Browsing by Author "Espinoza Ortega, Gerson"
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Item Simulación en Dinámica Sistema de la Enfermedad Renal Crónica en Nariño.(2023) Espinoza Ortega, Gerson; Wilfredo GuaitaThis article aims to model the healthcare system for comprehensive healthcare of CKD (Chronic Kidney Disease) in the Department of Nariño using system dynamics. To achieve this, the burden of CKD in the Department of Nariño was projected through data search and collection from secondary sources such as articles, DANE National Population and Housing Census 2018 - CNPV-2018, Higia de CAC, SISPRO, Nariño Departmental Health Institute (IDSN), and the Bank of the Republic of Colombia. Model and submodels were constructed using system dynamics in the Vesim tool to simulate the causal chain of the disease, obtaining prevalence, incidence, mortality, stage transitions, healthcare costs, and service supply for CKD and its precursor diseases from 2018 to 2050. The estimated prevalence of hypertension (HTN) in the Department of Nariño was 25.20%, and for diabetes mellitus (DM) it was 6.70%. The most common stage of CKD was stage 3, accounting for 43.53%. Hemodialysis was the most frequent type of renal replacement therapy (RRT), with an average of 62.64%. The average per capita healthcare cost for individuals with HTN and/or DM was $701,685. The average per capita healthcare cost for CKD without RRT was $801,459, while for CKD with RRT, it was estimated at $36.88 million per person, making it 529.65 times more expensive than the healthcare for the HTN and/or DM population without CKD. The total cost of CKD precursor diseases and CKD during the study period ranged from 6.39% to 11.08% of the Unit Cost Per Capita (UPC). In conclusion, the prevalence of CKD precursor diseases and CKD is increasing, as well as the cost of intervention in the Department of Nariño, due to late detection, high prevalence, rapid progression, and expensive treatment of advanced stages of CKD.