Evaluación económica y sostenibilidad financiera del Modelo de Atención Primaria en Salud (APS) en la localidad de Suba de Bogotá - Colombia.

Objective: To perform the economic evaluation and analyze the financial sustainability of the primary health care model (APS) of the Suba Hospital II Level - State Social Company (ESE). Methodology: This is a cost effective analysis in which the effectiveness units were life years gained by reduction in maternal and infant mortality caused by acute diarrheic disease. Cost units were expressed in monetary units, and the threshold level of cost effectiveness was the Gross Domestic Income (PIB) per capita. Epidemiologic data was used from the Suba locality (2002-2003, 2005-2006); from the Ciudad Bolivar locality (2005-2006); and from Bogota (2005-2006). The sustainability analysis was also performed from the qualitative behavior expected from the income and costs result of the implementation of the APS and considering accounting data from 2004 to 2006. Results: The annual cost effective increment was $6'473,091 pesos for 2006. The implementation of the model in the Suba locality was cost effective. The model generated 412.8 years of life gained for the locality. The implementation of the APS eventually decreases some of the costs and income at the same time. It does not generate losses, but it does decrease billing. Conclusions: The implementation of the APS generates benefits for society, which nonetheless, are not susceptible to being translated into monetary income for the hospital. This can generate contradictory incentives in the actual system, which incentives and principles lean more to the treatment of disease, instead of achieving health results [ABSTRACT FROM AUTHOR]