Abstract

BERNZTEIN, Ricardo; DRAKE, Ignacio  and  ELORDI, Susana. Cost of treatment of acute otitis media in the first level of public attention of Argentina. Arch. argent. pediatr. [online]. 2007, vol.105, n.5, pp.398-404. ISSN 0325-0075.

Acute otitis media (AOM) is a frequent health problem, with its treatment requiring numerous resources. An important limitation of this cost assessment is that the incidence of AOM in Argentina is not known, neither the costs. Objective. To describe how often AOM is diagnosed, how it is treated at the primary level of patient care, and to estimate treatment cost for AOM. Material and methods. The database from the Remediar Program allows for crossover of diagnosis, prescriptions and costs. Visits to over six thousand primary care health centers corresponding to the period between March 2005 and February 2006, in all 24 provinces of the Argentine Republic, were analyzed. The study is retrospective. The sources of information are secondary. The cost assessment, associated with diagnosis made and prescriptions rendered, is estimated according to national treatment guidelines and to public bids for drugs of the Remediar Program. Results. 15 million prescriptions were assessed. The diagnosis of AOM had an overall frequency of 2.2% for all ages, 3.3% in patients under two years of age, and 4.1% in patients between 2 and 5 years of age. Amoxicillin was the drug prescribed with most frequency (67.8%), followed by ibuprofen (43.9%). The frequency of diagnosis varied between different provinces. Each prescription had a cost of $ 32.7 (retail price) or $3.51 (Remediar bid price); 72% of the prescriptions corresponded to antibiotics and 28% to analgesic drugs. Discussion. The surprising lack of epidemiological data and cost data made it necessary to utilize a limited study base to assess the cost of AOM. Diagnostic variability exists among the jurisdictions. Considerable savings are generated by bulk purchases troughs Remediar. The cost of the treatment represents an important part of the budget from homes of low incomes. Previous publications support that the treatment of AOM without antibiotics is cost effective, therefore the cost of treating AOM can be further decreased.

Keywords : Costs; Otitis; Remediar Program; Antibiotics; Treatment.

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