Cost analysis:
We included infants under two years of age admitted in tertiary centers, in Rionegro, Colombia due to asthma according to the national clinical guideline of asthma in children from January 2018 to December 2018. Our country has been characterized by having a very small price variation in the last 10 years, especially in health services between the different clinics and over time (20). Moreover, the proportions of each of the costs remain relatively constant, which, with few variations in their composition in the last ten years (20). The municipality of Rionegro had a total population of 101,046 inhabitants, and hast two tertiary referral hospital (21) All cost and use of resources were collected directly from medical invoices and electronic medical records. The direct costs considered in the analysis include medical consultation at emergency room, specialist referrals, chest physiotherapy, diagnosis support (laboratory, electrocardiogram, x-ray, etc), medication (oxygen, nebulization, antibiotics, corticosteroids, bronchodilators, etc.), medical devices, hotel services at intensive care unit, hotel services in general medical ward, table 2 .
We use US dollars (Currency rate: US$ 1.00 = COP$ 3,000) (22) to express all costs in the study. For the valuation of the indirect costs associated with the loss of productivity of parents, the human capital method was used, assuming everyone receives an income of at least a legal minimum wage for formal or informal work. The cost-opportunity of the productivity loss at the workplace and the caregiver was assessed based on the minimum wage without including the transportation assistance for the year 2019 (U$ 229.81 per month). The legal minimum wage approved by the government was taken as a reference and not an average or median wage thereof, given that in Colombia more than 75% of the population has this value as income(23). Because all patients with acute ashtma eísode included were children, we assumed that at least one family, member accompanies the patient permanently during hospitalization, since pediatric hospitals in the country usually allow only one companion per patient in the hospital. The cost associated with transportation and food (does not include a stay), was assumed to correspond to 50% of minimum wage per day.