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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Universidad Militar Nueva Granada
2016
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Acceso en línea: | http://hdl.handle.net/10654/34487 |
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Universidad Militar Nueva Granada |
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Español (Spanish) |
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Diarrhea fecal test stool analysis Diarrea leucocitos fecales coproscópico Diarrea exame fecal análise de fezes |
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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 |
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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 |
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1712101817407504384 |
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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. É necessário abordar a análise custo-oportunidade para a distribuição adequada de recursos em intervenções que reduzam a morbi-mortalidade. 2016-12-05 2020-01-08T19:36:24Z 2020-01-08T19:36:24Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://revistas.unimilitar.edu.co/index.php/rmed/article/view/2642 10.18359/rmed.2642 http://hdl.handle.net/10654/34487 spa http://revistas.unimilitar.edu.co/index.php/rmed/article/view/2642/2462 /*ref*/Parashar D, Hummelman EG, Bresse JS, et al. Global illness and deaths caused by rotavirus disease in children. Emerging Infect Dis. 2003;9(5):565–72 https://doi.org/10.3201/eid0905.020562 /*ref*/Instituto Nacional de Salud. Informe Quincenal Epidemiológico Nacional 2003;8(20):321-36. /*ref*/Benguini Y, Bernal C, Figueroa D. Fisiología y etiología de las enfermedades diarreicas. En: Organización panamericana de la Salud. Manual de tratamiento de la diarrea en ni-os. 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B., López C., Céspedes J. Manejo de diarrea aguda de origen bacteriano: estudio de casos y controles. Rev.Medica.Sanitas 13 (3): 40-50, 2010 /*ref*/Murillo OA, Leal AL, Eslava JH. Uso de Antibióticos en Infección de Vías Urinarias en una Unidad de Primer Nivel de Atención en Salud, Bogotá, Colombia. Rev. salud pública [revista en la Internet]. 2006 Jul [citado 2012 Mayo 01]; 8(2): 170-181. Derechos de autor 2016 Revista Med https://creativecommons.org/licenses/by-nc-nd/4.0 application/pdf Universidad Militar Nueva Granada Revista Med; Vol. 24 Núm. 2 (2016); 66-73 1909-7700 0121-5256 |
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