Cost-effectiveness of improving pediatric hospital care in Nicaragua Costo-eficacia de la mejora de la atención hospitalaria pediátrica en Nicaragua
OBJECTIVE: To determine the costs and cost-effectiveness of an intervention to improve quality of care for children with diarrhea or pneumonia in 14 hospitals in Nicaragua, based on expenditure data and impact measures. METHODS: Hospital length of stay (LOS) and deaths were abstracted from a random...
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Pan American Health Organization
2011
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ftdoajarticles:oai:doaj.org/article:ed0392016de64aab8aff8f254e22bbd6 2023-05-15T15:19:02+02:00 Cost-effectiveness of improving pediatric hospital care in Nicaragua Costo-eficacia de la mejora de la atención hospitalaria pediátrica en Nicaragua Edward I Broughton Ivonne Gomez Oscar Nuñez Yudy Wong 2011-11-01T00:00:00Z https://doaj.org/article/ed0392016de64aab8aff8f254e22bbd6 EN ES PT eng spa por Pan American Health Organization http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892011001100008 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 https://doaj.org/article/ed0392016de64aab8aff8f254e22bbd6 Revista Panamericana de Salud Pública, Vol 30, Iss 5, Pp 453-460 (2011) Costos de hospital hospitales pediátricos nálisis costo-beneficio diarrea neumonía prestación de atención de salud Nicaragua Hospital costs hospitals pediatric cost-benefit analysis diarrhea pneumonia delivery of health care Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2011 ftdoajarticles 2022-12-31T08:28:33Z OBJECTIVE: To determine the costs and cost-effectiveness of an intervention to improve quality of care for children with diarrhea or pneumonia in 14 hospitals in Nicaragua, based on expenditure data and impact measures. METHODS: Hospital length of stay (LOS) and deaths were abstracted from a random sample of 1294 clinical records completed at seven of the 14 participating hospitals before the intervention (2003) and 1505 records completed after two years of intervention implementation ("post-intervention"; 2006). Disability-adjusted life years (DALYs) were derived from outcome data. Hospitalization costs were calculated based on hospital and Ministry of Health records and private sector data. Intervention costs came from project accounting records. Decision-tree analysis was used to calculate incremental cost-effectiveness. RESULTS: Average LOS decreased from 3.87 and 4.23 days pre-intervention to 3.55 and 3.94 days post-intervention for diarrhea (P = 0.078) and pneumonia (P = 0.055), respectively. Case fatalities decreased from 45/10 000 and 34/10 000 pre-intervention to 30/10 000 and 27/10 000 post-intervention for diarrhea (P = 0.062) and pneumonia (P = 0.37), respectively. Average total hospitalization and antibiotic costs for both diagnoses were US$ 451 (95% credibility interval [CI]: US$ 419-US$ 482) pre-intervention and US$ 437 (95% CI: US$ 402-US$ 464) post-intervention. The intervention was cost-saving in terms of DALYs (95% CI: -US$ 522- US$ 32 per DALY averted) and cost US$ 21 per hospital day averted (95% CI: -US$ 45- US$ 204). CONCLUSIONS: After two years of intervention implementation, LOS and deaths for diarrhea decreased, along with LOS for pneumonia, with no increase in hospitalization costs. If these changes were entirely attributable to the intervention, it would be cost-saving. OBJETIVO: Determinar el costo y la eficacia en función del costo de una intervención para mejorar la calidad de la atención de niños con diarrea o neumonía en 14 hospitales de Nicaragua, sobre la base de la información ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Daly ENVELOPE(63.761,63.761,-67.513,-67.513) |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English Spanish Portuguese |
topic |
Costos de hospital hospitales pediátricos nálisis costo-beneficio diarrea neumonía prestación de atención de salud Nicaragua Hospital costs hospitals pediatric cost-benefit analysis diarrhea pneumonia delivery of health care Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Costos de hospital hospitales pediátricos nálisis costo-beneficio diarrea neumonía prestación de atención de salud Nicaragua Hospital costs hospitals pediatric cost-benefit analysis diarrhea pneumonia delivery of health care Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Edward I Broughton Ivonne Gomez Oscar Nuñez Yudy Wong Cost-effectiveness of improving pediatric hospital care in Nicaragua Costo-eficacia de la mejora de la atención hospitalaria pediátrica en Nicaragua |
topic_facet |
Costos de hospital hospitales pediátricos nálisis costo-beneficio diarrea neumonía prestación de atención de salud Nicaragua Hospital costs hospitals pediatric cost-benefit analysis diarrhea pneumonia delivery of health care Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
OBJECTIVE: To determine the costs and cost-effectiveness of an intervention to improve quality of care for children with diarrhea or pneumonia in 14 hospitals in Nicaragua, based on expenditure data and impact measures. METHODS: Hospital length of stay (LOS) and deaths were abstracted from a random sample of 1294 clinical records completed at seven of the 14 participating hospitals before the intervention (2003) and 1505 records completed after two years of intervention implementation ("post-intervention"; 2006). Disability-adjusted life years (DALYs) were derived from outcome data. Hospitalization costs were calculated based on hospital and Ministry of Health records and private sector data. Intervention costs came from project accounting records. Decision-tree analysis was used to calculate incremental cost-effectiveness. RESULTS: Average LOS decreased from 3.87 and 4.23 days pre-intervention to 3.55 and 3.94 days post-intervention for diarrhea (P = 0.078) and pneumonia (P = 0.055), respectively. Case fatalities decreased from 45/10 000 and 34/10 000 pre-intervention to 30/10 000 and 27/10 000 post-intervention for diarrhea (P = 0.062) and pneumonia (P = 0.37), respectively. Average total hospitalization and antibiotic costs for both diagnoses were US$ 451 (95% credibility interval [CI]: US$ 419-US$ 482) pre-intervention and US$ 437 (95% CI: US$ 402-US$ 464) post-intervention. The intervention was cost-saving in terms of DALYs (95% CI: -US$ 522- US$ 32 per DALY averted) and cost US$ 21 per hospital day averted (95% CI: -US$ 45- US$ 204). CONCLUSIONS: After two years of intervention implementation, LOS and deaths for diarrhea decreased, along with LOS for pneumonia, with no increase in hospitalization costs. If these changes were entirely attributable to the intervention, it would be cost-saving. OBJETIVO: Determinar el costo y la eficacia en función del costo de una intervención para mejorar la calidad de la atención de niños con diarrea o neumonía en 14 hospitales de Nicaragua, sobre la base de la información ... |
format |
Article in Journal/Newspaper |
author |
Edward I Broughton Ivonne Gomez Oscar Nuñez Yudy Wong |
author_facet |
Edward I Broughton Ivonne Gomez Oscar Nuñez Yudy Wong |
author_sort |
Edward I Broughton |
title |
Cost-effectiveness of improving pediatric hospital care in Nicaragua Costo-eficacia de la mejora de la atención hospitalaria pediátrica en Nicaragua |
title_short |
Cost-effectiveness of improving pediatric hospital care in Nicaragua Costo-eficacia de la mejora de la atención hospitalaria pediátrica en Nicaragua |
title_full |
Cost-effectiveness of improving pediatric hospital care in Nicaragua Costo-eficacia de la mejora de la atención hospitalaria pediátrica en Nicaragua |
title_fullStr |
Cost-effectiveness of improving pediatric hospital care in Nicaragua Costo-eficacia de la mejora de la atención hospitalaria pediátrica en Nicaragua |
title_full_unstemmed |
Cost-effectiveness of improving pediatric hospital care in Nicaragua Costo-eficacia de la mejora de la atención hospitalaria pediátrica en Nicaragua |
title_sort |
cost-effectiveness of improving pediatric hospital care in nicaragua costo-eficacia de la mejora de la atención hospitalaria pediátrica en nicaragua |
publisher |
Pan American Health Organization |
publishDate |
2011 |
url |
https://doaj.org/article/ed0392016de64aab8aff8f254e22bbd6 |
long_lat |
ENVELOPE(63.761,63.761,-67.513,-67.513) |
geographic |
Arctic Daly |
geographic_facet |
Arctic Daly |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista Panamericana de Salud Pública, Vol 30, Iss 5, Pp 453-460 (2011) |
op_relation |
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892011001100008 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 https://doaj.org/article/ed0392016de64aab8aff8f254e22bbd6 |
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1766349219031941120 |