<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2216-0973</journal-id>
<journal-title><![CDATA[Revista Cuidarte]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cuid]]></abbrev-journal-title>
<issn>2216-0973</issn>
<publisher>
<publisher-name><![CDATA[Programa de Enfermería, Facultad de Ciencias de la Salud, Universidad de Santander UDES]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2216-09732024000200015</article-id>
<article-id pub-id-type="doi">10.15649/cuidarte.3796</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Analysis of health outcomes in acute myocardial infarction: a value-based healthcare approach]]></article-title>
<article-title xml:lang="es"><![CDATA[Análisis de los resultados de salud en el infarto agudo de miocardio: un enfoque de atención en salud basada en el valor]]></article-title>
<article-title xml:lang="pt"><![CDATA[Análise dos resultados de saúde no infarto agudo do miocárdio: uma abordagem de saúde baseada em valor]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bermon]]></surname>
<given-names><![CDATA[Anderson]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Licht-Ardila]]></surname>
<given-names><![CDATA[Maricel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Manrique-Hernández]]></surname>
<given-names><![CDATA[Edgar Fabián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hurtado-Ortiz]]></surname>
<given-names><![CDATA[Alexandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad CES  ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Fundación Cardiovascular de Colombia  ]]></institution>
<addr-line><![CDATA[Piedecuesta Santander]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Fundación Cardiovascular de Colombia  ]]></institution>
<addr-line><![CDATA[Piedecuesta Santander]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Fundación Cardiovascular de Colombia  ]]></institution>
<addr-line><![CDATA[Piedecuesta Santander]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2024</year>
</pub-date>
<volume>15</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S2216-09732024000200015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S2216-09732024000200015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S2216-09732024000200015&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Understanding the impact of value-based healthcare and various healthcare payment models on the health outcomes of patients with acute myocardial infarction (AMI) is pivotal for guiding clinical strategies and decisions.  Objective: To compare health outcomes and costs associated with healthcare for AMI patients under insurance prospective global payment (PGP) and fee-for-service models.  Materials and Methods: A retrospective cohort study encompassing AMI patients was conducted from 2021-2023. Convenience sampling of participants over 18 years of age diagnosed with type 2 myocardial infarction was conducted. Analysis was based on Colombian healthcare system payment models: PGP and fee-for-service.  Results: The study involved 2134 patients, 657 (31%) under PGP and 1477 (69%) under fee-for-service. Length of hospital stay was associated with the payment model (coefficient -0.68, CI 95%: 0.40 to 0.98, p=0.037). Payment models also correlated with costs (845 USD, CI 95%: 87.92 to 1601; p=0.02). In-hospital mortality is not associated with either of the two contracting models. Quality-adjusted life years (QALYs) totaled 1.6 over a 2-year follow-up  Discussion: It is evident that throughout the care cycle at the Center of Excellence for Acute Myocardial Infarction, there is added value for patients with the PGP model, as the costs are lower and health outcomes comparable to the fee-for-service model.  Conclusions: The findings of this study underscore the importance of understanding the relationship between value-based healthcare, different healthcare payment models, and health outcomes in AMI patients.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: Es fundamental comprender cómo la atención en salud basada en el valor y los diversos modelos de contratación afectan los resultados de salud de los pacientes con infarto agudo de miocardio para orientar las estrategias y decisiones clínicas.  Objetivo: Comparar los resultados de salud y los costos asociados a la atención en salud de pacientes con infarto agudo de miocardio bajo los modelos de contratación de pago global prospectivo y pago por servicio.  Materiales y Métodos: Estudio de cohortes retrospectivo en pacientes con infarto agudo de miocardio realizado entre 2021 y 2023. Se realizó un muestreo por conveniencia de participantes mayores de 18 años con diagnóstico de infarto de miocardio tipo 2. El análisis se basó en dos modelos de contratación del sistema de salud colombiano: modelo de pago global prospectivo y modelo de pago por servicio.  Resultados: En el estudio participaron 2134 pacientes, 657 (31%) bajo el modelo pago global prospectivo y 1477 (69%) bajo el modelo de pago por servicio. La duración de la estancia hospitalaria se asoció con el modelo de contratación (coeficiente 0,68; 95% IC: 0,04 a 1,33; p=0,037). El modelo de contratación mostró correlación con los costos (coeficiente 845; 95% IC: 87,92 a 1601; p=0,02). La mortalidad intrahospitalaria no se asocia a ninguno de los dos modelos de contratación. Los AVAC totalizaron un valor de 1,6 durante un seguimiento de 2 años.  Discusión: Es evidente que en todo el ciclo de atención en el Centro de Excelencia para el Infarto Agudo de Miocardio existe un valor añadido para el paciente bajo el modelo de contratación de pago global prospectivo, ya que los costos son menores con resultados en salud comparables al modelo de contratación de pago por servicio.  Conclusiones: Es crucial comprender la relación entre la atención en salud basada en el valor, los distintos modelos de contratación y los resultados de salud de pacientes con infarto agudo de miocardio.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução: Compreender o impacto dos cuidados de saúde baseados em valor e de vários modelos de contratação nos resultados de saúde em pacientes com enfarte agudo do miocárdio é fundamental para orientar estratégias e decisões clínicas.  Objetivo: Comparar os resultados de saúde e os custos associados aos cuidados de saúde para pacientes com infarto agudo do miocárdio sob modelos prospectivos de pagamento global e taxa por serviço de seguros.  Materiais e Métodos: Estudo de coorte retrospectivo abrangendo pacientes com Infarto Agudo do Miocárdio, realizado de 2021 a 2023. Amostra de conveniência de participantes com 18 anos ou mais, com diagnóstico de infarto do miocárdio tipo 2. A análise baseou-se nas modalidades de contratação do sistema de saúde colombiano: modelo de pagamento global prospectivo e taxa por serviço.  Resultados: O estudo envolveu 2.134 pacientes, com 657 (31%) sob pagamento global prospectivo e 1477 (69%) sob taxa por serviço. O tempo de internação esteve associado ao modelo (Coeficiente 0,68, IC 95%: 0,04 a 1,33, p=0,037). Tipos de contratos correlacionados com custos (Coeficiente 845, IC 95%: 87,92 a 1601; p=0,02). A mortalidade intra-hospitalar não está associada a nenhum dos dois modelos de contratação. QALYs totalizaram 1,6 em um acompanhamento de 2 anos.  Discussão: É evidente que ao longo de todo o ciclo de atendimento no Center of Excellence for Acute Myocardial Infarction, há valor agregado para o paciente com o Modelo de Pagamento Global Prospectivo, pois os custos são menores com resultados de saúde comparáveis à taxa por serviço tipo de contratação.  Conclusões: Compreender a relação entre cuidados de saúde baseados em valor, diferentes modelos de contratação e resultados de saúde em pacientes com enfarte agudo do miocárdio é crucial.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Acute Myocardial Infarction]]></kwd>
<kwd lng="en"><![CDATA[Value-Based Health Care]]></kwd>
<kwd lng="en"><![CDATA[Hospital Costs]]></kwd>
<kwd lng="en"><![CDATA[Outcome Assessment]]></kwd>
<kwd lng="es"><![CDATA[Infarto Agudo de Miocardio]]></kwd>
<kwd lng="es"><![CDATA[Atención Médica Basada en Valor]]></kwd>
<kwd lng="es"><![CDATA[Costos de Hospital]]></kwd>
<kwd lng="es"><![CDATA[Evaluación de Resultados]]></kwd>
<kwd lng="pt"><![CDATA[Enfarto Agudo do Miocárdio]]></kwd>
<kwd lng="pt"><![CDATA[Cuidados de Saúde Baseados em Valores]]></kwd>
<kwd lng="pt"><![CDATA[Custos Hospitalares]]></kwd>
<kwd lng="pt"><![CDATA[Avaliação de Resultados]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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