Arredondo Armando, Díaz-Castro Lina, Cabello-Rangel Hector, Arredondo Pablo, Recaman Ana Lucía
Instituto Nacional de Salud Pública, Cuernavaca, México.
Instituto Nacional de Psiquiatría, Huipulco, México.
Cad Saude Publica. 2018 Feb 5;34(1):e00165816. doi: 10.1590/0102-311X00165816.
The study aimed to analyze the costs of medical care for mental disorders in the Mexican health system. This was a retrospective cross-sectional evaluation study. As markers for the problem, the study selected two of the principal psychological processes in mental disorders in recent years: depression and schizophrenia. Annual accumulated incidence was identified based on epidemiological reporting by type of institution in 2005-2013. The mean annual case management cost was determined with the instrumentation and consensus technique, identifying the production functions, types of inputs, costs, and amounts of inputs ordered, concentrated in the mean case matrix. Finally, an econometric adjustment factor was applied to control the inflationary effect for each year in the study period. Mean annual case management cost was USD 2,216.00 for schizophrenia and USD 2,456.00 for depression. All the institutions in the Mexican health system showed upward and constant epidemiological and economic trends. The total cost for the two disorders in the last year of the period (2013) was USD 39,081,234.00 (USD 18,119,877.00 for schizophrenia and USD 20,961,357.00 for depression). The largest impact for the two disorders combined was in institutions serving the population without health insurance (USD 24,852,321.00) versus the population with private insurance (USD 12,891,977.00). The cost of meeting the demand for services for the two disorders differs considerably between institutions that treat the population with private health service versus the population without, and is higher in the latter. The study's epidemiological and economic indicators provide evidence for decision-making in the use and allocation of healthcare resources for these two disorders in the coming years.
该研究旨在分析墨西哥卫生系统中精神障碍的医疗成本。这是一项回顾性横断面评估研究。作为该问题的指标,该研究选取了近年来精神障碍中两个主要的心理过程:抑郁症和精神分裂症。基于2005 - 2013年各机构类型的流行病学报告确定年度累计发病率。采用工具和共识技术确定平均年度病例管理成本,确定生产函数、投入类型、成本以及订购的投入数量,集中在平均病例矩阵中。最后,应用计量经济学调整因子来控制研究期间每年的通胀效应。精神分裂症的平均年度病例管理成本为2216.00美元,抑郁症为2456.00美元。墨西哥卫生系统中的所有机构在流行病学和经济方面均呈现上升且持续的趋势。该时期最后一年(2013年)这两种疾病的总成本为39081234.00美元(精神分裂症为18119877.00美元,抑郁症为20961357.00美元)。这两种疾病综合起来对未参保人群服务机构的影响最大(248