학술논문
Evaluation of effective coverage for type 2 diabetes in Mexican primary care health information systems: a retrospective registry analysis.
Document Type
Academic Journal
Author
Gallardo-Rincón H; Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico.; Ríos-Blancas MJ; Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico.; National Institute of Public Health, Av. Universidad 655, Cuernavaca, 62100, México.; Montoya A; Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico. airainmr@fundacioncarlosslim.org.; Saucedo-Martínez R; Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico.; Morales-Juárez L; Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico.; Mujica R; Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico.; Cantoral A; Health Department, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico.; Idueta LS; Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Floor 20, Col. Ampliacion Granada, Miguel Hidalgo, 11529, Mexico City, Mexico.; Lozano R; Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA.; Tapia-Conyer R; School of Medicine, National Autonomous University of Mexico, Av. Universidad 3000, Circuito Escolar CU, Edificio B 1Er Piso, Coyoacan, 04510, Mexico City, Mexico.
Source
Publisher: BioMed Central Country of Publication: England NLM ID: 101147692 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-9276 (Electronic) Linking ISSN: 14759276 NLM ISO Abbreviation: Int J Equity Health Subsets: MEDLINE
Subject
Language
English
Abstract
Background: As the leading cause of disability and the fourth leading cause of premature death in Mexico, type 2 diabetes (T2D) represents a serious public health concern. The incidence of diabetes has increased dramatically in recent years, and data from the Mexican National Health and Nutrition Survey (ENSANUT) indicate that many people remain undiagnosed. Persistent socioeconomic health care barriers exacerbate this situation, as T2D morbidity and mortality are worsened in vulnerable populations, such as those without social security. We evaluated the performance of public primary health centers (PHCs) in T2D medical attention through the measure of effective coverage (EC, a combined measure of health care need, use, and quality) at national, state, health jurisdiction, and municipality levels.
Methods: This retrospective analysis used blinded data recorded during 2017 in the Non-communicable Diseases National Information System (SIC) and T2D prevalence reported in 2018 ENSANUT to evaluate the EC achieved. We included individuals ≥ 20 years old without social security who did not declare the use of private health care services. Each EC component (need, use, and quality) was estimated based on the Shengelia adapted framework. The Kruskal-Wallis test was applied to evaluate the associations among EC quintiles and demographics.
Results: In 2017, 26.5 million individuals, aged ≥ 20 years, without social security, and without the use of private health care services, were under the care of 12,086 PHCs. The national prevalence of T2D was 10.3%, equivalent to 2.6 million people living with T2D in need of primary health care. Large contrasts were seen among EC components between and within Mexican states. We found that only 37.1% of the above individuals received health services at PHCs and of them, 25.8% improved their metabolic condition. The national EC was 9.3%, and the range (by health jurisdiction) was 0.2%-38.6%, representing a large geographic disparity in EC. We found an evident disconnect among need, utilization, and quality rates across the country.
Conclusions: Expansion and improvement of EC are urgently needed to address the growing number of people living with T2D in Mexico, particularly in states with vulnerable populations.
(© 2023. The Author(s).)
Methods: This retrospective analysis used blinded data recorded during 2017 in the Non-communicable Diseases National Information System (SIC) and T2D prevalence reported in 2018 ENSANUT to evaluate the EC achieved. We included individuals ≥ 20 years old without social security who did not declare the use of private health care services. Each EC component (need, use, and quality) was estimated based on the Shengelia adapted framework. The Kruskal-Wallis test was applied to evaluate the associations among EC quintiles and demographics.
Results: In 2017, 26.5 million individuals, aged ≥ 20 years, without social security, and without the use of private health care services, were under the care of 12,086 PHCs. The national prevalence of T2D was 10.3%, equivalent to 2.6 million people living with T2D in need of primary health care. Large contrasts were seen among EC components between and within Mexican states. We found that only 37.1% of the above individuals received health services at PHCs and of them, 25.8% improved their metabolic condition. The national EC was 9.3%, and the range (by health jurisdiction) was 0.2%-38.6%, representing a large geographic disparity in EC. We found an evident disconnect among need, utilization, and quality rates across the country.
Conclusions: Expansion and improvement of EC are urgently needed to address the growing number of people living with T2D in Mexico, particularly in states with vulnerable populations.
(© 2023. The Author(s).)