María Eugenia Elorza

Evaluación de políticas públicas de provisión de fármacos para diabetes mellitus tipo 2 en Argentina: estudio de caso

In Argentina, the provision of drugs for patients suffering from type 2 diabetes mellitus who lack health insurance is carried out through public programs. In the Province of Buenos Aires, the national program Remediar and the provincial program PRODIABA (from the Spanish Programa de Prevencion, Diagnostico y Tratamiento del Paciente Diabetico) coexist. This study estimates the percentage of adults in the municipality of Bahia Blanca (Province of Buenos Aires) who suffer from type 2 diabetes mellitus and lack health insurance, thus satisfying their need for oral antidiabetic treatments within the public sector. It is a quantitative study that assesses the need and demand for public provision. The results indicate that: 1) the greatest percentage of demand is satisfied at the primary health care level; 2) the province of Buenos Aires funds the largest share of the pills, followed by the municipal and the national levels; 3) the local government intervenes to satisfy the demand and 4) the total public provision covers approximately 25% of the overall need in relation to the average consumption. This shows that despite the presence of these public programs, the provision is insufficient and thus requires the intervention of the local government even though economic theory does not recommend the decentralization of drug purchases.In Argentina, the provision of drugs for patients suffering from type 2 diabetes mellitus who lack health insurance is carried out through public programs. In the Province of Buenos Aires, the national program Remediar and the provincial program PRODIABA (from the Spanish Programa de Prevención, Diagnóstico y Tratamiento del Paciente Diabético) coexist. This study estimates the percentage of adults in the municipality of Bahia Blanca (Province of Buenos Aires) who suffer from type 2 diabetes mellitus and lack health insurance, thus satisfying their need for oral antidiabetic treatments within the public sector. It is a quantitative study that assesses the need and demand for public provision. The results indicate that: 1) the greatest percentage of demand is satisfied at the primary health care level; 2) the province of Buenos Aires funds the largest share of the pills, followed by the municipal and the national levels; 3) the local government intervenes to satisfy the demand and 4) the total public provision covers approximately 25% of the overall need in relation to the average consumption. This shows that despite the presence of these public programs, the provision is insufficient and thus requires the intervention of the local government even though economic theory does not recommend the decentralization of drug purchases.

Descentralización y equidad: el gasto público en salud en los municipios de la provincia de Buenos Aires

In this paper we analyze the degree of equity in access to the public health care system in the Province of Buenos Aires (Argentina). Through a quantitative retrospective study, we analyze the inequalities in the distribution of the total public health expenditure per capita. This variable is used as a proxy for the ability of the inhabitants of each jurisdiction to access health care services. The results indicate the existence of large disparities in the levels of expenditure devoted to the population without health coverage. Moreover, the existence of greater health care needs (estimated using infant mortality rates and percentage of homes with basic needs unmet) does not translate into higher levels of public expenditure. Finally, we detect a positive association between the relative wealth of municipalities (measured by the gross geographic product per capita) and the public health expenditure per capita.In this paper we analyze the degree of equity in access to the public health care system in the Province of Buenos Aires (Argentina). Through a quantitative retrospective study, we analyze the inequalities in the distribution of the total public health expenditure per capita. This variable is used as a proxy for the ability of the inhabitants of each jurisdiction to access health care services. The results indicate the existence of large disparities in the levels of expenditure devoted to the population without health coverage. Moreover, the existence of greater health care needs (estimated using infant mortality rates and percentage of homes with basic needs unmet) does not translate into higher levels of public expenditure. Finally, we detect a positive association between the relative wealth of municipalities (measured by the gross geographic product per capita) and the public health expenditure per capita.

Clasificación de las causas que determinan estadía inadecuada útil para la gestión hospitalaria

Introduccion: la busqueda de eficiencia en la gestion hospitalaria motiva el empleo de indicadores de gestion que detecten y evaluen la presencia de estancias hospitalarias inadecuadas. Objetivo: disenar una clasificacion de las causas que determinan una estadia hospitalaria inadecuada adaptada al contexto del sistema de salud argentino. Metodos: se revisaron 25 articulos publicados entre los anos 1990 y 2009 en revistas argentinas y de otras nacionalidades, en idioma ingles y espanol. Para la exploracion se incluyeron buscadores genericos de Internet y las bases de datos bibliograficos: Medline, Cochrane y Lilacs. Las palabras clave empleadas fueron: inappropriateness, inappropriate hospital days, the appropriateness evaluation protocol, factors associated with inappropriate hospitalization days, uso inadecuado de la hospitalizacion, lenght of stay. Sintesis de los datos: es necesario distinguir entre ingresos y estadias inadecuadas. Las causas de estas ultimas, segun la clasificacion disenada, pueden deberse a la responsabilidad de: 1. La planificacion y gestion hospitalaria. 2. El medico. 3. La familia del paciente. 4. El sistema de salud. Conclusiones: el diseno de esta clasificacion es una herramienta util para la implementacion de indicadores de gestion hospitalaria que involucren los dias de estadia.

The role of the pharmacist in the determination of pharmacotheraphy costs: Ischemic cardiopathy patients with smoking habits

In the last decades the pharmacist has played a main role in the policies of costs containment in the health sector. The present study has been designed to assess this role in the costs containment of the pharmacological treatments of patients at a Coronary Care Unit (CCU) of a public hospital in Argentina, through an analitic and retrospective study. It has been observed that the pharmacist could determine in all the service a saving of

Costos de enfermedades: clasificación y perspectivas de análisis

3,393.03 buying the prescriptive drugs at minimum prices during the analized period. However, it has been proved that there are costs which the pharmacist cannot modify, as in the case of certain risk factors that may increase the pharmacological costs in the treatment of a pathology. This cost variation has been proved in ischemic cardiopathy patients with smoking habits.