Cost analysis:
To estimate the cost of each health state defined in the model we
extracted all costs of infants less than two years of age admitted on a
tertiary center, in Medellin, Colombia due to asthma according to the
national clinical guideline of asthma in children from January 2018 to
December 2018. All costs 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 the 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 a general medical ward, Table 2 . 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 (14). Moreover, the proportions of each of the costs remain
relatively constant, which, with few variations in their composition in
the last ten years (14). We use US dollars (Currency rate: US$ 1.00 =
COP$ 3,000) (15) 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(16). Because all
patients with asthma 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 the minimum wage per day.