Estudio de variabilidad geográfica de las hospitalizaciones potencialmente evitables en México durante tres quinquenios

Valdés-Hernández, Javier; Reyes-Pablo, Aldelmo Eloy; Canún‐Serrano, Sonia; Navarrete-Hernández, Eduardo

doi:10.24875/gmm.17003613

Cited by 3 publications

(4 citation statements)

References 9 publications

(8 reference statements)

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“…There appears to be little change between the different measures of variation, and there is consistency in terms of the relative magnitude of variation. But, with respect to SCV, the change remains constant, and in a second period of 2015 to 2017, high variation by SCV ≥ 3 is observed (according to McPherson) (27).…”

Section: Resultsmentioning

confidence: 93%

“…Regarding ACSC as causes of avoidable hospitalizations, we took as a starting point the classification of Purdy 2009 (5), which included 19 categories, adding two additional categories that apply to their context in Mexico based on previous studies (17,26,27). These 21 categories of ACSC were grouped into acute, chronic and preventable by vaccination, using the classification proposed by Page (7).…”

Section: Standardization By Age and Sexmentioning

confidence: 99%

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Avoidable Hospitalization Trends From Ambulatory Care-Sensitive Conditions in the Public Health System in México

Verástegui

Torres-Arreola

Flores‐Hernández

et al. 2022

Front. Public Health

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ObjectivesTo estimate and identify the variations in rates of Avoidable Hospitalization for Ambulatory Care Sensitive Conditions (AH-ACSC) in public institutions of the Mexican health system during the period 2010–2017.MethodsSecondary analysis of the hospital discharge database of the Ministry of Health (MoH) from 2010 to 2017. AH for ACSC was calculated by age group and sex per 100,000. Variations per year between institutions were calculated with the extreme quotient (EQ), coefficient of variation (CV) and systematic component of variance (SCV). Adjusted AH rates were calculated by group of causes (acute, chronic and preventable by vaccination). Adjusted AH trend rates were analyzed by Join Point Regression.ResultsFor the period 2010–2017, the number of AH for ACSC decreased from 676,705 to 612,897, going from almost 13% to 10.7% of hospital discharges. There is consistency in terms of relative variance magnitude. But, with regards to SCV, the change remained constant, and in a second period of 2015–2017, high variation was observed by SCV ≥ 3. All-cause AH is diminishing in all institutions. AH rates for diabetes are the highest, but like other chronic diseases, there was a decline in the period from 2010 to 2017. The relative reduction varied from 15% for heart failure to 38% for complications from diabetes or hypertension, to 75% for angina.ConclusionsAH for ACSC is an indirect indicator of quality and access to first-level care. Variations by institutions are observed. This variation in CV and SCV across subsystems and states may be due to inequities in the provision of services. The factors that contribute to the burden of AH for ACSC in the Mexican Health System require detailed analysis.

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Section: Resultsmentioning

confidence: 93%

Section: Standardization By Age and Sexmentioning

confidence: 99%

Avoidable Hospitalization Trends From Ambulatory Care-Sensitive Conditions in the Public Health System in México

Verástegui

Torres-Arreola

Flores‐Hernández

et al. 2022

Front. Public Health

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“…En México, un estudio de HCSCA que abarcó tres quinquenios encontró que la DM, las gastroenteritis y otras enfermedades de las vías respiratorias inferiores fueron las de mayor porcentaje, y llegaban a constituir casi la mitad de las HCSCA en cada quinquenio (24).…”

Section: Discussionunclassified

“…Esta elección está respaldada por evidencia científica en la extensa bibliografía internacional (4). En ese contexto, las HCSCA pueden ser un indicador indirecto de la capacidad de resolución de la APS, de la efectividad, de la eficiencia, de la calidad de los servicios y de la reducción de los costos hospitalarios (7). Este concepto se desarrolló en Estados Unidos de América a mediados de los años ochenta para analizar el acceso de la población a la atención médica, y a finales de los años noventa lo propuso el Servicio Nacional de Salud británico para el análisis de la calidad de la APS (8).…”

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Estrategia de atención primaria de salud y su impacto en las hospitalizaciones evitables por condiciones sensibles a la atención ambulatoria, Paraguay, 2000-2017

Lerea

Tullo

López³

2019

Revista Panamericana De Salud Pública

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RESUMEN Objetivo. Explorar la influencia que ha tenido la implementación y fortalecimiento de la estrategia de atención primaria (APS) sobre las hospitalizaciones por condiciones sensibles al cuidado ambulatorio (HCSCA). Métodos. Estudio observacional descriptivo y transversal, que consideró datos correspondientes a los registros de internaciones de hospitales públicos de todo el país en el período 2000-2017. Se considera el año 2009 como punto de inicio de la estrategia de APS. Para definir los diagnósticos de las HCSCA se utilizaron los propuestos por la Organización Panamericana de la Salud/Organización Mundial de la Salud. Se realizó el análisis de su comportamiento considerando dos etapas: 2000-2008 y 2009-2017. Resultados. Las HCSCA mostraron una tendencia a la disminución, se halló una diferencia de 6,75% entre los años finales de cada etapa. La disminución fue mayor en la medida que se amplió la cobertura de APS. Las principales causas de HCSCA fueron la neumonía y la enfermedad diarreica aguda. Las internaciones por enfermedades crónicas disminuyeron en su mayoría: por el contrario, los ingresos por enfermedades infecciosas aumentaron. Conclusiones. La cobertura y acceso poblacional con unidades de salud familiar puede limitar el impacto de la APS en las HCSCA. Se verifica una disminución de las HCSCA luego de la implementación de la APS en Paraguay. Las internaciones por enfermedades crónicas muestran mejor resultado que las internaciones por enfermedades infecciosas.

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Hospital care direct costs due to ambulatory care sensitive conditions related to diabetes mellitus in the Mexican public healthcare system

Saturno-Hernández,

Moreno-Zegbe,

Poblano-Verastegui

et al. 2024

BMC Health Serv Res

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Background Hospitalizations for ambulatory care sensitive conditions (ACSC) incur substantial costs on the health system that could be partially avoided with adequate outpatient care. Complications of chronic diseases, such as diabetes mellitus (DM), are considered ACSC. Previous studies have shown that hospitalizations due to diabetes have a significant financial burden. In Mexico, DM is a major health concern and a leading cause of death, but there is limited evidence available. This study aimed to estimate the direct costs of hospitalizations by DM-related ACSC in the Mexican public health system. Methods We selected three hospitals from each of Mexico’s main public institutions: the Mexican Social Security Institute (IMSS), the Ministry of Health (MoH), and the Institute of Social Security and Services for State Workers (ISSSTE). We employed a bottom-up microcosting approach from the healthcare provider perspective to estimate the total direct costs of hospitalizations for DM-related ACSC. Input data regarding length of stay (LoS), consultations, medications, colloid/crystalloid solutions, procedures, and laboratory/medical imaging studies were obtained from clinical records of a random sample of 532 hospitalizations out of a total of 1,803 DM-related ACSC (ICD-10 codes) discharges during 2016. Results The average cost per DM-related ACSC hospitalization varies among institutions, ranging from $1,427 in the MoH to $1,677 in the IMSS and $1,754 in the ISSSTE. The three institutions’ largest expenses are LoS and procedures. Peripheral circulatory and renal complications were the major drivers of hospitalization costs for patients with DM-related ACSC. Direct costs due to hospitalizations for DM-related ACSC in these three institutions represent 1% of the gross domestic product (GDP) dedicated to health and social services and 2% of total hospital care expenses. Conclusions The direct costs of hospitalizations for DM-related ACSC vary considerably across institutions. Disparities in such costs for the same ACSC among different institutions suggest potential disparities in care quality across primary and hospital settings (processes and resource utilization), which should be further investigated to ensure optimal supply utilization. Prioritizing preventive measures for peripheral circulatory and renal complications in DM patients could be highly beneficial.

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Estudio de variabilidad geográfica de las hospitalizaciones potencialmente evitables en México durante tres quinquenios

Cited by 3 publications

References 9 publications

Avoidable Hospitalization Trends From Ambulatory Care-Sensitive Conditions in the Public Health System in México

Avoidable Hospitalization Trends From Ambulatory Care-Sensitive Conditions in the Public Health System in México

Estrategia de atención primaria de salud y su impacto en las hospitalizaciones evitables por condiciones sensibles a la atención ambulatoria, Paraguay, 2000-2017

Hospital care direct costs due to ambulatory care sensitive conditions related to diabetes mellitus in the Mexican public healthcare system

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