Treatment, outcomes and costs of asthma exacerbations in Chilean children: a prospective multicenter observational study
Allergol. immunopatol
; 47(3): 282-288, mayo-jun. 2019. tab
Article
in English
| IBECS
| ID: ibc-186491
Responsible library:
ES1.1
Localization: BNCS
ABSTRACT
Objective:
To describe potential regional variations in therapies for severe asthma exacerbations in Chilean children and estimate the associated health expenditures.Methods:
Observational prospective cohort study in 14 hospitals over a one-year period. Children five years of age or older were eligible for inclusion. Days with oxygen supply and pharmacological treatments received were recorded from the clinical chart. A basic asthma hospitalization basket was defined in order to estimate the average hospitalization cost for a single patient. Six months after discharge, new visits to the Emergency Room (ER), use of systemic corticosteroids and adherence to the controller treatment were evaluated.Results:
396 patients were enrolled. Patients from the public health system and from the north zone received significantly more days of oxygen, systemic corticosteroids and antibiotics. Great heterogeneity in antibiotic use among the participating hospitals was found, from 0 to 92.3% (ICC 0.34, 95% CI 0.16-0.52). The use of aminophylline, magnesium sulfate and ketamine varied from 0 to 36.4% between the different Pediatric Intensive Care Units (ICC 0.353, 95% CI 0.010-0.608). The average cost per inpatient was of $1910 USD. 290 patients (73.2%) completed the follow-up six months after discharge. 76 patients (26.2%) were not receiving any controller treatment and nearly a fourth had new ER visits and use of systemic corticosteroids due to new asthma exacerbations.Conclusions:
Considerable practice variation in asthma exacerbations treatment was found among the participating hospitals, highlighting the poor outcome of many patients after hospital discharge, with an important health costRESUMEN
No disponible
Search on Google
Collection:
National databases
/
Spain
Database:
IBECS
Main subject:
Asthma
/
Cost of Illness
/
Adrenal Cortex Hormones
Limits:
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Chile
Language:
English
Journal:
Allergol. immunopatol
Year:
2019
Document type:
Article
Institution/Affiliation country:
Alemana Clinic/Chile
/
Concepción Regional Hospital/Chile
/
Finis Terrae University/Chile
/
Fusat Hospital/Chile
/
Gustavo Fricke Hospital/Chile
/
José Joaquín Aguirre Hospital/Chile
/
Leonardo Guzmán Hospital/Chile
/
Luis Calvo Mackenna Hospital/Chile
/
Ovalle Hospital/Chile
/
Padre Hurtado Hospital/Chile