Armando Nevárez-Sida

Socioeconomic factors associated with drug consumption in prison population in Mexico

BackgroundConsumption of illegal drugs is a public health problem in Mexico, and the prison population is a vulnerable group with higher rates of prevalence than in the general population. The objective of this study was to determine the main socioeconomic variables associated with drug consumption in the prison population.MethodsUtilizing data from the Second Incarcerated Population Survey carried out by the Centre of Research and Teaching of Economics (CIDE) in Mexico, a logistic model in two stages was developed. The first stage analyzed the determinants of habitual drug consumption by prisoners (prior to admittance into prisons), while the second stage of the model addressed drug consumption within prisons.ResultsPrevalence of drug consumption previous to incarceration was 28.5%, although once people were imprisoned this figure dropped to 7.4%. The characteristics that most heavily influenced against the possibility of habitual drug consumption prior to admittance to prison were: preparatory school or higher, being employed and having children; while the variables associated negatively were: male gender, childhood home shared with adults who consumed illegal drugs; abandoning childhood home; and having previous prison sentences. Once in prison, the negative conditions in there are associated with drug consumption.ConclusionsWork and study during incarceration, in addition to being instruments for rehabilitation, seem to exert an important positive association against drug consumption. However, this correlation seems to be minimized in the face of negative conditions of the penal institution; thus, public policies are necessary to improve the prisoners environment.

Triggering factors of primary care costs in the years following type 2 diabetes diagnosis in Mexico.

BACKGROUND AND AIMS Diabetes represents a high epidemiological and economic burden worldwide. The cost of diabetes care increases slowly during early years, but it accelerates once chronic complications set in. There is evidence that adequate control may delay the onset of complications. Management of diabetes falls almost exclusively into primary care services until chronic complications appear. Therefore, primary care is strategic for reducing the expedited growth of costs. The objective of this study was to identify predictors of primary care costs in patients without complications in the years following diabetes diagnosis. METHODS Direct medical costs for primary care were determined from the perspective of public health services provider. Information was obtained from medical records of 764 patients. Microcosting and average cost techniques were combined. A generalized linear regression model was developed including characteristics of patients and facilities. Primary health care costs for different patient profiles were estimated. RESULTS The mean annual primary care cost was USD

Costos medicos directos en pacientes con enfermedad pulmonar obstructiva Crónica en Mexico

465.1. Gender was the most important predictor followed by weight status, insulin use, respiratoty infections, glycemic control and dyslipidemia. A gap in costs was observed between genders; women make greater use of resources (42.1% on average). Such differences are reduced with obesity (18.1%), overweight (22.8%), respiratory infection (20.8%) and age >80 years (26.8%). Improving glycemic control shows increasing costs but at decreasing rates. CONCLUSIONS Modifiable factors (glycemic control, weight status and comorbidities) drive primary care costs the first 10 years. Those factors had a larger effect in costs for males than in for females.

Direct Medical Costs for Partial Refractory Epilepsy in Mexico

INTRODUCTION chronic obstructive pulmonary disease (COPD) is a progressive, incurable and potentially mortal. COPD generates a high burden of illness and decreased quality of life in patients. The aim of this study was to determine the direct medical cost of COPD and the primary variables associated. METHODOLOGY We conducted a multicenter clinical study, based in a retrospective cohort as base of a partial economic evaluation in patients diagnosed with moderate to severe COPD. It was considered an institutional point of view to determine medical costs, with an annual time horizon. For analysis of associations between explanatory and end point variables, a generalized lineal regression model was developed. RESULTS We analyzed data from 283 patients, Fifty-nine percent were women, the average age was 72 years ± 11, Sixty-five percent of patients had a history of smoking and 57.6 % were exposed to wood smoke. The annual direct medical costs (MXN 2016) was 20,754 and 41,887 for patients with moderate and severe COPD, respectively, this difference is mainly due to the use of oxygen as well as longer hospital stay (12.9 vs. 24.7 days) of patients with severe COPD. CONCLUSIONS Although the severity level is associated with greater health care costs, the quality of life of the patients should be considered carefully because it is inversely associated with the cost of care for patients with COPD.