The true cost of a broken heart



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A person with cardiovascular disease costs the country between eight and sixteen times more than a healthy person. The researchers warn that if cases continue to increase, the financial collapse of the Colombian health system can be released.

Since 2005, outbreaks have affected more and more Colombians. It began as a small value which in 2016 represented the first cause of death in this country: that year, an epidemic cardiovascular disease it resulted in 53% of deaths in Colombia. And although the increase in cases has been a cause of constant concern, there is no clarity about how much the disease costs in this country. (Read: Medimas will be sold to America)

For this reason, researchers from the Salutia Foundation, with support from the Risaralda Government, decided to label prices for the epidemic of cardiovascular disease. The results of his research have just been published in the newspaper Plos ONE and they don't show anything good.

According to their findings, a person suffering from acute myocardial infarction weighs on Colombia's health system eight to ten times more than someone who does not suffer from this disease every year. Those who suffer from cardiovascular accidents increase that value between ten and sixteen times more.

To give real value to this problem, every patient with cardiovascular disease harms the country between US $ 4,277 and US $ 4,846 (between $ 14 million and $ 16 million) each year and every person suffering a heart attack requires the State to issue US $ 5,816 and US $ 5,816. $ 6,616 (between $ 19 million and $ 21 million). A patient without the cost of this disease, every year, is around US $ 602. That is, almost no $ 2 million.

Norman Maldonado, one of the main researchers of the article, said that in order to achieve these figures they had to stay away from traditional ways of calculating the cost of disease. Usually, the calculation of disease is carried out through a technique called microcosteo, which involves the addition of costs from each procedure, tool or personnel needed to meet certain diseases or conditions. But these calculations are often inaccurate and, in addition, are not in accordance with the way the Colombian health system works.

Maldonado explained that, in Colombia, mandatory health services per person, not because of illness. Meaning: someone does not insure events, someone is guaranteed as a person. In addition, the cost of pre-infarction events is calculated without taking into account whether, for example, the person has a obesity problem and has received attention to problems related to blood sugar or the treatment of joint pain associated with being overweight.

"Microcosting exercises are based on theory. In theory, there is so much input involved in attending an event x o and in health, but reality is another thing, what part of the cost is actually using, "Maldonado said.

Therefore, his research is based on real data from collections made by EPS for Ministry of Health for health services provided throughout the year. "We identify people who have been reported with a diagnosis of a heart attack, and we see how many people pay the system in a year," explained the researcher. From this data they take an average.

If the numbers remain stable, financial planning will not be difficult. But, as the Ministry of Health has warned, cases of cardiovascular disease continue to increase in this country. Only in 2017, this condition caused 37,452 deaths. And, according to data collected by researchers, who compared information from 2010 and 2012, in just two years the case skyrocketed 20%.

With that growth rate, what can happen is serious, said Maldonado. "The number of cases continues to increase, which in turn means that maintaining the health system will cost ten times. If this expansion continues as has happened, Colombia's health system will be totally unsustainable," he said.

The paradox is that this epidemic can be managed. We know the exact cause and how to fight it. "Smoking, being overweight, sedentary lifestyles, and hypertension are the main risk factors that must be overcome," said Maldonado, one of the study's main researchers.

What failed?

According to Blanca Llorente, one of the coin investigators from the Salutia Foundation, "evolutionary numbers show us that prevention efforts don't help reverse this trend". In other words: the steps taken by the government are not enough to stop this disease with certainty.

The most serious, said Maldonado, is that it seems that the government does not want to struggle to reduce these risk factors. Researchers point out that the effectiveness of measures such as increasing taxes on tobacco, alcohol or food with added sugar, such as soda, which the Government and Congress of Colombia avoided in any tax reforms have been proven throughout the world. . "Raising taxes on these products and making them less accessible to the population is not a new discovery, they are steps that have proven effective," Llorente said.

But this is not the only way out and, in fact, the problem has many sides so that, even if these steps are implemented, researchers believe that they will not be enough to change trends. They give an example of an inactive lifestyle, another of the most common risk factors for cardiovascular disease. Even though the Ministry of Health has carried out several campaigns that promote the recommended 40-minute daily intensive exercise, if there are no conducive spaces in the cities to implement, it will be very difficult to reach the goal.

In this case, the researchers say that to combat this growing problem, it is necessary for the authorities to take articulations that are not common in Colombia, as well as to make decisions based on evidence and not political income.

"In Colombia, decision makers always have the reason that the data on problems like this come from countries whose conditions are very different from the Colombian context," explained Maldonado, adding that "with this type of study we provide scientific evidence to countries to make policies based on evidence. The next step is the Ministry of Finance and Health to make a decision guided by these findings. "

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