaluar la mejor forma de asignar los recursos usados en esta intervención a una alternativa que produzca  mayor beneficio. Métodos: Revisión de la literatura en diarrea aguda y utilidad del coproscópico. Recopilación de datos de consultas por diarrea en niños de 0-5 años y coproscópicos realizados entre octubre de 2011 y febrero de 2012 en Hospital de Bogotá, con selección de aquellos sugestivos de enfermedad enteroinvasiva, cálculo del costo de su uso y estimación  del costo-oportunidad en  realización de programas que reduzcan la morbimortalidad en menores de 5 años.Resultados: La principal etiología de la enfermedad diarreica es viral. Más de 5 leucos/campo tiene una sensibilidad y especificidad adecuada que no supera la valoración clínica.  Se solicitó coproscópico en 44.8%;  el 14.6% sugerían enfermedad enteroinvasiva. El 30.2% de los pacientes no requerían coproscópico y su costo corresponde a $5.266.400.Conclusiones: La utilidad del coproscópico es baja y no mejora  la probabilidad pretest de diarrea enteroinvasiva, es necesario abordar la el análisis de costo-oportunidad para la distribución correcta de los recursos en intervenciones que reduzcan la morbimortalidad. Objetivo: Analisar o uso do teste rotineiro de triagem fecal em crianças menores de 5 anos com doença diarréica aguda em um hospital de atenção primária em Bogotá e avaliar a melhor forma de alocação dos recursos utilizados nessa intervenção para uma alternativa que produza maior benefício.Métodos: Revisão da literatura sobre diarréia aguda e utilidade do teste de triagem fecal. Coleta de dados de consul­tas de diarréia em crianças menores de 5 anos e teste de triagem fecal realizado entre outubro de 2011 e fevereiro de 2012 em um hospital de Bogotá. Selecionar aquelas que diagnosticam diarréia entero-invasiva e custo de uso rotineiro e custo de oportunidade estimado em programas para reduzir a morbi-mortalidade em crianças menores de 5 anos.Resultados: A principal etiologia da diarréia é viral. Mais de 5 WBCs / campo tem sensibilidade e especificidade adequadas, mas a avaliação clínica é melhor na detecção de doença enteroinvasiva. O teste de triagem fecal foi so­licitado em 44,8%; 14,6% foi sugerida doença enteroinvasiva. Os recursos utilizados em 30,2% dos pacientes não necessitaram do teste correspondente a US $ 2,633.Conclusões: A utilidade do teste de triagem Fecal é baixa e não melhora a probabilidade pré-teste de diarréia en­teroinvasiva. 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