Asociación entre la cuota moderadora y la frecuencia en la consulta a los servicios de urgencias en pacientes adultos con asma, usuarios del régimen contributivo en Colombia

Objective. To determine the relation between the moderating fee and the frequency of consultations to emergency services in patients with asthma who belong to the contributory insurance regime in Colombia. Methods. A retrospective cohort - analytical observational study was conducted which included contributors over the age of 18 with a diagnosis of asthma, users of the contributory regime who were registered in the database for calculating the Capitation Unit between the years 2012 and 2014; the patients were recruited during 2013 and the cohort was followed for one year from the admission date; the consultation frequency at the emergency service was used as the outcome variable, the influence of the principal confounding variables was evaluated, and a model of negative binomial regression for data analysis was applied. Results. 54 516 asthmatic patients with their comorbidities were included, of which 13.69% consulted emergency services. After controlling by the Charlson index and age of emergency consultation, the risk of consulting emergency services is 1.1 times more frequent in level 3 of the moderating fee with respect to level 1. Conclusions. It is suggested that moderating fee could behave as an access barrier to health services in asthmatic patients. It is recommended that studies to evaluate this hypothesis more precisely be carried out.