Search

Background: Chronic lower limb ulcers (CLLU) have an important burden to the individual and the healthcare system Objective: To determinate the number and cost of consultation and hospitalization associated to CLLU in a public hospital in Tucumán, Argentina. Methods: Retrospective observational study. Cost estimation were calculated based on days of stay, treatments and laboratory tests in a inpatient population and the number of consultations, treatments and laboratory tests in a outpatient population. Results: In 2013 and 2014, the overall number of consultation with ICD-10 codes was 7224 and the number of inpatient was 359. The length of stay was 22.88 days. There was a mean of 0.41 surgeries per patient where 25% were amputations. The mean annual cost in a single public hospital was US$ 4053.65 per inpatient and US$ 3589.24 per outpatient. Conclusion: CLLU generate a great economic burden for the public Health System in Argentina. Therefore, there is a need of changing the way of registration of CLLU in hospitals, allowing the public Health System to become aware of the problem and generate the necessary policies to solve it., Las úlceras crónicas de miembros inferiores (UCMI) representan un gran problema para los pacientes y los sistemas de salud. Objetivo: Determinar el número y el costo de consultas e internaciones asociadas a las UCMI en un hospital público en Tucumán, Argentina. Métodos: Estudio retrospectivo observacional. La estimación del costo se calculó basada en los días de internación, número de consultas, tratamientos realizados y análisis de laboratorio. Resultados: En el periodo 2013-2014, se identificaron 7224 consultas y 359 internados con códigos CIE-10 relacionados a UCMI. La estancia media fue de 22.88 días. Se observó una media de 0.41 cirugías por pacientes, donde el 25% fueron amputaciones. El costo anual asociado al tratamiento de UCMI en pacientes internados fue US$ 4.053,65, mientras que en pacientes ambulatorios fue US$ 3.589,24. Conclusión: Las UCMI generan una gran carga económica para el Sistema de Salud público en Argentina. Por tanto, es necesario un cambio en la forma de registro de las UCMI en los hospitales, que permita al Sistema de Salud público tomar conciencia del problema y generar las políticas necesarias para resolverlo.

Background: Chronic lower limb ulcers (CLLU) have an important burden to the individual and the healthcare system Objective: To determinate the number and cost of consultation and hospitalization associated to CLLU in a public hospital in Tucumán, Argentina. Methods: Retrospective observational study. Cost estimation were calculated based on days of stay, treatments and laboratory tests in a inpatient population and the number of consultations, treatments and laboratory tests in a outpatient population. Results: In 2013 and 2014, the overall number of consultation with ICD-10 codes was 7224 and the number of inpatient was 359. The length of stay was 22.88 days. There was a mean of 0.41 surgeries per patient where 25% were amputations. The mean annual cost in a single public hospital was US$ 4053.65 per inpatient and US$ 3589.24 per outpatient. Conclusion: CLLU generate a great economic burden for the public Health System in Argentina. Therefore, there is a need of changing the way of registration of CLLU in hospitals, allowing the public Health System to become aware of the problem and generate the necessary policies to solve it., Las úlceras crónicas de miembros inferiores (UCMI) representan un gran problema para los pacientes y los sistemas de salud. Objetivo: Determinar el número y el costo de consultas e internaciones asociadas a las UCMI en un hospital público en Tucumán, Argentina. Métodos: Estudio retrospectivo observacional. La estimación del costo se calculó basada en los días de internación, número de consultas, tratamientos realizados y análisis de laboratorio. Resultados: En el periodo 2013-2014, se identificaron 7224 consultas y 359 internados con códigos CIE-10 relacionados a UCMI. La estancia media fue de 22.88 días. Se observó una media de 0.41 cirugías por pacientes, donde el 25% fueron amputaciones. El costo anual asociado al tratamiento de UCMI en pacientes internados fue US$ 4.053,65, mientras que en pacientes ambulatorios fue US$ 3.589,24. Conclusión: Las UCMI generan una gran carga económica para el Sistema de Salud público en Argentina. Por tanto, es necesario un cambio en la forma de registro de las UCMI en los hospitales, que permita al Sistema de Salud público tomar conciencia del problema y generar las políticas necesarias para resolverlo.

Background HAART has significantly reduced AIDS-related morbidity in children. However, limited evidence is available from developing countries regarding patterns of opportunistic illnesses. We describe these events and their associated factors in children with AIDS in Brazil. Methods This study is based on two representative retrospective multi-center cohorts including a total 1,859 children with AIDS, infected via mother-to-child transmission (MTCT), between 1983-2002. Opportunistic illnesses were described and analyzed over time. The association of demographic, clinical and operational data with the occurrence of opportunistic diseases was assessed. Results In total, 1,218 (65.5%) had at least one event of an opportunistic disease. Variables significantly associated with occurrence of these events included: region of residence (OR 2.68-11.33, as compared to the Northern region), age < 1 year at diagnosis (OR 2.56, 95% CI 1.81-3.61, p < 0.001), and non-performance of MTCT prevention measures (OR 1.58, 95% CI 1.21-2.07, p < 0.001). Protective factors included year of HIV diagnosis in the HAART era (OR 0.34, 95% CI 0.15-0.76, p = 0.009) and ART use (OR 0.58, 95% CI 0.44-0.77, p < 0.001). In both periods bacterial infections represented the most common opportunistic events (58.6 vs. 34.7%; p < 0.001), followed by Pneumocystis jirovecii pneumonia (21.9 vs. 13.2%; p < 0.001), and bacterial meningitis/sepsis (16.8 vs. 7.4%; p < 0.001). Conclusions Despite the significant reduction in recent years, opportunistic illnesses are still common in Brazilian children with AIDS in the HAART era, especially bacterial diseases. The data reinforce the need for scaling up prevention of MTCT, early diagnosis of infection, and improvement of comprehensive pediatric care.

Background HAART has significantly reduced AIDS-related morbidity in children. However, limited evidence is available from developing countries regarding patterns of opportunistic illnesses. We describe these events and their associated factors in children with AIDS in Brazil. Methods This study is based on two representative retrospective multi-center cohorts including a total 1,859 children with AIDS, infected via mother-to-child transmission (MTCT), between 1983-2002. Opportunistic illnesses were described and analyzed over time. The association of demographic, clinical and operational data with the occurrence of opportunistic diseases was assessed. Results In total, 1,218 (65.5%) had at least one event of an opportunistic disease. Variables significantly associated with occurrence of these events included: region of residence (OR 2.68-11.33, as compared to the Northern region), age < 1 year at diagnosis (OR 2.56, 95% CI 1.81-3.61, p < 0.001), and non-performance of MTCT prevention measures (OR 1.58, 95% CI 1.21-2.07, p < 0.001). Protective factors included year of HIV diagnosis in the HAART era (OR 0.34, 95% CI 0.15-0.76, p = 0.009) and ART use (OR 0.58, 95% CI 0.44-0.77, p < 0.001). In both periods bacterial infections represented the most common opportunistic events (58.6 vs. 34.7%; p < 0.001), followed by Pneumocystis jirovecii pneumonia (21.9 vs. 13.2%; p < 0.001), and bacterial meningitis/sepsis (16.8 vs. 7.4%; p < 0.001). Conclusions Despite the significant reduction in recent years, opportunistic illnesses are still common in Brazilian children with AIDS in the HAART era, especially bacterial diseases. The data reinforce the need for scaling up prevention of MTCT, early diagnosis of infection, and improvement of comprehensive pediatric care.