Abstract
ABSTRACTOBJECTIVE To analyze the epidemiological and economic burden of the health services demand due to diabetes and hypertension in Mexico.METHODS Evaluation study based on a time series study that had as a universe of study the assured and uninsured population that demands health services from the three main institutions of the Health System in Mexico: The Health Department, the Mexican Institute of Social Security, and Institute of Services and Social Security for State Workers. The financing method was based on instrumentation and consensus techniques for medium case management. In order to estimate the epidemiological changes and financial requirements, a time series of observed cases for diabetes and hypertension 1994–2013 was integrated. Probabilistic models were developed based on the Box-Jenkins technique for the period of 2013–2018 with 95% confidence intervals and p < 0.05.RESULTS Comparing results from 2013 versus 2018, in the five regions, different incremental trends of 14%–17% in epidemiological changes and 58%-66% in the economic burden for both diseases were observed.CONCLUSIONS If the risk factors and the different models of care remained as they currently are in the three institutions analyzed, the financial consequences would be of greater impact for the Mexican Institute of Social Security, following in order of importance the Institute of Services and Social Security for State Workers and lastly the Health Department. The financial needs for both diseases will represent approximately 13%–15% of the total budget allocated to the uninsured population and 15%–17% for the population insured depending on the region.
Highlights
Como resultado del análisis de las funciones de autocorrelación y autocorrelación parcial, se propusieron los siguientes modelos: Modelo 1 – Operador de movimiento promedio de orden 1: Zτ
Costos totales de hipertensión en diferentes estados
Se invierten totalmente la tendencia en los estados, de manera que Yucatán quedó en primer lugar y Jalisco en último lugar por orden de importancia en el impacto
Summary
Fuentes: Consejo Nacional de Población – Instituto Nacional de Estadística y Geografía, 2000–2015. Los resultados fueron presentados en Moneda Nacional y dólares de EUA, al tipo de cambio en junio de 2015 y con una tasa de cambio de 1 $EUA = 14.35 $Mex. Los resultados para el caso de diabetes y de hipertensión fueron similares en el desarrollo del modelo excepto en el número de casos por tipo de enfermedad, como se aprecia más adelante. Como resultado del análisis de las funciones de autocorrelación y autocorrelación parcial, se propusieron los siguientes modelos: Modelo 1 – Operador de movimiento promedio de orden 1: Zτ. En todos los estados se observaron tendencias epidemiológicas de casos observados y esperados para diabetes e hipertensión crecientes constantes, con picos irregulares antes del 2012, sobre todo en Jalisco, donde se observó la mayor carga epidemiológica en términos absolutos (Tabla 3).
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