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Decision-Making and the Health Sector in Argentina CEA and the Use of Nitrous Oxide in Anesthesia

Published online by Cambridge University Press:  10 March 2009

Jacob A. Tieffenberg ,
Irene Wood ,
Hernan Del Pino ,
Alberto Berbeglia  and
Lars A. Marké
Jacob A. Tieffenberg
Affiliation:
ACINDES
Irene Wood
Affiliation:
ACINDES
Hernan Del Pino
Affiliation:
ACINDES
Alberto Berbeglia
Affiliation:
ACINDES
Lars A. Marké
Affiliation:
SPRI
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Extract

We analyze Argentina's demographic and socioeconomic data as the context for understanding its health sector. Health expenditures and the number of physicians are high in Argentina. Health coverage is extensive, but covers only about 50% of the per capita expenditures. The high expenditures in health do not correlate with improvements of indicators such as infant and general mortality. Evaluations of the way health care is provided are insufficient. Argentina's “medical-intensive” model of health is responsible for the expansion of the “small-ticket technology”, which accounts for a significant proportion of the increase in health expenditures. With this picture, we believe that health decision-makers could benefit from cost-effectiveness analysis (CEA), because this technique stresses the relationship between expenditures and appropriately defined goals. As a demonstration project, we look at the way that technology is used in Argentina using CEA to assess anesthesia procedures. The results of our study show that increasing the use of N2O would save us $670,000 per year, and 10,300 years of life to surgical patients of all ages.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 4 , Issue 4 , October 1988 , pp. 601 - 611
Copyright
Copyright © Cambridge University Press 1988

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References

REFERENCES

1. Bodlander, F. M. S.Deaths associated with anesthesia. British Journal of Anaesthesia, 1975, 47, 36–40.CrossRefGoogle Scholar
2. Carrillo, R. Control of use and sales of medical equipment and instruments, Decree No. 25.209 (10 10, 1949). Official Bulletin, House of Representatives, 10 18, 1949.Google Scholar
3. Delegue, L., Caillet, J., & Chen, M.Les arrets circulatoires en rapport avec I'anesthesie au CHR de Rouen, d'octobre 1967 à octobre 1970. Anesthesie, Analgesie, et Reanimation, 29, 133–50.Google Scholar
4. Eisele, J. H., & Smith, N. T.Cardiovascular effects of nitrous oxide on systolic time intervals. Acta Anaesthesica Scandinava, 1972, 24, 74.Google Scholar
5. Holland, R.Special committee investigating deaths under anesthesia: Report on 745 Classified Cases, 1960–1968. Medicine Journal of Australia, 1970, 1, 573–94.Google Scholar
6. Johnstone, M.Halothane-oxygen, a universal anaesthetic. British Journal ofAnaesthesia, 1961, 33, 29–39.CrossRefGoogle ScholarPubMed
7. Lappas, D. G., Buckley, M. J., Laver, M. B., Dagget, W. M., & Lowenstein, E.Left ventricular performance and pulmonary circulation following addition of nitrous oxide to morphine during coronary-artery surgery. Anesthesiology, 1975, 43, 61.CrossRefGoogle ScholarPubMed
8. Marx, G. F., Mateo, C. V., & Orkin, L. R.Computer analysis of postanesthetic deaths. Anesthesiology, 1973, 39, 54–58.CrossRefGoogle ScholarPubMed
9. Ministry of Health. Births, mortality and infant mortality –Provisional data 1984, 1985, 1986. National Program of Health Statistics Bulletin No. 52, 05 1987.Google Scholar
10. Ministry of Health and Social Action (MSAS) and Pan American Health Organization. Argentina: Description of its health status. 1985.Google Scholar
11. Committee on Anesthesia, National Academy of Sciences – National Research Council. National halothane study. Journal of the American MedicalAssociation, 1966, 197, 775–78.CrossRefGoogle Scholar
12. The World Bank. Argentina, population, health and nutrition – Sector review. PHN Department, Mission Report, 1986.Google Scholar
13. Tieffenberg, J. A., Wood, I., Berbeglia, A., & Bagnoli, O.Annual distribution and costs utilization of private health services (1986) analysis of a model population: A report. Buenos Aires: ACINDES, 1987.Google Scholar
14. Vourc'h, G. Enquete epidemiologique sur les anesthesies. Annales Francaises d'Anesthesie et de Reanimation, 1983, 5.Google Scholar
15. Wikinski, , de, Leonardis, Perasso, , Arlia, , Torrieri, . Pharmacology and Pharmacodynamics of procaine in surgical general anesthesia. Revista Argentina de Anestesiologia, 1976, 34.Google Scholar