Revista chilena de cardiología
versión ISSN 0718-8560
GUTIERREZ V, Carmen Gloria y MEDINA G, Alex. Cost of ambulatory care of hypertensive subjects in a community hospital (bulnes): comparison of activity associated costs to the national health fund (fonasa) estimated payments in the setting of a national cardiovascular care program. Rev Chil Cardiol [online]. 2011, vol.30, n.3, pp. 207-211. ISSN 0718-8560. doi: 10.4067/S0718-85602011000300003.
Background: Payments for ambulatory care of hypertensive patients in the national cardiovascular program is defined by FONASA based on national studies. Considerable differences are observed upon confrontation with the real costs involved in a given place. Aim: to determine direct and indirect costs of health care actions in the ambulatory care of hypertensive patients through an activity based cost (ABC) methodology and to compare these with the corresponding payments defined by FONASA Method: In a cross sectional design, 290 records of hypertensive subjects under control at the Community Hospital in Bulnes were analyzed. Costs of doctor, nurse and nutritionist controls were determined along with those related to laboratory tests including hematocrit, lipid profile, glycemia, plasma creatinine, urine analysis, plasma K level and electrocardiogram. Cost of pharmacy was also included. Results: a monthly mean of $ 39 992 ± 12 000 per hypertensive patient cared was determined through ABC based costs. This is considerable greater than de $ 21 370 determined by FONASA (p<0.001). Conclusion: Payments considered by FONASA are insufficient to cover real costs involved in ambulatory care of hypertensive patients. A better financing of the cardiovascular care program requires these costs and payments to converge.
Palabras clave : activity based costs; hypertension; cardiovascular care program.