The economic impact of critical congenital heart disease to the health system and families in Colombia [version 1; peer review: 2 approved with reservations]

• Published in: F1000 research Vol. 8; p. 92
• Main Authors: Chamorro Velásquez, Cindy Lorena, Sandoval Reyes, Nestor Fernando, Taborda Restrepo, Alejandra, Romero Ducuara, Sandra Vanessa, Domínguez, Maria Teresa, Troncoso Moreno, Gloria Amparo, Cuevas, Alejandra Fonseca, Aranguren Bello, Hernan Camilo, Bermúdez Hernadez, Pablo Andres, Trujillo, Pablo Sandoval, Dennis, Rodolfo Jose, Londoño Trujillo, Darío
• Format: Journal Article
• Language: English
• Published: 2019
• Subjects: Hospital Costs; Cost of Illness; Cost Analysis; Indirect Expenditures; Economic impact; Out-of-pocket Expenditures
• ISSN: 2046-1402; 2046-1402
• DOI: 10.12688/f1000research.17631.1

Background: Critical congenital heart disease (CCHD) make up a group of heart diseases present in newborns since the prenatal period and requiring early intervention through surgery or percutaneous interventions in the first year of life. Little is known about the societal economic impact associated with their care in low to middle income countries. We estimated direct medical costs, out-of-pocket expenditures and indirect costs of CCHD patients in Colombia.
Methods: The methodology to estimate costs involved four stages: identification, measurement, and assessment of resources consumed, and total cost calculation. Regarding medical costs, hospital and ambulatory costs were estimated for the patient's first year of life using clinical records of 73 patients and with thematic experts. A survey was carried out on 20 children´s caregivers to determine the out-of-pocket expenses and indirect costs. For this estimation, a descriptive analysis was made on the survey taking into account the reported salary. All costs are expressed in US dollars (2017 exchange rates).
Results: The average direct medical hospital costs for CCHDs were $25,835 and the ambulatory costs reached $480. Indirect costs were $1,303 and out-of-pocket expenses were $2,058, which for families with an income lower than one monthly minimum wage (1 SMMLV) in 2017 correspond to $250. The impact on their budget was 57%.
Conclusions: CCHDs represent an important economic impact both for the Colombian General Social Health System and for families. This study made it possible to estimate the costs that are not easily visible and thus quantified.