Costo efectividad de las salas de enfermedad respiratoria aguda en Bogotá – Colombia

Objective: To assess the cost effectiveness of Salas ERA, a primary health care program for the prevention and treatment of Acute Respiratory Disease, in the area of Ciudad Bolivar in Bogota. Methods: The situation with and without Salas Era was modeled with a decision tree. Effectiveness was measured in avoided hospitalizations. By means of the Chow test, we checked the seasonally adjusted series of monthly hospitalizations (2002-2010) for structural change in the tendency since the implementation of Salas Era. The no-intervention situation was projected by means of an ARIMA model for the pre Salas ERA data. It was the compared to the actual data with Salas ERA. Costs associated with each arm were calculated in Colombian pesos and in 2011 US dollars. Cost-effectiveness ratio was estimated and a probabilistic sensitivity analysis was performed. Results: The average cost per patient was CO$ 89 624 (US$ 46) in Salas ERA, and CO$ 202 868 (US$104) without Salas ERA. The additional cost per patient without Salas ERA was CO$ 113 245 (US$58). The no-Salas-ERA situation has an additional hospitalization rate of 0.014, i.e. 58 per group of 4.000 children. In the probabilistic sensitivity analysis, Salas ERA turned out to be dominant in 90.9% of the cases. Conclusions: Salas Era is a dominant and cost-effective alternative as it simultaneously reduces hospitalizations and costs.