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Desenlaces económicos sobre fragmentación en la atención de pacientes con cáncer de mama y estómago en el régimen contributivo en Colombia
dc.rights.license | Atribución-NoComercial-SinDerivadas 4.0 Internacional |
dc.contributor.advisor | Sanchez Pedraza, Ricardo |
dc.contributor.advisor | Buitrago Gutierrez, Giancarlo |
dc.contributor.author | Rozo Agudelo, Nicolás |
dc.date.accessioned | 2022-08-09T17:01:30Z |
dc.date.available | 2022-08-09T17:01:30Z |
dc.date.issued | 2022 |
dc.identifier.uri | https://repositorio.unal.edu.co/handle/unal/81823 |
dc.description | ilustraciones, graficas, mapas |
dc.description.abstract | Introducción: El cáncer de mamá y estomago son patologías de alta incidencia y mortalidad en Colombia. Para su tratamiento se requiere de los tres pilares del tratamiento: cirugía oncológica, quimioterapia y radioterapia. La falta de integración de los tres pilares puede llevar a la fragmentación de la atención en salud, esta investigación mide el impacto sobre los costos totales de atención. Métodos: Se realizó un estudio retrospectivo de cohortes de sujetos incluidos entre los años 2013 y 2015 y un seguimiento de 3 años. Los sujetos fueron identificados mediante algoritmos basados en el registro de servicios y códigos CIE-10 relacionados con los tipos de cáncer en estudio. La exposición fue la fragmentación definida como el número de IPS diferentes durante el primer año de supervivencia que conformaron la red de atención de los pacientes. El desenlace fue la suma los costos de todos los servicios pagados desde la vista del tercer pagador y se deflactaron a pesos del año 2021. Se estimó el impacto de la fragmentación sobre los costos con modelos multivariados de regresión lineal utilizando intervalos de confianza del 95% a partir de errores estándar robustos. Resultados: Se ensambló una cohorte para cada enfermedad (cáncer de mama: 13106, cáncer de estómago: 2434). La mediana de costos en cáncer de mama es $1.601.333 COP y en cáncer de estómago $2.947.926 COP. Por cada incremento en un punto porcentual del número de IPS en el primer año de supervivencia los costos aumentaron significativamente 2.18% (IC 95% 2.09 – 2.24) en cáncer de mama y 1.97% (IC 95% 1.82 – 2.12) en cáncer de estómago. Conclusión: La fragmentación de la atención en pacientes con cáncer de mama y estomago se asocia significativamente con un aumento en los costos. Se requieren múltiples esfuerzos para alcanzar la integralidad en la atención del paciente con cáncer. (Texto tomado de la fuente) |
dc.description.abstract | Background: Breast and gastric cancer have high incidence and mortality in Colombia. Both types of cancer require three principal treatments: surgery, chemotherapy and radiotherapy. Lack of integration could lead to healthcare fragmentation, this investigation measures fragmentation impact on total cost. Methods: A retrospective cohort study included subjects from 2013 to 2015 and followed those patients for a period of 3 years. Subjects were identified by algorithms based on services and ICD – 10 codes related to the types of cancer. For measuring fragmentation, the count of providers during the first year of follow-up has been used. All cost was added and adjusted by inflation to 2021. Impact on cost were modeled with lineal robust regression. Results: Cohorts were assembled by cancer type (breast cancer: 13106, gastric cancer: 2434). Median follow up time was 3 years in both cohorts. The median cost in breast cancer was $1.601.333 and $2.947.926 in gastric cancer. The increase by one percentage point in the number of providers increases costs significantly 2.18% (CI 95% 2.09% – 2.24%) in breast cancer and 1.97% (CI 95% 1.82% – 2.12%) in gastric cancer. Conclusion: Healthcare fragmentation in breast and gastric cancer is associated with increase in total cost. Multiple efforts are required in order to reach healthcare integration in cancer care. |
dc.format.extent | 86 páginas |
dc.format.mimetype | application/pdf |
dc.language.iso | spa |
dc.publisher | Universidad Nacional de Colombia |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
dc.subject.ddc | 610 - Medicina y salud::614 - Medicina Forense; incidencia de lesiones, heridas, enfermedades; medicina preventiva pública |
dc.subject.other | Atención al Paciente |
dc.subject.other | Patient Care |
dc.subject.other | Costo de Enfermedad |
dc.subject.other | Cost of Illness |
dc.title | Desenlaces económicos sobre fragmentación en la atención de pacientes con cáncer de mama y estómago en el régimen contributivo en Colombia |
dc.type | Trabajo de grado - Maestría |
dc.type.driver | info:eu-repo/semantics/masterThesis |
dc.type.version | info:eu-repo/semantics/acceptedVersion |
dc.publisher.program | Bogotá - Medicina - Maestría en Epidemiología Clínica |
dc.description.degreelevel | Maestría |
dc.description.degreename | Magíster en Ciencias Epidemiología Clínica |
dc.description.researcharea | Atención en salud |
dc.identifier.instname | Universidad Nacional de Colombia |
dc.identifier.reponame | Repositorio Institucional Universidad Nacional de Colombia |
dc.identifier.repourl | https://repositorio.unal.edu.co/ |
dc.publisher.faculty | Facultad de Medicina |
dc.publisher.place | Bogotá, Colombia |
dc.publisher.branch | Universidad Nacional de Colombia - Sede Bogotá |
dc.relation.indexed | RedCol |
dc.relation.indexed | LaReferencia |
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dc.rights.accessrights | info:eu-repo/semantics/openAccess |
dc.subject.proposal | Neoplasias de la Mama |
dc.subject.proposal | Neoplasias gástricas |
dc.subject.proposal | Continuidad de la Atención al Paciente |
dc.subject.proposal | Breast cancer |
dc.subject.proposal | Stomach cancer |
dc.subject.proposal | Delivery of health Care |
dc.title.translated | Economic outcomes about healthcare fragmentation in breast and stomach cancer patients in contributive regimen, Colombia |
dc.type.coar | http://purl.org/coar/resource_type/c_bdcc |
dc.type.coarversion | http://purl.org/coar/version/c_ab4af688f83e57aa |
dc.type.content | Text |
dc.type.redcol | http://purl.org/redcol/resource_type/TM |
oaire.accessrights | http://purl.org/coar/access_right/c_abf2 |
oaire.awardtitle | Impacto de la fragmentación en la atención de pacientes con cáncer de mama y estomago en el régimen contributivo en Colombia |
oaire.fundername | MinCiencias |
dcterms.audience.professionaldevelopment | Investigadores |
dcterms.audience.professionaldevelopment | Padres y familias |
dcterms.audience.professionaldevelopment | Público general |
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