[Health impact and treatment costs of community-acquired pneumonia in children in the first level of public attention in Argentina].
Community acquired pneumonia in children remains an important cause of childhood deaths throughout the world that can be prevented by the use of antibiotics and access to medical care. Both were reduced in 2001 when Argentina suffered a severe social crisis. Among the responses to the crisis, the Remediar Program provided free essential medicines to the socially vulnerable population.


OBJECTIVE
Assess the health impact and costs of the provision of free medicines at the first level of public attention for childhood pneumonia.


METHODS
Three designs: 1. Ecological study with cross comparisons of diagnoses, prescriptions, beneficiaries by individual provinces of Remediar forms.


METHODS
children under 15 years old attended at 6 thousand health centres in Argentina, encompassing 24 Argentine provinces from March 2005 until February 2006. 2. Counterfactual approach. 3. Calculation of drug costs per unit of outcome.


RESULTS
Over 15 million prescriptions were identified, 2,420 children under 1 year, 19,205 of 1 to 4 years and 15,977 from 5 to 14 years old with pneumonia. 90% of beneficiaries received antibiotics, most often amoxicillin. In children's under 5 years of age, Remediar coverage was 27.8%, with greater impact in the poorest provinces. The likely impact was 4,322 lives saved or 310,325 years of life lost avoided if mortality without antibiotics was 20%. Indigents who had children with pneumonia saved by medicines 14.3% of their income. Each life saved could have cost US $ 6.46 and each year of life lost averted US $ 0.09.


CONCLUSIONS
This work highlights the impact of a low-cost health program for the treatment of vulnerable populations with childhood pneumonia in Argentina.
Bernztein
Ricardo
R
Programa Remediar, Hospital Nacional de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires. rbernztein@proaps.gov.ar
Drake
Ignacio
I
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use*; D001118:Argentina; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000191:economics; D003365:Costs and Cost Analysis; D006801:Humans; D007223:Infant; D017063:Outcome Assessment, Health Care; D011014:Pneumonia / Q000188:drug therapy* / Q000191:economics*; D011320:Primary Health Care; D017150:Public Sector
D000900:Anti-Bacterial Agents