Atención Médica en colangitis aguda

Abstract

This is descriptive study of 57 patients with acute cholangitis who were operated in El Salvador Hospital, (Santiago, Chile) between January 1987 and June 1989. The patients were divided into two groups; simple cholangitis and complicate cholangitis respectively. and the following factors were studied: the difference in medical care. factors associated with greater morbidity and mortality, and the cost of health care. The cost of care was calculated according to the day-bed occupancy, the use of ultrasound and the pre-or pos-operative use of antibiotics. It was found that the cholangitis is more serious if there is a delay in consulting, or a delay in making the diagnosis. This leads to operations that are longer and more complicated, longer day-bed occupancy and an increase in the prolonged use of expensive antibiotics as well as higher rates of mortality and morbidity in the post-operative period. It is interesting to note that there was less use of ultrasound in cases of complicated cholangitis. It was concluded that the factors studies lead not only to greater suffering for the patients and their relatives but also to more expensive medical care. The cost of medical care varied, according to prices set by the National Health Service, from $ 29.355 (USD 103) per case of simple cholangitis to $ 50.717 (USD 179) per case of complicated cholangitis, without taking into consideration the cost of ultrasound, laboratory tests or the operation itself. These values would be approximately doubled if they included the cost of the operation. A low price has been set for ultrasound, and so this would add little to the total cost.