Direct medical cost of COVID-19 in children hospitalized at a tertiary referral healthcare center in Mexico City.

Introduction: Despite the end of the COVID-19 pandemic being declared by the WHO, the economic consequences are far from over. One of these implications was the cost of inpatient care for health institutions. To date, some studies have examined the economic burden of COVID-19 in the adult population but only a few have focused on child populations. Objective: To estimate the direct medical costs of COVID-19, focusing on children in Mexico. Method: Data about resources consumed during hospital stays were extracted from the medical records of patients hospitalized at a Mexican tertiary healthcare institution. Other sources of information were the unit prices of inputs and the salaries of health personnel. A micro-costing methodology was used to obtain cost results by age group over different hospital areas. Data analysis was performed with descriptive statistics and regression models to evaluate the predictors of total cost. Results: One hundred and ten medical records were reviewed of which 57.3% corresponded to male patients and the mean age was 7.2 years old. The estimated average cost per patient was US$5,943 (95% CI: US$4,249-7,637). When the costs of the three clinical areas were summed, only the 5-10 years old group showed a maximum cost of US$14,000. The regression analysis revealed the following factors as significant: sex, age, staying at an emergency room, having a positive bacterial culture, and having comorbidities. Discussion: The cost results were somewhat similar to those reported in children from the USA, but only regarding low severity COVID-19 cases. However, comparability between these types of studies should be done with caution due to the huge differences between the healthcare systems of countries. The study cost results may help public decision-makers in budget planning and as inputs for future cost-effectiveness studies about interventions regarding COVID-19.

Correction: Martínez-Valverde et al. Health Needs Assessment: Chronic Kidney Disease Secondary to Type 2 Diabetes Mellitus in a Population without Social Security, Mexico 2016-2032. Int. J. Environ. Res. Public Health 2022, 19, 9010.

In the original publication [...].

Costs associated with adverse events from remission induction for children with Acute Lymphoblastic Leukemia (ALL).

BACKGROUND: ALL is the most frequent hematological tumor in children, so during remission induction chemotherapy protocol (RICP) adverse events (AEs) may appear. The public program in Mexico in charge of financial support to oncologic children without social security delivered a fix amount for ALL chemotherapy, but additional money needed to treat any other unexpected condition should be taken from the budget of the oncologic healthcare providers. So the purpose of our study was to estimate and evaluate the direct medical costs associated to EAs during RICP in children with ALL. METHODS: This study was retrospective, longitudinal, and observational based on medical records review of patients in RICP. The CTCAE was used to identify and classify AEs according to a SOC category. We focused on extracting resources data that were consumed both for inpatients and outpatients AEs. A micro-costing approach was adopted which involve quantification of each healthcare resource consumed by the hospital multiplying them by unit cost. The probability distributions of data were evaluated to identify the appropriated statistical tests to be used for comparisons between groups that were performed with Wilcoxon rank sum test. Generalized linear models (GLM) were adjusted to evaluate the effects of patient characteristics on total cost. RESULTS: Forty patients accumulated 204 inpatient and 81 outpatient AEs during RICP. Comparison of total costs between groups showed an incremental cost of $7,460.23 likewise attributable to AEs. The total cost of a pediatric patient undergoing RICP without adverse events was $3,078.36 and the total cost of a patient with AEs exceeds it threefold. CONCLUSIONS: The costs associated with AEs during RICP in Mexican children with ALL representing a high burden for the healthcare provider. Generalized linear models showed that variables such as sex, risk category and alive status are associated with the total costs of AEs. This is the first study aiming to analyze the effect of ALL-related AEs on health care costs in pediatric population, so our results may help not only to local decision making but also it may contribute to the research agenda in this field.

Health Needs Assessment: Chronic Kidney Disease Secondary to Type 2 Diabetes Mellitus in a Population without Social Security, Mexico 2016-2032.

Health needs assessment is a relevant tracer of planning process of healthcare programs. The objective is to assess the health needs of chronic kidney disease (CKD) secondary to type 2 diabetes mellitus (T2 DM) in a population without social security in Mexico. The study design was a statistical simulation model based on data at the national level of Mexico. A stochastic Markov model was used to simulate the progression from diabetes to CKD. The time horizon was 16 years. The results indicate that in 2022, kidney damage progression and affectation in the diabetic patient cohort will be 34.15% based on the time since T2 DM diagnosis. At the end of the 16-year period, assuming that the model of care remains unchanged, early renal involvement will affect slightly more than twice as many patients (118%) and cases with macroalbuminuria will triple (228%). The need for renal replacement therapy will more than double (169%). Meanwhile, deaths associated with cardiovascular risk will more than triple (284%). We concluded that the clinical manifestations of patients with CKD secondary to T2 DM without social security constitute a double challenge. The first refers to the fact that the greatest health need is early care of CKD, and the second is the urgent need to address cardiovascular risk in order to reduce deaths in the population at risk.

Childhood Cancer Survival, 2006-2012 Cohorts of Mexican Institute of Social Security Beneficiaries at the Central-South Region of Mexico.

Introduction: In Mexico, the main institution of social security is the "Instituto Mexicano del Seguro Social" (IMSS), with more than 60 million enrolled individuals. This study of childhood cancer survival is the first based on complete cohorts of incident cases for the population IMSS- affiliated in the central-south region, which represents 27% of all children IMSS affiliated. Methods: It is an observational cohort study from 2006 to 2012 to estimate the 5-year observed survival of the minors under 18 years old, identified in the Central-South Region Registry of Children with Cancer. The survival of cases was carried out through the active and passive search. Survival rates were estimated by the Kaplan-Meier (KM) method, the analysis of equality of survival functions was evaluated for some clinical variables. Results: The study included 2,357 minors; the 5-year observed survival was 56.1% with a time of survival median of 3.4 years, and the overall loss of follow-up was 18.4%. The 5-year survival in cases with a diagnosis of leukemia was 53.5%, while for solid tumors, it was 57.9%. The median time of death was 1 year. The types of cancer with a survival greater than 70% were group V-retinoblastoma (87.2%), IIa-Hodgkin's lymphoma (86.8%), Xc- gonadal tumors (83.3%), Iid-miscellaneous lymphomas (80%), IVa-nephroblastoma (79.5%), and IIc-Burkitt's lymphoma (75.4%). Meanwhile, the lowest survival rates were in group VIII-bone tumors (32.3%), III-CNS (central nervous system; 44.1%), and IX-soft tissues (46.8%). Conclusions: Survival results in the 2006-2012 cohorts show a significant gap in relation to the goal of 60% proposed by the World Health Organization for 2030.

Last Year of Life, Frailty, and Out-of-Pocket Expenses in Older Adults: A Secondary Analysis of the Mexican Health and Aging Study.

OBJECTIVE: To determine the association of frailty with out-of-pocket expenses (OOPEs) during the last year of life of Mexican older adults. METHODS: Cross-sectional secondary analysis of the Mexican Health and Aging Study (MHAS), a representative population-based cohort study. Health care expenses were estimated, and a probit model was used to estimate the probability that older adults had OOPE. A general linear model was applied to explain OOPE magnitudes. RESULTS: A total of 55.8% of individuals reported having OOPE with a mean of 3,261 USD. Average OOPE for hospitalization during the last year of life was 7,011.9 USD. Older adults taking their own medical decisions during the last year of life expended less than those who did not. CONCLUSION: No affiliation to health services, frailty, and health decision-making by others increased the probability of OOPE. The magnitude is determined by age, hospitalization, medical visits, affiliation, frailty, and health decision-making by others.

Out-of-pocket expenditures and care time for children with Down Syndrome: A single-hospital study in Mexico City.

AIM: To examine the burden of out-of-pocket household expenditures and time spent on care by families responsible for children with Down Syndrome (DS). METHODS: A cross-sectional analysis was performed after surveying families of children with DS. The children all received medical care at the Hospital Infantil de México Federico Gomez (HIMFG), a National Institute of Health. Data were collected on out-of-pocket household expenditures for the medical care of these children. The percentage of such expenditure was calculated in relation to available household expenditure (after subtracting the cost of food/housing), and the percentage of households with catastrophic expenditure. Finally, the time spent on the care of the child was assessed. RESULTS: The socioeconomic analysis showed that 67% of the households with children with DS who received medical care in the HIMFG were within the lower four deciles (I-IV) of expenses, indicating a limited ability to pay for medical services. Yearly out-of-pocket expenditures for a child with DS represented 27% of the available household expenditure, which is equivalent to $464 for the United States dollars (USD). On average, 33% of families with DS children had catastrophic expenses, and 46% of the families had to borrow money to pay for medical expenses. The percentage of catastrophic expenditure was greater for a household with children aged five or older compared with households with younger children. The regression analysis revealed that the age of the child is the most significant factor determining the time spent on care. CONCLUSIONS: Some Mexican families of children with DS incur substantial out-of-pocket expenditures, which constitute an economic burden for families of children who received medical care at the HIMFG.

Direct medical costs of neonatal respiratory distress syndrome in two specialized public hospitals in Mexico / Costo médico directo del síndrome de dificultad respiratoria neonatal en dos hospitales públicos de alta especialidad en México

Objective. To estimate direct medical costs (DMC) associated with treatment of Respiratory Distress Syndrome (RDS) in newborns (NB) in two specialized public hospitals in Mexico. Materials and methods. The perspective used was health care payer. We estimated DMC associated with RDS management. The pattern of resource use was established by reviewing clinical records. Microcosting and bootstrap techniques were used to obtain the DMC. Estimated costs were reported in 2011 US dollars. Results. Average DMC per RDS event was 14 226 USD. The most significant items that account for this cost were hospitalization (38%), laboratory and diagnostic exams (18%), incubator time (10%), surfactant therapy (7%), and mechanical ventilation (7%). Conclusion. Average DMC in NB with RDS fluctuated in relation to gestational age weight at birth and clinical complications presented by patients during their hospitalization.

Objetivo. Determinar los costos médicos directos (CMD) asociados con el tratamiento del síndrome de dificultad respiratoria (SDR) en recién nacidos pretérmino en dos hospitales públicos de alta especialidad de México. Material y métodos. Se utilizó la perspectiva del pagador de servicios de salud. El uso de recursos se estimó mediante la revisión de expedientes clínicos. Se empleó la técnica de microcosteo y de bootstrap para la obtención de los CMD. Los costos fueron reportados en dólares estadounidenses de 2011. Resultados. El CMD por evento de SDR promedio fue de 14 226 dólares distribuidos entre los costos de hospitalización (38%), laboratorio y exámenes de diagnóstico (18%), tiempo en incubación (10%), terapia con surfactantes (7%) y ventilación mecánica (7%). Conclusión. Los CMD promedio en recién nacidos pretérmino con SDR están relacionados con la edad gestacional, el peso al nacer y las complicaciones clínicas que presentan los pacientes durante su hospitalización.

An approximation to data on mortality and out-of-pocket expenses for medical attention of infants <2 years old affiliated with the Medical Insurance Siglo XXI

Background: Medical Insurance Siglo XXI (MISXXI) in Mexico provides funds for the medical and preventive care of children from households lacking any health insurance, thus seeking to reduce impoverishing due to health problems. This paper analyzes mortality of children <2 years of age affiliated with this program and out-of-pocket expenses attributable to this event. Methods: An in-home survey addressed to determine the health conditions of children affiliated with MISXXI was carried out in all Mexican states. If the infant had died, information was collected with emphasis on diagnosis (death certificate), medical attention and out-of-pocket expenses. Diagnoses were classified in agreement with ICD-10. Results: Of 9181 children, 74 died by the time during which the survey was gathered; 51% of children died before 28 days. Deaths were attributable to short gestation, low birth weight, asphyxia, or sepsis. In newborns who died before 7 days of age, 95.7% received medical care; however, among those who died between 7 and 28 days, only 58% received medical care. During the neonatal period, medical care was predominantly given in the Ministry of Health facilities. During the post-neonatal period, almost all children received medical care, predominantly in private facilities, a reason for households incurring in out-of-pocket expenditures. Conclusions: Mortality of infants who are beneficiaries of MISXXI mainly occurs during the neonatal period; however, households incurred in out-of-pocket expenditures, especially in the post-neonatal period. It seems convenient to boost the access of users to benefits provided by this medical insurance.

Direct medical costs of neonatal respiratory distress syndrome in two specialized public hospitals in Mexico.

OBJECTIVE: To estimate direct medical costs (DMC) associated with treatment of Respiratory Distress Syndrome (RDS) in newborns (NB) in two specialized public hospitals in Mexico. MATERIALS AND METHODS: The perspective used was health care payer. We estimated DMC associated with RDS management. The pattern of resource use was established by reviewing clinical records. Microcosting and bootstrap techniques were used to obtain the DMC. Estimated costs were reported in 2011 US dollars. RESULTS: Average DMC per RDS event was 14 226 USD. The most significant items that account for this cost were hospitalization (38%), laboratory and diagnostic exams (18%), incubator time (10%), surfactant therapy (7%), and mechanical ventilation (7%). CONCLUSION: Average DMC in NB with RDS fluctuated in relation to gestational age weight at birth and clinical complications presented by patients during their hospitalization.

An approximation to data on mortality and out-of-pocket expenses for medical attention of infants <2 years old affiliated with the Medical Insurance Siglo XXI.

BACKGROUND: Medical Insurance Siglo XXI (MISXXI) in Mexico provides funds for the medical and preventive care of children from households lacking any health insurance, thus seeking to reduce impoverishing due to health problems. This paper analyzes mortality of children <2 years of age affiliated with this program and out-of-pocket expenses attributable to this event. METHODS: An in-home survey addressed to determine the health conditions of children affiliated with MISXXI was carried out in all Mexican states. If the infant had died, information was collected with emphasis on diagnosis (death certificate), medical attention and out-of-pocket expenses. Diagnoses were classified in agreement with ICD-10. RESULTS: Of 9181 children, 74 died by the time during which the survey was gathered; 51% of children died before 28 days. Deaths were attributable to short gestation, low birth weight, asphyxia, or sepsis. In newborns who died before 7 days of age, 95.7% received medical care; however, among those who died between 7 and 28 days, only 58% received medical care. During the neonatal period, medical care was predominantly given in the Ministry of Health facilities. During the post-neonatal period, almost all children received medical care, predominantly in private facilities, a reason for households incurring in out-of-pocket expenditures. CONCLUSIONS: Mortality of infants who are beneficiaries of MISXXI mainly occurs during the neonatal period; however, households incurred in out-of-pocket expenditures, especially in the post-neonatal period. It seems convenient to boost the access of users to benefits provided by this medical insurance.

[Transforming health systems based on primary care]. / La transformación del sistema de salud con base en la atención primaria.

Access to health services is a social basic determinant of health in Mexico unlike what happens in developed countries. The demand for health services is focused on primary care, but the design meets only the supply of hospital care services. So it generates a dissonance between the needs and the effective design of health services. In addition, the term affiliation refers to population contributing or in the recruitment process, that has been counted as members of these social security institutions (SS) and Popular Insurance (SP). In the case of Instituto Mexicano del Seguro Social (IMSS) three of four contributors are in contact with health services; while in the SP, this indicator does not exist. Moreover, the access gap between health services is found in the health care packages so that members of the SS and SP do not have same type of coverage. The question is: which model of health care system want the Mexicans? Primary care represents the first choice for increasing the health systems performance, as well as to fulfill their function of social protection: universal access and coverage based on needs, regardless whether it is a public or private health insurance. A central aspect for development of this component is the definition of the first contact with the health system through the creation of a primary health care team, led by a general practitioner as the responsible of a multidisciplinary health team. The process addresses the concepts of primary care nursing, consumption of inputs (mainly medical drugs), maintenance and general services. Adopting a comprehensive strategy that will benefit all Mexicans equally and without discrimination, this primary care system could be financed with a total operating cost of approximately $ 22,809 million by year.

Economic evaluation of the use of exogenous pulmonary surfactants in preterm newborns in a Mexican population.

OBJECTIVE: To estimate the cost-effectiveness ratio of surfactant rescue treatment of premature infants with respiratory distress syndrome (RDS) who are covered by the Medical Insurance for a New Generation. MATERIALS AND METHODS: A cost-effectiveness evaluation was conducted from the third-payer perspective. Comparisons were made between the use of bovine surfactant (BS) therapy and without BS therapy. A decision tree model with a lifetime horizon was used where the measurements of effectiveness were life years gained (LYG) and quality-adjusted life years (QALYs). A 5% discount rate was considered for costs and health outcomes. All costs are expressed in Mexican pesos 2009. RESULTS: Incremental cost-effectiveness ratios (ICER) were MXN$136,670 per LYG and MXN$125,250 per QALY. CONCLUSION: Surfactant therapy was confirmed as a cost-effective strategy in accordance with World Health Organization criteria of three per capita gross domestic product (GDP) per QALY in premature infants with RDS in Mexico.

Direct medical costs of treating Mexican children under 2 years of age with respiratory syncytial virus

Background. Respiratory syncytial virus (RSV) is the most frequent etiologic agent causing lower respiratory tract infection in children <2 years of age. Between 0.5 and 3% of patients will require hospitalization. The aim of this study was to estimate the direct medical cost of treating children <2 years old with suspicion of RSV at the Instituto Mexicano del Seguro Social (IMSS). Methods. Direct medical costs were estimated from an institutional perspective. Medical records were reviewed from patients <2 years of age who attended emergency services in second-level hospitals including subjects who required hospitalization. Estimated costs were obtained with the microcosting technique using the institutional costs from IMSS (year 2010). Costs were reported in USD (year 2011). Results. When analyzing total medical costs, outpatient management yielded a cost of $230.0 ± $10.30 U.S. dollars (USD), whereas hospitalized patients exhibited an average cost of $8,313.20 ± $595.30 USD. The main components of outpatient management costs were emergency visits, specialist consultations and diagnostic testing (41.6%, 32.7% and 10.7% of the total cost, respectively). In the case of hospitalized patients, intensive care unit cost (89.3%) and overall hospitalization cost (6.5%) represented 95.7% of the total cost. Conclusions. RSV is a disease that represents a significant economic burden for health care institutions, although most patients are treated on an outpatient basis.

Cost-effectiveness analysis of the use of palivizumab in the prophylaxis of preterm patients in Mexico / Análisis de costo-efectividad del uso de palivizumab en la profilaxis de pacientes prematuros en México

OBJECTIVE: The study evaluated the incremental cost-effectiveness ratio (ICER) of the prophylaxis of palivizumab, for the reduction of complications associated to the respiratory syncytial virus in preterm patients in Mexico. MATERIAL AND METHODS: A decision tree was developed in preterm groups [<29 and 29-32 weeks of gestational age (wGA)], by using epidemiological and cost local data; the effectiveness was obtained with a systematic review. Patients were evaluated according to their life expectancy. Mexican Health System perspective was used. Effectiveness measures employed were LYG and QALYs. The costs are reported in USD 2009. RESULTS: ICERs per LYG resulted on values of USD $25,029 and USD $29,637 for <29 wGA and 29-32 wGA respectively, whereas ICERs per QALYs obtained in the model accounted for USD $17,532 and USD $20,760. CONCLUSIONS: Palivizumab prophylaxis for preterm newborn patients ≤32 weeks of age resulted in a cost-effective alternative.

OBJETIVO: El estudio evaluó la razón costo-efectividad incremental (RCEI) de profilaxis con palivizumab para reducción de complicaciones asociadas al virus sincicial respiratorio en prematuros en México. MATERIAL Y MÉTODOS: Se empleó un árbol de decisiones en los grupos pretérmino [<29 y 29-32 semanas de edad gestacional (SEG)], empleando datos epidemiológicos y costos locales; la eficacia se obtuvo con una revisión sistemática, evaluando a los pacientes de acuerdo con su esperanza de vida. Se empleó la perspectiva del Sistema Nacional de Salud. Las medidas de eficacia fueron AVG y AVAC. Los costos son reportados en dólares de 2009. RESULTADOS: Las RCEI por AVG resultaron de USD $25 029 y USD $29 637 para <29 y 29-32 SEG, mientras que las RCEI por AVAC fueron de USD $17 532 y USD $20 760. CONCLUSIONES: La profilaxis con palivizumab en pacientes recién nacidos pretérmino ≤32 semanas de edad resultó ser una alternativa costo-efectiva.

Cost-effectiveness analysis of the use of palivizumab in the prophylaxis of preterm patients in Mexico.

OBJECTIVE: The study evaluated the incremental cost-effectiveness ratio (ICER) of the prophylaxis of palivizumab, for the reduction of complications associated to the respiratory syncytial virus in preterm patients in Mexico. MATERIAL AND METHODS: A decision tree was developed in preterm groups [<29 and 29-32 weeks of gestational age (wGA)], by using epidemiological and cost local data; the effectiveness was obtained with a systematic review. Patients were evaluated according to their life expectancy. Mexican Health System perspective was used. Effectiveness measures employed were LYG and QALYs. The costs are reported in USD 2009. RESULTS: ICERs per LYG resulted on values of USD $25,029 and USD $29,637 for <29 wGA and 29-32 wGA respectively, whereas ICERs per QALYs obtained in the model accounted for USD $17,532 and USD $20,760. CONCLUSIONS: Palivizumab prophylaxis for preterm newborn patients ≤32 weeks of age resulted in a cost-effective alternative.

Cost Utility of Sirolimus versus Tacrolimus for the Primary Prevention of Graft Rejection in Renal Transplant Recipients in Mexico.

OBJECTIVE: Therapies for end-stage renal disease improve quality of life, and survival. In Mexico, clinicians often must choose between different therapies without the availability of comparative outcomes evaluation. The present study evaluates the comparative cost-utility of sirolimus (SIR) versus tacrolimus (TAC) for the primary prevention of graft rejection in renal transplant recipients in Mexico. METHODS: We used modeling techniques to estimate the cost-effectiveness of SIR versus TAC to prevent graft rejection in patients with end-stage renal disease in the Mexican setting. The model estimates the cost of quality-adjusted life-year (QALY) per patient. We applied a 20-year horizon (1-year Markov cycles). Cost-effectiveness was expressed in terms of cost per QALY. All costs are presented in 2011 US dollars. Probabilistic sensitivity analyses were conducted. RESULTS: The total cost for the SIR treatment arm over the 20-year duration of the model is estimated to be $136,778. This compares with $142,624 for the TAC treatment arm, resulting in an incremental cost of SIR compared with that of TAC of-$5,846. Over 20 years, SIR was estimated to have 8.18 QALYs compared with 7.33 QALYs for TAC. The resulting incremental utility of SIR compared with that of TAC is 0.84 QALY gained. SIR is estimated to be both less costly and more effective than TAC, indicating that it is the dominant strategy. Notably, results suggest that SIR has a 78% probability of being dominant over the TAC strategy and a 100% probability of having an incremental cost-effectiveness ratio at or below $10,064 (1 GDP) per QALY. CONCLUSIONS: These analyses suggest that in the Mexican setting, the use of SIR in place of TAC for the prevention of graft rejection in this population is likely to be cost saving.

Economic evaluation of the use of exogenous pulmonary surfactants in preterm newborns in a Mexican population / Evaluación económica de la utilización de surfactantes pulmonares exógenos en recién nacidos pretérmino en población mexicana

OBJECTIVE: To estimate the cost-effectiveness ratio of surfactant rescue treatment of premature infants with respiratory distress syndrome (RDS) who are covered by the Medical Insurance for a New Generation. MATERIALS AND METHODS: A cost-effectiveness evaluation was conducted from the third-payer perspective. Comparisons were made between the use of bovine surfactant (BS) therapy and without BS therapy. A decision tree model with a lifetime horizon was used where the measurements of effectiveness were life years gained (LYG) and quality-adjusted life years (QALYs). A 5% discount rate was considered for costs and health outcomes. All costs are expressed in Mexican pesos 2009. RESULTS: Incremental cost-effectiveness ratios (ICER) were MXN$136670 per LYG and MXN$125250 per QALY. CONCLUSION: Surfactant therapy was confirmed as a cost-effective strategy in accordance with World Health Organization criteria of three per capita gross domestic product (GDP) per QALY in premature infants with RDS in Mexico.

OBJETIVO: Estimar la razón de costo efectividad incremental del tratamiento de surfactante de rescate en pacientes pretérmino con Síndrome de Dificultad Respiratoria (SDR) cubiertos por el Seguro Médico para una Nueva Generación. MATERIAL Y MÉTODOS: Evaluación de costo-efectividad desde la perspectiva del tercer pagador. Los comparadores fueron la terapia de surfactante bovino y la alternativa de no emplear ésta. Se utilizó un árbol de decisión que consideró la esperanza de vida como horizonte temporal y las medidas de efectividad fueron los años de vida ganados (AVG) y los años de vida ajustados por calidad de vida ( AVAC).Resultados en pesos mexicanos del 2009. RESULTADOS: Las RCEI por AVG y AVAC fueron de MXN$136670 y MXN$125250. CONCLUSIÓN: La razón de costo por AVG y AVAC para la terapia de surfactantes en pacientes prematuros con SDR en México fue menor a tres veces el PIB per cápita, por lo que es una estrategia costo-efectiva según los criterios de la OMS.

Potential savings in Mexico from screening and prevention for early diabetes and hypertension.

This study analyzes the potential economic benefits of identifying and treating patients with so-called prediabetes and prehypertension through the Mexican prevention program known by its Spanish acronym PREVENIMSS. The results show that for each US dollar invested in prevention, $84-$323 would be saved over a twenty-year period. For this and other reasons, providing preventive care for prediabetes and prehypertension patients is better than the current routine care model, in which care is provided in most cases when the disease has progressed substantially. Yet data show that screening and preventive care services are still not being used widely enough in Mexico, are provided too late, or are not sufficiently targeted to the most at-risk individuals. Investing in preventive care for patients with prediabetes and prehypertension is cost saving.

Una mirada desde los servicios de salud a la nutrición de la niñez mexicana: III. Carga económica y en salud de la obesidad en niños mexicanos. Proyecciones de largo plazo / A look from health services to the nutrition of Mexican childhood: III. Economic and health burden of Mexican childhood obesity. Long-term projections

Objetivo. Estimar la carga económica y en salud de la obesidad en niños mexicanos en un horizonte de largo plazo. Estimación de costos médicos atribuibles a la obesidad en niños mexicanos durante 2006-2050. Una cohorte hipotética de 5-11 años de edad obesa se modeló con base en prevalencia, incidencia y evolución clínica. Los costos considerados fueron por diabetes mellitus tipo 2 e hipertensión arterial. En 2015 se presentarían los primeros casos de diabetes mellitus y de hipertensión arterial. Cuando el primer grupo de niños cumpla 40 años aumentarán considerablemente las complicaciones de la obesidad. Para 2050, 67.3% de la cohorte tendría obesidad. El costo de atención a la obesidad será de $57 678 millones de pesos. La magnitud de la obesidad se reporta en niveles preocupantes en todas las edades, con costos que consumirán buena parte de los recursos del sistema de salud.

Objective. To estimate the economic and health burden of childhood obesity in Mexican population over the long term. This study estimates healthcare costs due to child obesity in Mexican children from 2006-2050. A hypothetic 5-11-year-old obese cohort based on prevalence, incidence, and clinical development data was modelled. Cost allocation considerations include type 2 diabetes mellitus and high blood pressure. The first cases of diabetes mellitus and with a risk of high blood pressure appears in the year 2015. When the first group of children is 40 years old, there is a considerable increase in obesity-related complications. A total of 67.3% of the cohort would have obesity in the year 2050. The cost of obesity care would be $57 678 million Mexican pesos. The magnitude of obesity reported is at worrisome levels in all age groups, showing costs that would consume a high percentage of the health system’s resources.