Georgina Mayela Núñez-Rocha

Costo de la atención de la hipertensión arterial y su impacto en el presupuesto destinado a la salud en México

Objetivo. Determinar el costo de la atencion de la hipertension arterial, su impacto en el gasto en salud y en el producto interno bruto (PIB) de Mexico. Material y metodos. Diseno ecologico, efectuado de junio a noviembre de 1999 en el Instituto Mexicano del Seguro Social (IMSS), en la ciudad de Monterrey, Nuevo Leon, Mexico. Se selecciono aleatoriamente una muestra de expedientes clinicos con diagnostico de hipertension arterial, a los cuales se les contabilizo el uso de los servicios de salud y paralelamente se estimo el costo unitario por servicio. El costo por servicio y por paciente hipertenso se calculo ajustando el costo unitario en funcion de la utilizacion promedio y de un escenario extremo, cantidad que se proyecto a la poblacion total de hipertensos y el resultado se comparo con el gasto anual en salud realizado en Mexico. Resultados. El costo anual por hipertenso en la Seguridad Social correspondio a

The Cost of Diabetes Mellitus and Its Impact on Health Spending in Mexico

1 067 en el escenario promedio y de

Eficiencia técnica de la atención al paciente con diabetes en el primer nivel

3 913 en el escenario extremo. El gasto anual en hipertension arterial equivale a 13.95% del presupuesto destinado a la salud y a 0.71% del PIB, valores que se modifican a 51.17% y 2.62% respectivamente en el escenario extremo. Conclusiones. La hipertension arterial consume gran cantidad de recursos, por lo que debera ser objeto de estudio por equipos multidisciplinarios de salud, en la busqueda de alternativas de manejo mas eficientes.

Obesidad como Factor de Riesgo para Trastornos Metabólicos en Adolescentes Mexicanos, 2005

BACKGROUND The objective of this study was to determine the cost of diabetes mellitus, its impact on health spending in Mexico, and its percentage of the gross domestic product (GDP). METHODS There was a four-stage approach: identification of the epidemiology of the use of health services; estimate of treatment cost; determination of the diabetic population, and calculation of the percentage of health spending. RESULTS The average annual cost per diabetic patient was

Necesidades en salud del diabético usuario del primer nivel de atención

708 U.S. dollars (USD), the total annual cost of diabetics was

Diabetes y consulta médica grupal en atención primaria: ¿Vale la pena el cambio?

2,618,000 USD, the percentage of health spending was 15.48%, and the percentage of the GDP was 0.79%. CONCLUSIONS It is necessary to seek strategies that allow for a more efficient use of resources designated for type 2 diabetes treatment.

Accesibilidad geográfica para detección temprana de enfermedades crónico-degenerativas

Objective. To quantify the technical efficiency of diabetes care in family practice settings, characterize the provision of services and health results, and recognize potential sources of variation. Material and Methods. We used data enve lopment analysis with inputs and outputs for diabetes care from 47 family units within a social security agency in Nuevo Leon. Tobit regression models were also used. Results. Seven units were technically efficient in providing services and nine in achieving health goals. Only two achieved both outcomes. The metropolitan location and the total number of consultations favored efficiency in the provision of services regardless of patient attributes; and the age of the doctor, the efficiency of health results. Conclusions. Performance varied within and among family units; some were efficient at providing services while others at accomplishing health goals. Sources of variation also differed. It is necessary to include both outputs in the study of efficiency of diabetes care in family practice settings.

Desnutrición en prescolares de familias migrantes

OBJECTIVE Determining the prevalence and estimating the risk of obesity for dyslipidemia and hyperinsulinemia in adolescents. The existence of a linear association betweenanthropometric measures, lipids and insulin was also evaluated. MATERIAL AND METHODS A comparative study was carried out amongst obese (body mass index=BMI >95th percentile for age and gender; n=120) and non-obese adolescents (BMI <85th percentile for age and sex; n=120) aged 10-19. A structured questionnaire was used for collecting anthropometric and demographic data. Glucose, insulin and lipid profiles were obtained for each adolescent. RESULTS Prevalence of at least one dyslipidemia was 56,6 % among obese adolescents and 20,8 % amongst non-obese ones (p<.001). The former registered 50 % prevalence of hyperinsulinemia, the latter 4 % (p<.001). Obesity increased hyperinsulinemia risk having a 23 odds ratio (8.3-68.9 95 % CI) and for at least one dyslipidemia (OR=5,0; 2,7-9,2 95 % CI). Insulin level significantly correlated with BMI (r=0,57), triglycerides (r=0,57), VLDL (r=0,57), HDL (-0,37), waist-hip circumference index (r=0,29), cholesterol (r=0,22), and LDL (r=0,13). CONCLUSIONS Obesity can be considered to be a risk factor for developing metabolic disorders in adolescents. In fact, there was a linear relationship between anthropometric measurement, lipids and insulin. Prevention should focus on improving predisposing environments for obesity amongst families having children and teenagers. Emphasising life-styles and healthy behaviour is essential, as well as training and treatment options for complete care of individuals in this age-group.

Prácticas preventivas de los habitantes mayores de 25 años en Monterrey y su zona metropolitana (México)

Objetivo. Determinar la magnitud y jerarquizar la necesidad de salud satisfecha del diabetico tipo 2, usuario del primer nivel de atencion. Material y metodos. Se realizo un estudio transversal comparativo con representatividad rural y urbana, en el Instituto Mexicano del Seguro Social, en Nuevo Leon, en 1999. Fueron entrevistados, al azar, 256 diabeticos tipo 2 con dos o mas anos de diagnostico. La informacion fue complementada con el expediente clinico y encuesta al proveedor. Se evaluaron cinco areas y cuatro determinantes de salud, con base en estandares de la Norma Oficial Mexicana y la Asociacion Americana de Diabetes. El plan de analisis consistio en estadistica descriptiva y estimacion de puntajes z. Resultados. Se registro una media de satisfaccion global de necesidades de salud de 48.8%. En la zona rural la media de satisfaccion fue menor que en la urbana (36.8% vs 53.3%, p http://www.insp.mx/salud/index.html

Necesidades de accesibilidad para acciones preventivas. Una perspectiva de la población en Monterrey, México en 2005

Two cohorts of type 2 diabetic patients, matched by sex, ageand fasting plasma glucose (FPG) were studied. Group visits (monthly medical consultationand one hour sessions with group interaction on the same day) were implemented in 600patients and routine visits (monthly one-to-one medical consultation) were implemented in 601patients. The evolution on FPG, cholesterol, systolic (SBP) and diastolic blood pressure (DBP)and body mass index (BMI) were compared.