The financial and health burden of diabetic ambulatory care sensitive hospitalisations in Mexico

Lugo-Palacios, David; Cairns, John

doi:10.21149/spm.v58i1.7665

Cited by 11 publications

(18 citation statements)

References 11 publications

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“…El gasto generado por la atención a la diabetes y a sus complicaciones es considerable, tanto para los sistemas de salud como para los enfermos y sus familias. [38][39][40] Es fundamental para la aplicación de medidas preventivas la identificación de los sujetos con prediabetes o diabetes no diagnosticada, mediante scores autoaplicados o a partir de preguntas que personal de los servicios de salud pueden hacer. Si se determina que podrían tener prediabetes o diabetes, deberán realizarse estudios de laboratorio para confirmar o descartar el diagnóstico.…”

Section: Discussionunclassified

Diseño y validación de un score para detectar adultos con prediabetes y diabetes no diagnosticada

et al. 2018

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Objetivo. Diseñar y validar un score de riesgo de fácil aplicación para detectar prediabetes y diabetes no diagnosticada en población mexicana. Material y métodos. Empleando la información del estudio de cohorte de 10 234 adultos del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), se identificaron factores de riesgo incluidos en modelos de regresión logística múltiple estratificados por sexo. Los coeficientes beta fueron multiplicados por 10 para obtener el peso de cada variable en el score. Una submuestra de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 se usó para validar el score. Resultados. El score propuesto clasificó correctamente 55.4% a las mujeres con diabetes no diagnosticada y 57.2% a las mujeres con prediabetes o diabetes. Por su parte, clasificó correctamente a los hombres en 68.6 y 69.9%, respectivamente. Conclusiones. Presentamos el diseño y validación de un score de riesgo estratificado por sexo para determinar si un adulto podría tener prediabetes o diabetes, en cuyo caso deberán realizarse estudios de laboratorio para confirmar o descartar el diagnóstico.

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Section: Discussionunclassified

Diseño y validación de un score para detectar adultos con prediabetes y diabetes no diagnosticada

et al. 2018

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“…Other studies have estimated preventable hospitalization rates by defining a group of diseases where there was evidence of outpatient care effectiveness in reducing hospital admissions and claimed that every hospitalization event related to those causes might have been prevented [5,[12][13][14]30].…”

Section: Discussionmentioning

confidence: 99%

“…other studies have analyzed hospitalization trends for potentially preventable chronic conditions, which at the same time, helped to indirectly measure outpatient care effectiveness and quality [11][12][13][14][15][16][17]. Thus, several studies have provided evidence regarding different interventions to avoid hospitalization and the use of emergency services in diabetic patients [18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…The impact that such integrated programs have on death rates, and the frequency of the diseases that have been focused on, have been documented by PREVENIMSS [23]. This program has also allowed the Institute to estimate the diabetes preventable hospitalization burden at the IMSS; however, the effects of diabetes controlled though outpatient care services on hospitalization has not been studied in Mexico [12,24]. In Australia, from 2006 to 2014, a cohort study was performed among a group of government veterans to estimate the impact that the General Practitioner Management Plan (GPMP) had over diabetes hospitalization risk [25].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation in the first level of care of patients with type 2 diabetes and their risk of hospitalization in Mexico

Fernández-Gárate

Manuel‐Apolinar

Zurita‐Cruz

et al. 2020

Preprint

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Background: A significant body of international evidence suggests that effective primary care systems are associated with better health, lower total health costs, and more equitable access to health care services, which has led the World Health Organization (WHO) to call for strengthening primary care systems globally. Patients with diabetes often seek treatment and have follow-up as outpatients, be it at private or government health facilities. Thus, the objective of this study was to assess the effect of glucose control during outpatient care on first hospitalization risk in type 2 diabetes mellitus (T2DM) patients.Methods: The data used in this retrospective cohort study were obtained from the Non-Communicable Diseases Analysis System (SANENT)® of the Instituto Mexicano del Seguro Social (IMSS). Thus, this work was performed on 3,716,031 DM2 patients, with data regarding a first hospitalization risk estimated using a Cox regression model.Results: The first hospitalization crude risk for diabetes mellitus decreased by 32% in T2DM patients under control through outpatient care (HR: 0.68, 95% CI [0.68,0.69]). Adjusted risk decreased by 23% (HR: 0.77, 95% CI [0.76, 0.77]).Conclusion: The obtained results are consistent with what has been stated in the literature. Outpatient care of diabetic patients at the IMSS should be further strengthened by means of preventive and educational strategies and supported by technology.

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“…The health costs of treating chronic ulcers in diabetic patients with venous leg ulcers and diabetic foot ulcers are five times higher than in diabetic individuals with no ulcer [4,7]. Those costs are mainly related to hospitalizations, more frequent in diabetics, but also to the care costs of treatment and follow-up of outpatient clinical management [8][9][10][11].…”

mentioning

confidence: 99%

Cost of treatment and reduction achieved by chronic ulcer in diabetic patients - a comparison between hydrogel and human recombinant Epidermal Growth Factor

Deutsch

Oliveira

Pessanha

et al. 2019

Preprint

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Background: The study provides results from a double-blind clinical trial of 25 patients with diabetic or venous chronic ulcers. The main focus was to evaluate the assessing cost of outpatient treatment with two technologies: 2% carboxymethylcellulose hydrogel or human recombinant Epidermal Growth Factor carbogel. Methods: Patients were randomly allocated to two ulcer treatment groups, human recombinant Epidermal Growth Factor carbogel treated (intervention group, n = 14), and 2% carboxymethylcellulose hydrogel (CMC) (control group, n = 11); both treated during 90 days. To calculate the costs of each patient's procedures, direct costs and human resources costs were measured in Brazilian currency and converted into US dollars. Statistical analysis of clinical data was performed based on intention to treat. For each treatment were analyzed the proportion of cases with wound reduction; cost benefit of the treatment given by the average value of each 1cm2 wound reduction; statistics on the cost of reducing each cm2 of wound for each patient presenting wound reduction. Results: In all evaluated periods, the proportion of cases with decreased lesion area was higher in the intervention group; It presented better cost-benefit ratio and lower average and median reduction cost for each reduced cm2 of the wound. Conclusion: Data suggested that growth factor therapy may be cost-effective and innovative complement to standard wound care.

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The financial and health burden of diabetic ambulatory care sensitive hospitalisations in Mexico

Cited by 11 publications

References 11 publications

Diseño y validación de un score para detectar adultos con prediabetes y diabetes no diagnosticada

Diseño y validación de un score para detectar adultos con prediabetes y diabetes no diagnosticada

Evaluation in the first level of care of patients with type 2 diabetes and their risk of hospitalization in Mexico

Cost of treatment and reduction achieved by chronic ulcer in diabetic patients - a comparison between hydrogel and human recombinant Epidermal Growth Factor

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