Arredondo Armando, Duarte Maria Beatriz, Cuadra Silvia Magali
Cuernavaca, Mexico.
Int J Health Plann Manage. 2017 Apr;32(2):e121-e136. doi: 10.1002/hpm.2362. Epub 2016 May 30.
This study estimated the epidemiological and financial indicators of hypertension in order to identify challenges in strategic planning and management for health systems in Latin America. This is a longitudinal study with a population base of 187 326 reported cases of older adults with hypertension, diagnosed at public health institutions in Mexico. The cost-evaluation method that was used was based on the instrumentation and consensus techniques. To estimate the epidemiological changes and financial consequences for 2015-2017, time series analyses and probabilistic models were constructed according to the Box-Jenkins technique. Regarding epidemiological changes for 2015 versus 2017, an increase of 8-12% is expected (p < 0.001). Comparing the economic impact in 2015 versus 2017 (p < 0.001), there is a 22% increase in financial requirements. The total amount estimated for hypertension in 2015 (in US dollars) was $1 575 671 330. It included $747 527 259 as direct costs and $829 144 071 as indirect costs. If the risk factors and the different healthcare services for older adults remain as they are currently, the financial consequences of epidemiological changes in older adults will have a major impact on the users' pockets, following in order of importance, on social security providers and on public assistance providers. The challenges and implications of our findings in the context of universal coverage reforms in Latin America reinforce the urgent need to develop more and better strategic planning for the prevention of chronic diseases. Copyright © 2016 John Wiley & Sons, Ltd.
本研究估算了高血压的流行病学和财务指标,以便确定拉丁美洲卫生系统在战略规划和管理方面面临的挑战。这是一项纵向研究,以墨西哥公共卫生机构诊断出的187326例老年高血压病例为人群基础。所采用的成本评估方法基于仪器测量和共识技术。为了估算2015 - 2017年的流行病学变化和财务后果,根据Box-Jenkins技术构建了时间序列分析和概率模型。关于2015年与2017年的流行病学变化,预计增加8 - 12%(p < 0.001)。比较2015年与2017年的经济影响(p < 0.001),财务需求增加了22%。2015年高血压的估算总额(以美元计)为1575671330美元。其中包括747527259美元的直接成本和829144071美元的间接成本。如果老年人的风险因素和不同医疗服务保持现状,老年人流行病学变化的财务后果将对用户口袋产生重大影响,其次按重要性依次影响社会保障提供者和公共援助提供者。我们的研究结果在拉丁美洲全民覆盖改革背景下的挑战和影响,强化了为预防慢性病制定更多更好战略规划的迫切需求。版权所有© 2016 John Wiley & Sons, Ltd.