Introduction. Ischemic heart disease (IHD) is currently a public health problem in Peru, and its treatment tends to be very expensive for the health system. Goal. Establish the patterns of care costs of the EIC in the National Cardiovascular Institute (INCOR) of the Social Security in Health of Peru (EsSalud). Methods. The databases of care, surgeries, discharges and gross value of INCOR production of the population diagnosed and treated with IHD in 2019 (879 patients) were used. Costs of care were estimated using activity-based costing; an econometric model was used to establish the determinants of costs, and with the Euclidean distance method, “clusters” with similar characteristics were formed to establish cost patterns. Results. The highest cost of EIC care was 148 567 soles (US$ 44 830) for a patient with a 40-day stay. The main determinants of the cost of care were the hospital...

El desarrollo de instrumentos y herramientas para examinar la gestión de los programas sociales es un tema de permanente preocupación en la evaluación de las políticas sociales, por ello, este artículo reseña una forma de abordarla. Parece obvio que los resultados de la gestión de programas sociales se examinen a través de los efectos o impactos que se logren, pero una tarea importante es explorar los puntos críticos en la gestión del programa, con el fin de corregir limitaciones, problemas o errores que pudieran haber. Por tanto, se presentan elementos que sirven de marco de análisis teórico de los antecedentes, procesos, productos y actores que convergen en un programa social concreto, como es el Programa de Comedores Populares.

The technological development in the communications will be allowing a major level of access to the information and communication, in it there registers the adoption of a standard of digital terrestrial television (TDT) in Peru, which turns into an opportunity to improve the development of our society. This way then, the present study shows the relation that exists between technology and development from the perspective of access to the TDT and the characteristics of the TDT; likewise it indicates that 3 of every 4 homes in Peru it is ready to be TDT's demand; but that the bounding ones of poverty indicate that in order that it should exist a real demand of the equipments that allow to catch the TDT will be necessary a form of state subsidy.

El desarrollo de instrumentos y herramientas para examinar la gestión de los programas sociales es un tema de permanente preocupación en la evaluación de las políticas sociales, por ello, este artículo reseña una forma de abordarla. Parece obvio que los resultados de la gestión de programas sociales se examinen a través de los efectos o impactos que se logren, pero una tarea importante es explorar los puntos críticos en la gestión del programa, con el fin de corregir limitaciones, problemas o errores que pudieran haber. Por tanto, se presentan elementos que sirven de marco de análisis teórico de los antecedentes, procesos, productos y actores que convergen en un programa social concreto, como es el Programa de Comedores Populares.

The technological development in the communications will be allowing a major level of access to the information and communication, in it there registers the adoption of a standard of digital terrestrial television (TDT) in Peru, which turns into an opportunity to improve the development of our society. This way then, the present study shows the relation that exists between technology and development from the perspective of access to the TDT and the characteristics of the TDT; likewise it indicates that 3 of every 4 homes in Peru it is ready to be TDT's demand; but that the bounding ones of poverty indicate that in order that it should exist a real demand of the equipments that allow to catch the TDT will be necessary a form of state subsidy.

Introduction. The preventive services of health are very important like investment in the health of the people. If the secondary preventive services are examined to face the cervical cancer (CCU) in Peru, its access and demands are not equitable. In this article, the determining factors of the demand of services of Pap smear screening (services PAP) are identified and measured. Methods. One studied to a population of women of 30 to 49 years, with data of the Demographic Survey and of Family Health (ENDES) of years 2016 to 2019. A logistic model was used to explore the relation between demand of services PAP and variables of decision, socioeconomics and of health of the people. The predictability of the model based on the machine learning was examined. Results. The factors with the greatest probability of demand PAP services were having hypertension (OR = 4.76; 95% CI: 4.03 - 5.66) and be...

The present article is an advance of the study that develop in the Institute of Economic Investigations of the National University Main of Saint Marcos, pretends to be a frame of reference of the study on social security, thus it explores the economic context social Peruvian, to the light of the existent contradiction between economic growth and poverty; likewise examines the main characteristics of the employment, the demographical growth and the future the future changes for the society in terms of investment in the people through the social security; review also the state of the art of the social security in health and of pensions in the Peru. Finally presents the conceptual frame of what understand by social security from the economic approach.

El presente artículo explica el rol que juegan las organizaciones sociales en el financiamiento de los Programas Sociales, como es el caso del Programa de Comedores Populares en el Perú, donde el financiamiento recae fundamentalmente en la población (asociaciones de mujeres) que gestiona dichos Comedores Populares, pues sus aportes, mediante el trabajo y el “pago de bolsillo“, representan la mayor parte de recursos (cerca del 74% de recursos necesarios para que funcione el Programa). Por lo que en el presente artículo se presenta de manera explícita esta forma de organización como breve reseña del modelo de gestión y financiamiento de los Comedores Populares.

The present article is an advance of the study that develop in the Institute of Economic Investigations of the National University Main of Saint Marcos, pretends to be a frame of reference of the study on social security, thus it explores the economic context social Peruvian, to the light of the existent contradiction between economic growth and poverty; likewise examines the main characteristics of the employment, the demographical growth and the future the future changes for the society in terms of investment in the people through the social security; review also the state of the art of the social security in health and of pensions in the Peru. Finally presents the conceptual frame of what understand by social security from the economic approach.

El presente artículo explica el rol que juegan las organizaciones sociales en el financiamiento de los Programas Sociales, como es el caso del Programa de Comedores Populares en el Perú, donde el financiamiento recae fundamentalmente en la población (asociaciones de mujeres) que gestiona dichos Comedores Populares, pues sus aportes, mediante el trabajo y el “pago de bolsillo“, representan la mayor parte de recursos (cerca del 74% de recursos necesarios para que funcione el Programa). Por lo que en el presente artículo se presenta de manera explícita esta forma de organización como breve reseña del modelo de gestión y financiamiento de los Comedores Populares.

Identifica los factores determinantes de la demanda preventiva de la prueba de Papanicolaou (PAP); e identificar y medir la estrategia socialmente más rentable para hacer frente al Virus del Papiloma Humano (VPH), causa principal del CCU. Metodología. Para la demanda se propuso el uso del método de Aprendizaje Automático para entrenar y probar un Modelo Logit Binario. Para estudiar la rentabilidad social se realizó una evaluación económica en salud a través del “Análisis de costo-efectividad” y se propuso un “Modelo de Markov” según los antecedentes de enfermedad del CCU, se evaluaron las estrategias: a) Solo cribado de Papanicolaou y b) aplicación de la Vacuna Tetravalente contra la VPH más pruebas de Papanicolaou. Los resultados encontrados, indican que la demanda de servicios de tamizaje PAP, está determinada por factores como el conocimiento de la enfermedad, la ...

Background: Since the current medical recommendation for hormone replacement therapy (HRT) states that the most effective dosing schedules for the shortest time periods must be used, isoflavone compounds have become an interesting alternative, considering they have a good effect on bone mass, and this may be directly related with a reduction in fracture risk.Objective: 1) To determine if isoflavone-based therapy has a better cost-effectiveness (c-e) ratio compared to that of HRT; 2) to determine the incremental c-e ratio; and 3) to determine the sensitivity of our assessment uysing univariate and bivariate tests and also measuring changes in therapy adherence.Material and methods: Effectiveness was defined as “avoided fracture cases” for both therapeutic interventions. Costs were measured considering real expenses from the patients’ perspective (societal), reviewing cli...

Background: Since the current medical recommendation for hormone replacement therapy (HRT) states that the most effective dosing schedules for the shortest time periods must be used, isoflavone compounds have become an interesting alternative, considering they have a good effect on bone mass, and this may be directly related with a reduction in fracture risk.Objective: 1) To determine if isoflavone-based therapy has a better cost-effectiveness (c-e) ratio compared to that of HRT; 2) to determine the incremental c-e ratio; and 3) to determine the sensitivity of our assessment uysing univariate and bivariate tests and also measuring changes in therapy adherence.Material and methods: Effectiveness was defined as “avoided fracture cases” for both therapeutic interventions. Costs were measured considering real expenses from the patients’ perspective (societal), reviewing cli...

Objetivo: Estimar la costo efectividad de Abatacept combinado con Metotrexato (MTX) en comparación a otras DARMEs biológicas, en combinación con MTX, en pacientes con AR moderada a severamente activa. Materiales y métodos: Se adaptó un modelo de secuencias de tratamiento para la representación de la invalidez en términos del índice HAQ en un horizonte de 5 años de enfermedad para una cohorte de 1 000 pacientes. Abatacept en combinación con MTX se comparó contra etanercept, rituximab, infliximab, adalimumab y tocilizumab, todas asociadas a MTX. Resultados: El costo de tratamiento con Abatacept es de S/. 169 263 y su efectividad es de 1.96 AVAC. Respecto a etanercept, adalimumab, infliximab y tocilizumab, abatacept se ha mostrado más efectivo en términos de AVACs y menos costoso. Respecto a rituximab, abatacept presenta un índice de costo efectividad incremental de S/ 75 493 ...

Objective: To estimate the cost-effectiveness of Abatacept in combination with Methotrexate (MTX) versus other biologic DMARDs in combination with MTX in patients with moderately to severely active rheumatoid arthritis. Materials and methods: A sequential therapy model was adapted for representing disability using the HAQ Index in a 5-year horizon period for a 1000-patient cohort. Abatacept in combination with MTX was compared against etanercept, rituximab, infliximab, adalimumab, and tocilizumab, all of them combined with MTX. Results: The cost of abatacept therapy was S/. 169 263 and its effectiveness was found to be 1.96 QALY. Compared to etanercept, adalimumab, infliximab and tocilizumab, abatacept has shown to be the most effective agent in terms of QALYs and the least expensive. Compared to rituximab, abatacept has an incremental cost effectiveness ratio of S/. 75 49...

Objective: To estimate the cost-effectiveness of Abatacept in combination with Methotrexate (MTX) versus other biologic DMARDs in combination with MTX in patients with moderately to severely active rheumatoid arthritis. Materials and methods: A sequential therapy model was adapted for representing disability using the HAQ Index in a 5-year horizon period for a 1000-patient cohort. Abatacept in combination with MTX was compared against etanercept, rituximab, infliximab, adalimumab, and tocilizumab, all of them combined with MTX. Results: The cost of abatacept therapy was S/. 169 263 and its effectiveness was found to be 1.96 QALY. Compared to etanercept, adalimumab, infliximab and tocilizumab, abatacept has shown to be the most effective agent in terms of QALYs and the least expensive. Compared to rituximab, abatacept has an incremental cost effectiveness ratio of S/. 75 49...