PIH16 - Medium Term Tendency of Annual Direct Medical Cost of Pediatric Pulmonary Hypertension Health Care in Centro Medico Nacional 20 De Noviembre (Nmcissste, Mexico)

Abstract

To describe the tendency of annual direct medical cost average for pediatric pulmonary hypertension health care in NMCISSSTE, Mexico. A retrospective cohort study was conducted using medical records from a pediatric cardiology service at NMC ISSSTE, Mexico City. All patients who had PPH included were aged under 18 years. Clinical and economic variables were collected; direct healthcare costs were medical visits, hospitalization days, emergency visits, diagnostic or therapeutic procedures and medication. Prescriptions (acute, chronic, or upon request) were quantified based on mean dosage/patient, all resources used was obtained directly from patient´s charts and prices were obtained from www. compranet.funcionpublica.gob.mx. A descriptive analysis was performed, included mean, standard deviation and 95% confidence interval were done. A log linear regression model was done, p value >0.05 was consider statistically significant. The cost was expressed in USD (1USD =$18.8113 Mx, www. banxico.org Jan 2018). Fifty four pediatric pulmonary hypertension patients all of them treated with bosentan (52% males), the mean of age at diagnosis was 7.9±5.45 years and median follow-up 4 years, the average cost total annual cost/follow up was $89,024.47, the average first and second annual cost were $ 37,166.16, $24,674.41 respectively, costs kept tendency to go down, the average was $9,552.42 for third, fourth and fifth years. In generalized linear model analysis, the annual direct medical costs were predicted by functional class improved and hospitalizations decreases (p<0.000 y p=0.043 respectively). The decrease tendency in total direct medical cost was associated with functional class improvement and decrease in hospitalization number