Epidemiologic changes and economic burden of hypertension in Latin America: evidence from Mexico.
ABSTRACT Costs of health services for hypertension and the financial consequences of epidemiologic changes in this disease are important concerns for health systems in Latin America.
We conducted longitudinal analyses of the economic impact of the epidemiologic changes on health care services for hypertension in the Mexican health care system. The cost evaluation method used was based on costing technique by production function and consensus techniques. To estimate the epidemiologic changes and financial consequences for the period 2005 to 2007, three probabilistic models were constructed according to the Box-Jenkins technique.
If changes are not implemented in prevention programs to reduce the effects of current risk factors, there will be increases in the number of patients with hypertension as well as in the financial burden to treat the disease. The amount allocated for hypertension in 2007, which will be 6% to 8% of the total health budget, is US$ 2,486,145,132. Of these, US$ 1,178,725,132 will be direct costs and US$ 1,307,420,000 will be indirect costs. Regarding epidemiologic changes for 2005 v 2007 (P < .05), an increase is expected, although results show a greater increase in insured populations.
If the risk factors and different health programs remain as they currently are, the economic impact of expected epidemiologic changes on the social security system will be particularly strong. Another relevant financial factor is the appearance of internal competition in the allocation of financial resources among the main providers of health services for hypertension; this factor becomes even more complicated within each provider.
Article: Oportunidades program participation and body mass index, blood pressure, and self-reported health in Mexican adults.[show abstract] [hide abstract]
ABSTRACT: Governments around the world are seeking to address the increasing prevalence of obesity and hypertension. Our objective was to evaluate the effect of an incentive-based development program (Oportunidades, formerly Progresa) on body mass index (BMI), blood pressure, and self-reported health. An intervention group of low-income (below the 20th percentile nationally), rural, Mexican adults (aged 30-65 years) (n = 5280) received program benefits (cash transfers contingent on positive changes in health behavior such as regular health checkups) for 3.5 to 5.0 years. They were compared with a newly recruited control group of adults (n = 1063) who had not yet begun receiving benefits. Analyses were adjusted for almost 50 social and economic covariates. Age- and sex-adjusted BMI was lower in adults from intervention communities than in those from control communities (26.57 kg/m(2) vs 27.16 kg/m(2), P < .001), as was the prevalence of obesity (20.28% vs 25.31%, P < .001) and overweight (59.24% vs 63.04%, P = .03); these results were attenuated after covariates were included. Adults in intervention communities had a lower combined prevalence of uncontrolled hypertension (33.80% vs 34.52%, P = .008) when adjusting for all covariates. Mean systolic (beta = -2.60, P < .001) and diastolic (beta = -2.84, P < .001) blood pressures were significantly lower in the intervention communities after all covariates were included, and self-reported health outcomes were better. Participation in Oportunidades, a large-scale cash-transfer program, was associated with lower prevalence of obesity and hypertension and better self-reported health in adults in rural Mexico.Preventing chronic disease 07/2008; 5(3):A81. · 1.82 Impact Factor
Article: Impact of insurance and supply of health professionals on coverage of treatment for hypertension in Mexico: population based study.[show abstract] [hide abstract]
ABSTRACT: To examine the independent and combined contributions of insurance status and supply of health professionals on coverage of antihypertensive treatment among adults in Mexico. Population based study. Mexico. 4032 hypertensive adults (2967 uninsured and 1065 insured): 1065 uninsured adults matched with 1065 adults insured through Seguro Popular, a programme to expand health insurance coverage to uninsured people in Mexico. Coverage of antihypertensive treatment and coverage of antihypertensive treatment with control of blood pressure. Rates of treatment for hypertension varied by insurance status and supply of health professionals. Hypertensive adults insured through Seguro Popular had a significantly higher probability of receiving antihypertensive treatment (odds ratio 1.50, 95% confidence interval 1.27 to 1.78) and receiving antihypertensive treatment with control of blood pressure (1.35, 1.00 to 1.82). Greater supply of health professionals in areas with coverage through Seguro Popular was a significant predictor of antihypertensive treatment after adjusting for covariates (1.49, 1.00 to 2.20). Expansion of healthcare coverage to uninsured people in Mexico was associated with greater use of antihypertensive treatment and blood pressure control, particularly in areas with a greater supply of health professionals.BMJ (Clinical research ed.). 11/2007; 335(7625):875.