Costoefectividad del acceso directo del kinesiĆ³logo para la artrosis de rodilla leve a moderada en la atenciĆ³n primaria de salud de Chile
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Fecha
2017
Profesor/a GuĆa
Facultad/escuela
Idioma
es
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Universidad AndrƩs Bello
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Licencia CC
Licencia CC
Resumen
La artrosis de rodilla es una patologĆa mĆŗsculo esquelĆ©tica que tiene un lugar
importante dentro de las enfermedades crĆ³nicas en Chile. El sistema de Salud se ha visto
afectado por un aumento sostenido en la demanda de servicios por parte de la poblaciĆ³n
adulta, significando un alto costo para el estado en salud pĆŗblica.
En paralelo, la utilizaciĆ³n de evaluaciones econĆ³micas en salud ha jugado un rol
importante para la toma de decisiones (programa de salud, construcciĆ³n de polĆticas pĆŗblicas,
tratamientos, etc.) a nivel mundial, cuando los recursos son escasos. AsĆ mismo, en esta
investigaciĆ³n se da paso a la bĆŗsqueda de una alternativa al procedimiento aplicado respecto
a la atenciĆ³n de la Artrosis de Rodilla en el Sistema Primario de Salud a lo largo de su ciclo
vital, con el fin de entregar informaciĆ³n asociada a evidencia nacional e internacional, que
sean un aval a la hora de implementar una nueva opciĆ³n, siendo Ć©sta mĆ”s efectiva.
La metodologĆa aplicada es la recomendada por la GuĆa MetodolĆ³gica para la
EvaluaciĆ³n EconĆ³mica de Intervenciones en Salud en Chile, documento que entrega
recomendaciones para la construcciĆ³n de un estudio de este tipo.
Una vez recopilada la informaciĆ³n, escogimos uno de los modelos matemĆ”ticos de
decisiĆ³n, llamado Ćrbol de Decisiones. Este modelo encasilla las alternativas a investigar, y
busca simplificar la informaciĆ³n recopilada mediante āRamasā. La alternativa A se define
como la opciĆ³n que existe actualmente (A.1), donde el usuario debe asistir al centro de salud,
agendar una visita con el mĆ©dico para que Ć©ste haga la evaluaciĆ³n y prescriba fĆ”rmacos. Los
escenarios resultantes serĆan el Ć©xito (A.1.1) del tratamiento farmacolĆ³gico, o el fracaso y
posterior derivaciĆ³n a kinesiterapia adjunta a fĆ”rmacos (A.1.2). De Ć©ste Ćŗltimo se obtienen
otros dos posibles resultados, el Ć©xito de la kinesiterapia (A.1.2.1) o el fracaso de la terapia
y derivaciĆ³n a sistema secundario (A.1.2.2)
La alternativa B, consiste en la nueva propuesta: Todo usuario con artrosis de rodilla,
podrĆa asistir directamente a kinesiterapia, para que el KinesiĆ³logo realice la evaluaciĆ³n y
sea tratado de manera inmediata. Es decir, acceso directo a kinesiologĆa por Artrosis de
Rodilla (B.1), el cual podrĆa tener 2 escenarios, el Ć©xito de la kinesiterapia (B.1.1) o el fracaso
de Ć©sta (B.1.2). Si la terapia en este punto no da resultados, serĆ” evaluado nuevamente y se
adiciona el fĆ”rmaco (B.1.2.1). De no mejorar, se asume la derivaciĆ³n a especialista (B.1.2.2).
The Knee osteoarthritis (OA) is a pathology that has an important place on chronic diseases in Chile. The public health system has been affected by a sustained increase in the demand of its services by the adult population, meaning a high cost for the state on public health. On the other hand, the use of economic health assessments has played an important role for decision-making around the world when the resources are scarce. This research gives way to find an alternative to the procedure applied to the care of OA in the primary health system, throughout its life cycle, in order to deliver information associated with national and international evidence that are a guarantee to implement a new option, hoping to be more effective. The methodology applied is the recommended by the Guide methodological for the evaluation economic of interventions in health in Chile, document that delivers recommendations for the construction of a study of this type. Once collected the information, we chose one of mathematical decision models, called Decisionās Tree, that assigns them alternative to investigate, and seeks to simplify the information collected by "branches". The alternative A is defined as the option that currently exists (A.1), where the user must attend the health center, schedule a visit with your doctor so that this make the assessment and prescribe drugs. The resulting scenarios would be the success of drug treatment (A.1.1), or the failure and subsequent referral to physiotherapy attached to drugs (A.1.2). The latter is obtained other two possible outcomes, the physiotherapy success (A.1.2.1) or failure of therapy and referral to secondary system (A.1.2.2) The alternative B consists of the new proposal: All patient with Knee OA, could attend directly to physiotherapy, to the physiotherapist perform the evaluation and be treated immediately (B.1), which could have 2 scenarios: The success of the physiotherapy (B.1.1) or the failure of this (B.1.2). If the therapy at this point does not give results, it will be evaluated again and is added the drug (B.1.2.1). Does not improve, it is assumed the derivation specialist (B.1.2.2).
The Knee osteoarthritis (OA) is a pathology that has an important place on chronic diseases in Chile. The public health system has been affected by a sustained increase in the demand of its services by the adult population, meaning a high cost for the state on public health. On the other hand, the use of economic health assessments has played an important role for decision-making around the world when the resources are scarce. This research gives way to find an alternative to the procedure applied to the care of OA in the primary health system, throughout its life cycle, in order to deliver information associated with national and international evidence that are a guarantee to implement a new option, hoping to be more effective. The methodology applied is the recommended by the Guide methodological for the evaluation economic of interventions in health in Chile, document that delivers recommendations for the construction of a study of this type. Once collected the information, we chose one of mathematical decision models, called Decisionās Tree, that assigns them alternative to investigate, and seeks to simplify the information collected by "branches". The alternative A is defined as the option that currently exists (A.1), where the user must attend the health center, schedule a visit with your doctor so that this make the assessment and prescribe drugs. The resulting scenarios would be the success of drug treatment (A.1.1), or the failure and subsequent referral to physiotherapy attached to drugs (A.1.2). The latter is obtained other two possible outcomes, the physiotherapy success (A.1.2.1) or failure of therapy and referral to secondary system (A.1.2.2) The alternative B consists of the new proposal: All patient with Knee OA, could attend directly to physiotherapy, to the physiotherapist perform the evaluation and be treated immediately (B.1), which could have 2 scenarios: The success of the physiotherapy (B.1.1) or the failure of this (B.1.2). If the therapy at this point does not give results, it will be evaluated again and is added the drug (B.1.2.1). Does not improve, it is assumed the derivation specialist (B.1.2.2).
Notas
Tesis (Licenciado en KinesiologĆa)
Palabras clave
KinesiologĆa Salud PĆŗblica, ArtropatĆas