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.