Carga económica de la hipercolesterolemia en población con alto riesgo cardiovascular en México / Economic burden of hypercholesterolemia in high risk of cardiovascular disease population in Mexico

Resumen Objetivo: Se estimó la carga económica directa e indirecta de la hipercolesterolemia en población con alto riesgo de presentar un evento cardiovascular. Para ello se definieron específicamente cinco grupos de pacientes: 1) aquellos con hipercolesterolemia familiar; 2, 3 y 4) personas con hipercolesterolemia más el antecedente de diabetes, infarto o evento vascular cerebral; 5) pacientes con hipercolesterolemia más diabetes y antecedente de infarto agudo de miocardio (definidos como pacientes de muy alto riesgo cardiovascular). Los cálculos se hicieron desde la perspectiva de las instituciones de salud pública en México. Método: Para la estimación de los costos directos se incluyó la atención ambulatoria, el tratamiento farmacológico, la atención hospitalaria y las intervenciones quirúrgicas relacionadas con las enfermedades cardiovasculares. Para la carga económica indirecta, se consideraron las muertes reportadas específicamente por causa de hipercolesterolemia, en un momento anterior al final de la edad productiva (muerte prematura). Resultados: La carga económica directa de las cinco categorías de pacientes en riesgo consideradas es de MXN $39,601,464,154 (USD $1,987,526,432), mientras que la carga económica indirecta asciende a MXN $121,646,689 (USD $6,105,229). Conclusiones: El impacto económico de la hipercolesterolemia en población con alto riesgo cardiovascular correspondía a $39,723,110,843 en 2020 (equivalente a USD $1,993,631,661), equivalente al 0.16% del PIB nacional.

Abstract Objective: To estimate the direct and indirect economic burden of hypercholesterolemia in patients with high risk of a cardiovascular event, specifically there were defined 5 groups of patients: 1) familial hypercholesterolemia; 2, 3 and 4) patients with hypercholesterolemia and background of diabetes, myocardial infarction or stroke; 5) diabetes, myocardial infarction and hypercholesterolemia (very high-risk patients) from the Mexican public healthcare institutions. Methods: For the estimation of the direct costs the items included correspond to: outpatient care, pharmacological treatment, inpatient hospital care, and surgical procedures. For indirect economic burden, death certificates, before the end of the productive age due to hypercholesterolemia were calculated (premature mortality). Results: The direct economic burden for the 5 groups of patients at risk is MXN $39,601,464,154 (USD $1,987,526,432), while the indirect economic burden amounts to MXN $121,646,689 (USD $6,105,229). Conclusions: The economic impact of hypercholesterolemia in patients with high cardiovascular risk is $39,723,110,843 (equivalent to USD $1,993,631,661) and corresponds to the 0.16% of GDP.

Economic burden of hypercholesterolemia in high risk of cardiovascular disease population in Mexico.

OBJECTIVE: To estimate the direct and indirect economic burden of hypercholesterolemia in patients with high risk of a cardiovascular event, specifically there were defined 5 groups of patients: 1) familial hypercholesterolemia; 2, 3 and 4) patients with hypercholesterolemia and background of diabetes, myocardial infarction or stroke; 5) diabetes, myocardial infarction and hypercholesterolemia (very high-risk patients) from the Mexican public healthcare institutions. METHODS: For the estimation of the direct costs the items included correspond to: outpatient care, pharmacological treatment, inpatient hospital care, and surgical procedures. For indirect economic burden, death certificates, before the end of the productive age due to hypercholesterolemia were calculated (premature mortality). RESULTS: The direct economic burden for the 5 groups of patients at risk is MXN $39,601,464,154 (USD $1,987,526,432), while the indirect economic burden amounts to MXN $121,646,689 (USD $6,105,229). CONCLUSIONS: The economic impact of hypercholesterolemia in patients with high cardiovascular risk is $39,723,110,843 (equivalent to USD $1,993,631,661) and corresponds to the 0.16% of GDP.

OBJETIVO: Se estimó la carga económica directa e indirecta de la hipercolesterolemia en población con alto riesgo de presentar un evento cardiovascular. Para ello se definieron específicamente cinco grupos de pacientes: 1) aquellos con hipercolesterolemia familiar; 2, 3 y 4) personas con hipercolesterolemia más el antecedente de diabetes, infarto o evento vascular cerebral; 5) pacientes con hipercolesterolemia más diabetes y antecedente de infarto agudo de miocardio (definidos como pacientes de muy alto riesgo cardiovascular). Los cálculos se hicieron desde la perspectiva de las instituciones de salud pública en México. MÉTODO: Para la estimación de los costos directos se incluyó la atención ambulatoria, el tratamiento farmacológico, la atención hospitalaria y las intervenciones quirúrgicas relacionadas con las enfermedades cardiovasculares. Para la carga económica indirecta, se consideraron las muertes reportadas específicamente por causa de hipercolesterolemia, en un momento anterior al final de la edad productiva (muerte prematura). RESULTADOS: La carga económica directa de las cinco categorías de pacientes en riesgo consideradas es de MXN $39,601,464,154 (USD $1,987,526,432), mientras que la carga económica indirecta asciende a MXN $121,646,689 (USD $6,105,229). CONCLUSIONES: El impacto económico de la hipercolesterolemia en población con alto riesgo cardiovascular correspondía a $39,723,110,843 en 2020 (equivalente a USD $1,993,631,661), equivalente al 0.16% del PIB nacional.

Economic burden of liver disease in Colombia

Introduction: Liver diseases have a significant impact on global morbidity and mortality rates, primarily attributed to cirrhosis and hepatocellular carcinoma. However, the true extent of their impact on patients, healthcare systems, and countries is often underestimated. Materials and methods: This descriptive, cross-sectional study aimed to determine the economic burden associated with premature deaths caused by cirrhosis and primary liver cancer. The economic assessment was conducted by analyzing potentially productive years of life lost (PPYLL) due to liver diseases in Colombia between 2009 and 2016. Results and conclusions: The total burden of liver disease accounted for 687,861 disability-adjusted life years (DALYs). Men experienced a higher number of years of life lost from mortality (YLL), while women had a greater number of years lived with a disability (YLD). The economic burden of deaths caused by cirrhosis and primary liver cancer exceeded USD 8.6 million, highlighting the urgency to enhance intervention strategies ranging from promotion and prevention to timely diagnosis and treatment.

Introducción: la enfermedad hepática representa una de las principales causas de morbimortalidad a nivel mundial, principalmente por cirrosis y hepatocarcinoma; sin embargo, se subestima su impacto para el paciente, sistema de salud y el país. Materiales y métodos: estudio descriptivo de corte transversal que determinó la carga económica asociada a las muertes prematuras por cirrosis y tumores primarios del hígado, mediante la valoración económica de los años productivos de vida potencialmente perdidos (APVPP) en Colombia y de enfermedad hepática en Colombia entre 2009 y 2016. Resultados y conclusiones: la carga total de enfermedad hepática representó 687,861 años de vida saludable perdidos ajustados por discapacidad (AVAD), los hombres con mayores años de vida perdidos por muerte prematura (APMP) y las mujeres con mayores años vividos con discapacidad (AVD). Las muertes por cirrosis y tumores primarios del hígado representan una carga económica que supera los 8,6 millones de dólares, lo cual refleja la necesidad de fortalecer las estrategias de intervención desde la promoción y prevención hasta el diagnóstico y tratamiento oportuno.

The impact of patients with generalized anxiety disorder in the Brazilian Private Healthcare System: a claim database study with expert's perspective / O impacto de pacientes com transtorno de ansiedade generalizada no Sistema Único de Saúde: um estudo de base de sinistros com a perspectiva de especialistas

This study describes the healthcare resource use and costs associated with anxiety assessing claim database outcomes and expert opinion from the perspective of the Brazilian Private Healthcare System. A retrospective analysis of the Orizon database was conducted, containing claims data of anxiety patients reported in Private Healthcare Systems (2015-2017) according to the ICD-10 code (F40 or F41 and their subtypes). Further, a 3-hour online meeting brought together five anxiety and Health Insurance Companies experts to discuss their perspectives. The total cost of the 18,069 patients identified in the database was BRL 490 million: related to medical appointments (2%), exams (16%), emergency room (5%), and others (77%). The mean number of appointments was 5.1 in a 4-year period, performed by 61% of the patients. Approximately 2,595 visits were made to psychiatrists by 923 patients, and 95% underwent at least one examination (100.6 examinations per patient, on average). The identification of anxiety patients and their corresponding burden is challenging to estimate. The higher impact is related to the frequency of healthcare use before the diagnosis than the treatment itself. These outcomes may help plan and implement adequate healthcare programs for patients with anxiety.

Este estudo descreve o uso de recursos de saúde e os custos relacionados à ansiedade associando resultados de uma base de dados administrativa e opinião de especialistas na perspectiva do Sistema Privado de Saúde Brasileiro. Foi realizada uma análise retrospectiva da base de dados da Orizon de pacientes com ansiedade em atendimento hospitalizar ou ambulatorial no Sistema Privado de Saúde (2015 - 2017) com o código CID-10 (F40 ou F41 e os seus subtipos), adicionalmente promovemos uma reunião online de 3 horas com cinco especialistas em ansiedade e em seguros de saúde para discutir as suas perspectivas. O custo total dos 18.069 pacientes identificados no banco de dados foi de R$ 490 milhões, relacionados a consultas médicas (2%), exames (16%), pronto-socorro (5%) e outros (77%). A média de consultas foi de 5,1 em um período de 4 anos, realizadas por 61% dos pacientes. Aproximadamente 2.595 visitas foram feitas a psiquiatras por 923 pacientes, e 95% realizaram pelo menos um exame (média de 100,6 exames por paciente. É desafiador identificar e estimar o impacto da doença no Sistema Privado de Saúde Brasileiro. O impacto maior está relacionado à frequência de uso de serviços de saúde antes do diagnóstico, em comparação com o próprio tratamento. Esses resultados podem ajudar a planejar e implementar programas de saúde adequados para pacientes com ansiedade.

Carga económica de la degeneración macular neovascular y el edema macular diabético en Colombia / Economic burden of neovascular macular degeneration and diabetic macular edema in Colombia

Antecedentes: La pérdida de visión tiene consecuencias tanto en la salud como en la estabilidad económica, ya que promueve retrasos en el desarrollo emocional, social, además de reducciones en la productividad laboral. Objetivo: Estimar la carga económica de la degeneración macular asociada a la edad neovascular (DMAEn) y el edema macular diabético (EMD) en Colombia para el año 2022. Método: Para una perspectiva social se incluyeron costos directos utilizando la aproximación de Bottom-up y costos indirectos relacionados con la pérdida de productividad. Resultados: El costo directo de un paciente con DMAEn fue 5.974 USD$ desde una base teórica. A nivel nacional, la DMAEn costaría 179,9 millones USD$. Los costos indirectos de DMAEn se estimaron en 13,9 millones USD$. Los costos directos teóricos en EMD fueron 741,6 millones USD$. El costo nacional sería de 132,04 millones USD$. Para los costos indirectos de EMD, se estimó un costo de 93,3 millones USD$. Conclusiones: La DMAEn y el EMD tienen un alto impacto para el sistema de salud y la sociedad.

Background: The vision loss has consequences for both health and economic stability, since it promotes delays in emotional and social development, as well as reductions in labor productivity. Objective: To estimate the economic burden of age-related macular degeneration (AMD) and diabetic macular edema (DME) in Colombia for 2022. Method: For a social perspective, direct costs were included using the bottom-up approach, and indirect costs related to lost productivity. Results: The direct costs of treating a patient with AMD were USD $5,974 from a theoretical background. At national level, the AMD would cost USD $179.9 million. The AMD indirect cost in Colombia was estimated in USD $13.9 million. Patients theoretical direct cost of DME was USD $741.6 million. The cost at national level is USD $132.04 million. Regarding the indirect costs result for DME, a cost of USD $93.31 million was estimated. Conclusions: The AMD and the DME have a considerable impact on the health system and society.

Artritis reumatoide: carga económica y calidad de vida relacionada con la salud en Colombia y en el mundo: Revisión de alcance / Rheumatoid arthritis: its economic burden and health-related quality of life in Colombia and worldwide: A Scoping Review

Introducción: el aumento de las enfermedades crónicas es una de las mayores amenazas para la salud y la sostenibilidad de los sistemas de atención. Para ello, los ajustes del riesgo permiten desarrollar programas de clasificación de la población y se vuelven instrumentos para implementar nuevos modelos de atención, estructurados a partir de la morbilidad, clasificando el riesgo con el gasto asociado, y así desarrollar modelos predictivos y análisis del gasto per cápita según las características de la población, con lo cual se logra una mejor gestión financiera. Como atención primaria, la gestión del riesgo debe anticiparse a las enfermedades para diagnosticarlas de manera precoz y brindar tratamientos oportunos orientados a disminuir la severidad y secuelas. Algunas ocasionan grandes costos para el sistema de salud afectando su equilibrio y sostenibilidad, como la artritis reumatoide (AR), considerada de alto costo por su impacto y la asociación con otras comorbilidades. Objetivo: revisar los estudios realizados sobre carga económica (CE), carga de enfermedad (CE1), gastos de bolsillo, gastos catastróficos en salud (GCS) y calidad de vida relacionada con la salud (CVRS), en pacientes con AR en Colombia y en el mundo entre 2010 y 2022. Métodos: revisión de alcance de 482 artículos, 139 de CE y CE1, 14 de gastos de bolsillo y GCS, y 329 para CVRS, en literatura indexada utilizando las bases Scopus, Medline a través de Pubmed y JSTOR en inglés y español. Resultados: se observó tendencia en el crecimiento de la literatura, pero con predominio de reportes asociados con terapias biológicas tanto en CE y CE1 como CVRS, seguidos de estudios de atención médica y revisiones sistemáticas de literatura (RSL). Estados Unidos lidera las investigaciones seguido del Reino Unido; el cuestionario predominante para evaluar la calidad de vida relacionada con la salud fue el SF-36 (41,9%) seguido del EQ- 5D (19%) y aunque se cuenta con el Qol­RA (Quality of Life in Rheumatoid Arthritis Scale) validado en Colombia, su uso infrecuente. Conclusiones: el aumento de estudios sobre costos en salud ha tomado gran relevancia para comprender la realidad e instruir sobre aspectos de gestión del riesgo, enseñar conceptos, analizar escenarios de impacto y estudio de sensibilidades, mostrando todos los posibles resultados.

de Medicina y CirugíaREPERT MED CIR. 2023;32(3):197-207198ABSTRACTIntroduction: the rise in chronic diseases is one of the major threats to health and sustainability of care systems. To this end, risk adjustments allow the development of population classication programs which become instruments to implement care models based on morbidity, risk classication and cost, and for developing predictive models and analyzing per capita costs based on population characteristics, leading to achieve a better nancial management. As part of primary care, risk management should anticipate diseases for their early diagnosis and timely treatment, aimed at reducing their severity and sequelae. Some cause great costs for the health care system, aecting its balance and sustainability, such as, rheumatoid arthritis (RA), considered a high-cost disease, due to its impact and comorbidities. Objective: to review studies on economic burden (EB), burden of disease (BoD1), out-of-pocket expenses, catastrophic health expenditures (CHE) and health-related quality of life (HRQoL), in patients with RA in Colombia and worldwide, between 2010 and 2022. Methods: a scoping review of 482 articles, 139 on EB and BoD1, 14 on out-of-pocket expenses and CHE, and 329 on HRQoL, found in the indexed literature in the Scopus, Medline through Pubmed and JSTOR databases in English and Spanish. Results: a trend in the growth of the literature, was observed, with a predominance of reports on biological therapies, considering EB and BoD1 and HRQoL as well, followed by healthcare studies and systematic literature reviews (SLR). The United States leads this research, followed by the United Kingdom; the most used questionnaire to assess health-related quality of life was the SF-36 (41.9%) followed by the EQ- 5D (19%) and although the Qol­RA (Quality of Life in Rheumatoid Arthritis Scale) validated in Colombia is available, it is seldom used. Conclusions: the increase of studies on healthcare costs has gained great relevance for learning about reality and creating instructions on risk management, teach concepts, analyze impact scenarios, and study sensitivities, while showing all the possible results. Key words: economic burden, burden of disease, out-of-pocket expenditure, catastrophic expenditure, health-related quality of life, rheumatoid arthritis, scoping review.

Carga económica de la enfermedad neumocócica en niños de edad preescolar en el Policlínico Docente Playa / Economic burden of pneumococcal disease in pre-school age children from Playa Teaching Policlinic

Introducción: El cálculo de la carga económica de las enfermedades neumocócicas en niños de edad preescolar en el nivel primario de salud en Cuba contribuye a visualizar la necesidad de buscar vías para prevenir su padecimiento. Objetivo: Estimar la carga económica de la enfermedad neumocócica en niños de edad preescolar en el Policlínico Docente de Playa en el 2016. Métodos: Se realizó un estudio descriptivo transversal. Para estimar la carga económica se aplicó el enfoque del costo de la enfermedad sobre la base de la incidencia, desde la perspectiva institucional. Para calcular el costo de atención por paciente se empleó el método de costeo paciente tipo. Resultados: La otitis media aguda fue la enfermedad de mayor incidencia, con el 49 por ciento de los casos seguida por la neumonía con el 47 por ciento. El costo esperado de la enfermedad fue entre 47,97 CUP y 103,38 CUP para la otitis media aguda, de entre 83,99 CUP y 194,94 CUP para la neumonía y entre 105,69 CUP y 189,97 CUP para la meningitis y la sepsis. Dentro de los procesos, las visitas al hogar presentaron el mayor gasto y dentro de las partidas, el salario. La enfermedad neumocócica representó una carga económica de 8849,15 CUP para el área de salud estudiada. Conclusiones: La enfermedad neumocócica en niños no presenta alto nivel de incidencia en el área del Policlínico Docente de Playa, pero representa una carga económica para los servicios de salud en el primer nivel de atención. Estos costos son susceptibles a disminuir con la introducción de la vacuna antineumocócica conjugada(AU)

Introduction: Calculation of the economic burden caused by pneumococcal diseases in pre-school age children in the primary health care of Cuba contributes to visualize the need for finding ways to prevent them. Objective: To estimate the economic burden caused by the pneumococcal disease in pre-school age children from Playa Teaching Policlinic during 2016. Methods: It was conducted a descriptive cross-sectional study. For estimating the economic burden, it was used the approach of cost of the disease based on the incidence and from the institutional perspective. For calculating the cost of the care per patient, it was used the method of cost-patient-type. Results: Acute otitis media was the disease with higher incidence with 49 percent of the cases, followed by pneumonia with 47 percent . The expected cost by diseases was among 47,97 CUP (Cuban peso) and 103,38 CUP for acute otitis media; among 83,99 CUP and 194,94 CUP for pneumonia; and among 105,69 CUP and 189,97 CUP for meningitis and sepsis. Within the processes, home visits showed the higher expense, and among the entries, it was the salary. Pneumococcal disease represented an economic burden of 8849,15 CUP for the studied health area. Conclusions: Pneumococcal disease in children does not represent a high level of incidence in the area of Playa Teaching Policlinic, but it represents an economic burden for health services in the primary care level. These costs are likely to decrease with the introduction of the pneumococcal conjugate vaccine(AU)

Process improvement to effectively manage and reduce sharps injuries in a Tertiary Hospital in Northern India.

INTRODUCTION AND OBJECTIVES: Needle stick injuries are associated with a 0.3-30% risk of transmission of Human Immunodeficiency virus, Hepatitis C virus, and Hepatitis B virus. Despite causing psychological trauma they also involve a huge financial burden. A robust process improvement (RPI) toolkit was introduced in order to effectively manage and reduce needle stick injuries, as well as an attempt to report prevalence, post-exposure management, and associated economic burden. MATERIALS AND METHODS: Prospective Observational Study (2015-2018) has been design in a Corporate Tertiary Care Hospital. The participants included were needle stick injuries exposed staff. RPI toolkit was implemented (2015-2018) focusing on root cause analysis, availability of safety engineered devices, immunization and post-exposure management of needle stick injuries exposed staff. The main outcome measure was needle stick injuries incidence. RESULTS: A total of 211 needle stick injuries were reported (mean - 52.72/year, needle stick injury incidence - 13.18/year/100 beds). Yearly trends showed a decrease of 21.3% in injuries from 2015 (61) to 2018 (48). Half (106, 50%) of the total injuries were reported among nurses. Use of hypodermic needles was involved in 116 (55%) injuries, with 114 (54%) occurring due to nonadherence to hospital policies. Overall, 204 staff had protective immunity, and 135 (64%) of these had completed their Hepatitis B immunizations. The source was known in 165 (78%) cases, and 113 of these cases had an injury from a source with negative viral markers. A 6-month follow-up was completed in 90 cases. No seroconversion was reported. Overall costs incurred in post-exposure prophylaxis was approximately €30,000 (mean cost €143.50/needle stick injury). CONCLUSION: Nurses are most at risk of needle stick injury in healthcare settings. Implementation of RPI toolkit led to a 21.3% reduction in sharps injury incidences. These injuries incur huge financial burden on the hospital. Appropriate immunization strategies saved about €1360 expenditure on post-exposure prophylaxis.

The cost of colorectal cancer according to the TNM stage. / Valoración del coste económico del cáncer colorrectal según estadio tumoral.

INTRODUCTION: The aim of this study was to measure the cost of treatment of colorectal cancer in the Basque public health system according to the clinical stage. METHODS: We retrospectively collected demographic data, clinical data and resource use of a sample of 529 patients. For stagesi toiii the initial and follow-up costs were measured. The calculation of cost for stageiv combined generalized linear models to relate the cost to the duration of follow-up based on parametric survival analysis. Unit costs were obtained from the analytical accounting system of the Basque Health Service. RESULTS: The sample included 110 patients with stagei, 171 with stageii, 158 with stageiii and 90 with stageiv colorectal cancer. The initial total cost per patient was 8,644€ for stagei, 12,675€ for stageii and 13,034€ for stageiii. The main component was hospitalization cost. Calculated by extrapolation for stageiv mean survival was 1.27years. Its average annual cost was 22,403€, and 24,509€ to death. The total annual cost for colorectal cancer extrapolated to the whole Spanish health system was 623.9million€. CONCLUSIONS: The economic burden of colorectal cancer is important and should be taken into account in decision-making. The combination of generalized linear models and survival analysis allows estimation of the cost of metastatic stage.

Propuesta metodológica para el análisis económico del embarazo en la adolescencia en Cuba / Methodologic proposal for the economic analysis of pregnancy at adolescence in Cuba

El embarazo y parto en la adolescencia generan altos costos. Hasta el año 2006 la fecundidad adolescente en Cuba decreció. En los últimos años ha tendido a aumentar, lo que representa una alarma para la salud de este grupo de jóvenes. En Cuba se desarrollan proyectos destinados a mejorar las condiciones de salud de los adolescentes, entre los que se destaca el Programa Nacional de Atención Integral a la Salud de Adolescentes. La realización de análisis económico sobre el embarazo en la adolescencia en Cuba es una tarea pendiente que requiere de herramientas metodológicas que brinden información oportuna sobre sus consecuencias económicas. El propósito del trabajo es realizar una propuesta metodológica para identificar las implicaciones económicas del embarazo en la adolescencia en Cuba. Se hizo una revisión bibliográfica y documental utilizando el modelo BIG 6 como modelo de gestión de información para identificar estudios sobre salud sexual y reproductiva con énfasis en consecuencias económicas del embarazo en la adolescencia. Se complementó la información a partir de entrevistas a expertos en salud sexual y reproductiva y en análisis económico, quienes aportaron elementos para el diseño de la propuesta metodológica a realizar. Se obtuvo una propuesta metodológica para estudiar las consecuencias económicas del embarazo en la adolescencia con dos perspectivas, la macroeconómica y la microeconómica. Ambas perspectivas complementan información económica necesaria y útil para la asignación de recursos y toma de decisiones.

Sexual and reproductive health concerns man in its individual, economic and social dimensions. Pregnancy and child delivery in adolescents generate high costs. The fertility rate of adolescents decreased in Cuba until 2006, but in the last few years, there has been an increase that represents a warning about the health of this group of young people. Cuba is developing projects aimed at improving the health status of adolescents such as the National Program of Integrated Care to the Health of Adolescents. Making economic analysis of the pregnancy at adolescence in Cuba is a pending task. Methodological tools providing timely information on the economic consequences of pregnancy at adolescence are required. The objective of this paper was to submit a methodological proposal in order to identify the economic effects of pregnancy at adolescence in Cuba. A literature and document review was made with Big 6 model as the information management pattern, with a view to identifying the studies on sexual and reproductive health, emphasizing the economic consequences of pregnancy at adolescence. This information was supplemented with interviews to experts in sexual and reproductive health and in economic analysis, who contributed several elements for the design of the final methodological proposal for this type of study from the macroeconomic and the microeconomic perspectives. Both provide the necessary useful economic information to allocate resources and to make decisions.

Propuesta metodológica para el análisis económico del embarazo en la adolescencia en Cuba / Methodologic proposal for the economic analysis of pregnancy at adolescence in Cuba

El embarazo y parto en la adolescencia generan altos costos. Hasta el año 2006 la fecundidad adolescente en Cuba decreció. En los últimos años ha tendido a aumentar, lo que representa una alarma para la salud de este grupo de jóvenes. En Cuba se desarrollan proyectos destinados a mejorar las condiciones de salud de los adolescentes, entre los que se destaca el Programa Nacional de Atención Integral a la Salud de Adolescentes. La realización de análisis económico sobre el embarazo en la adolescencia en Cuba es una tarea pendiente que requiere de herramientas metodológicas que brinden información oportuna sobre sus consecuencias económicas. El propósito del trabajo es realizar una propuesta metodológica para identificar las implicaciones económicas del embarazo en la adolescencia en Cuba. Se hizo una revisión bibliográfica y documental utilizando el modelo BIG 6 como modelo de gestión de información para identificar estudios sobre salud sexual y reproductiva con énfasis en consecuencias económicas del embarazo en la adolescencia. Se complementó la información a partir de entrevistas a expertos en salud sexual y reproductiva y en análisis económico, quienes aportaron elementos para el diseño de la propuesta metodológica a realizar. Se obtuvo una propuesta metodológica para estudiar las consecuencias económicas del embarazo en la adolescencia con dos perspectivas, la macroeconómica y la microeconómica. Ambas perspectivas complementan información económica necesaria y útil para la asignación de recursos y toma de decisiones(AU)

Sexual and reproductive health concerns man in its individual, economic and social dimensions. Pregnancy and child delivery in adolescents generate high costs. The fertility rate of adolescents decreased in Cuba until 2006, but in the last few years, there has been an increase that represents a warning about the health of this group of young people. Cuba is developing projects aimed at improving the health status of adolescents such as the National Program of Integrated Care to the Health of Adolescents. Making economic analysis of the pregnancy at adolescence in Cuba is a pending task. Methodological tools providing timely information on the economic consequences of pregnancy at adolescence are required. The objective of this paper was to submit a methodological proposal in order to identify the economic effects of pregnancy at adolescence in Cuba. A literature and document review was made with Big 6 model as the information management pattern, with a view to identifying the studies on sexual and reproductive health, emphasizing the economic consequences of pregnancy at adolescence. This information was supplemented with interviews to experts in sexual and reproductive health and in economic analysis, who contributed several elements for the design of the final methodological proposal for this type of study from the macroeconomic and the microeconomic perspectives. Both provide the necessary useful economic information to allocate resources and to make decisions(AU)