OBJECTIVE: To analyze the emergency hospitalizations trend for ambulatory care sensitive conditions between 2011 and 2015 in a health insureance company of the Colombian Social Security General System. METHODS: A log-linear analysis based on age-adjusted hospitalization rates for ambulatory care sensitive conditions in the Entidad Promotora de Salud Sanitas was used to estimate the annual percentage change in these rates and to identify joinponts of the rates. Data was collected from administrative sources. RESULTS: There were 38,530 hospitalizations for ambulatory care sensitive conditions in 26,501 Entidad Promotora de Salud Sanitas enrollees, with a significant decrease in hospitalization rates. The annual percentage change estimated for the period was -9.5% with no significant joinpoints throughout the time interval. CONCLUSIONS: A significant reduction in hospital admissions due to ambulatory care sensitive conditions in Entidad Promotora de Salud Sanitas enrollees were reported for the last five years in this study.

Recomendaciones para el uso racional de la prueba 25-hidroxivitamina D Resumen de políticaRecommendations for the rational use of the 25-hydroxyvitamin D test

IntroductionEarly advice in the process of developing health technologies allows manufacturers to plan their production and transfer to health care systems more accurately. This review aims to describe frameworks used within HTA and their current use by HTA Agencies.Material and methodsWe carried out a systematic literature review in Pubmed, Embase, Scopus, and WoS, including all references published in Spanish and English. This was last updated in March 2022. We extracted all available information regarding the organizations involved, services offered, types of technology, collaborators involved, fees, output and impact. Websites of several HTA organizations and Google were also searched in order to update and complete the information obtained from this generic search.ResultsFive-hundred and forty one articles were identified and screened, of which 26 met the eligibility criteria and were selected. Seven of them were non-systematic reviews that described two or more HTA organizations. Ten studies were focused on the advice offered by individual organizations, and eight described the EMA and EUnetHTA parallel or joint advice. We found variations in the technology assessed, services offered, stage of development and costs for advisory services.ConclusionsEarly and scientific advice would help manufacturers focus their product development on what is needed for the management of specific diseases. Most of the examples or services found refer to drugs as well as to some medical devices and diagnostics. A common definition of the type of advice that could be offered for different health technologies by HTA bodies to ascertain health care systems and manufacturers' needs, in addition to the timeline in which that advice needs to be given, would help HTA bodies provide the right support at the right time.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020219401, PROSPERO CRD42020219401.

Background: Coronavirus disease (COVID-19) represents an unprecedented challenge for both people and health systems. Latin America is the current epicentre of the pandemic; however, there is little published clinical information on the clinical characteristics and outcomes.Objective: To analyse the clinic characteristics, risk factors and evolution of the first cohort of hospitalised patients with confirmed infection by COVID-19 in 5 Colombian institutions.Methods: In the present retrospective observational study, information was acquired from consecutive hospitalized patients with a diagnosis of COVID-19 confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) from March 01 to May 30, 2020 in Colombia.Results: A total of 44 patients were included. The median age was 62 years, and 65.9% of the patients were male. A total of 69.8% of the patients were overweight or obese, and 13.6% of the patients had high blood pressure and diabetes. The presence of systemic symptoms and cough were the most common. Ground-glass opacity was frequent finding upon chest imaging. The 30-day mortality rate was 47.7% with a median of 11 days. The composite outcome (critical care requirement, mechanical ventilation and death) occurred in 36.4% of the patients. The biomarkers associated with mortality risk included troponin higher than 14 ng/L (RR: 5.25; 95% CI 1.37-20.1, p = 0.004) and D-dimer higher than 1000 ng/ml (RR: 3.0; 95% CI 1.4-6.3, p = 0.008). Cardiovascular complications, acute respiratory distress syndrome (ARDS) and acute kidney injury were the most frequent comorbidities in patients with severe pneumonia.Conclusion: The clinical course of SARS-CoV-2 infection diagnosis confirmed by RT-PCR in Colombian patients admitted to a high-complexity hospital was similar to that reported in the literature; however, the population was characterised by a more advanced stage of the infection.

Introducción. La infección por SARS-COV2, que en principio se pensó solo causaba manifestaciones respiratorias, también puede ocasionar síntomas gastrointestinales, renales, neurológicos, cardiovasculares e incluso cutáneos según algunos reportes. Presentación del caso. Paciente femenina de 36 años quien asistió al servicio de urgencias por cuadró clínico consistente en disnea, astenia, adinamia, odinofagia leve y cefalea. Como antecedentes de relevancia se registró obesidad, tabaquismo y ocupación como trabajadora de la salud. Dados los síntomas, se indicó tratamiento antimalárico y antirretroviral para tratar COVID-19, diagnóstico que fue confirmado a los tres días de ingreso, pero al cuarto día de instaurado este manejo la mujer presentó polidipsia y rash macular, pruriginoso y generalizado. Por sospecha de toxicodermia, el tratamiento fue suspendido y con esto el cuadro cutáneo mejoró. Luego de 8 días de hospitalización, la paciente recibió el alta, junto con recomendaciones de bioseguridad y confinamiento durante 28 días. Conclusiones. El caso descrito corresponde a un evento de toxicodermia en una paciente con COVID-19 en manejo con antirretroviral y antimalárico. A partir de los hallazgos, se establece que la exploración minuciosa de piel y mucosas en los pacientes con sospecha o diagnóstico confirmado de COVID-19 puede ser de gran ayuda para la correcta caracterización de esta nueva enfermedad.