Burden of disease and costs of treating rotavirus diarrhea in Mexican children for the period 2001-2006.

OBJECTIVES: To estimate the health impact and the costs of treatment associated with rotavirus diarrhea in six yearly cohorts (2001-2006) of Mexican infants. METHODS: The perspective of study is from the health care system. We estimated the effect of rotavirus diarrhea on disability adjusted life years (DALYS) and diarrhea treatment costs in hypothetical cohorts of infants who are followed from birth up to five years of age beginning in years from 2001 to 2006. We used information from administrative databases on mortality and health care from the National System of Information on Health and from the Mexican Institute for Social Security to feed a decision analysis to project the burden of disease and costs of treatment. RESULTS: Estimates of DALYS were 19,426 in 2001 and decreased by 28.9% for 2006 meanwhile costs of treatment were relatively constant, estimated at US$ 38.7 million and increased only by 5%. CONCLUSION: Rotavirus diarrhea in Mexican children is a major disease burden, presenting significant treatment costs. Rotavirus diarrhea mortality is decreasing; however this has not led to a steady decrease in treatment costs in the 6 years period of analysis. A sensitivity analysis showed that incidences of rotavirus diarrhea as well as the parameters associated with health-care access were the main factors, which had a significant effect on the projected burden of disease and costs.

Direct costs associated with the appropriateness of hospital stay in elderly population.

BACKGROUND: Ageing of Mexican population implies greater demand of hospital services. Nevertheless, the available resources are used inadequately. In this study, the direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated. METHODS: Appropriateness of hospital stay was evaluated with the Appropriateness Evaluation Protocol (AEP). Direct medical costs associated with hospital stay under the third-party payer's institutional perspective were estimated, using as information source the clinical files of 60 years of age and older patients, hospitalized during year 2004 in a Regional Hospital from the Mexican Social Security Institute (IMSS), in Mexico City. RESULTS: The sample consisted of 724 clinical files, with a mean of 5.3 days (95% CI = 4.9-5.8) of hospital stay, of which 12.4% (n = 90) were classified with at least one inappropriate patient day, with a mean of 2.2 days (95% CI = 1.6-2.7). The main cause of inappropriateness days was the inexistence of a diagnostic and/or treatment plan, 98.9% (n = 89). The mean cost for an appropriate hospitalization per patient resulted in US$1,497.2 (95% CI = US$323.2-US$4,931.4), while the corresponding mean cost for an inappropriate hospitalization per patient resulted in US$2,323.3 (95% CI = US$471.7-US$6,198.3), (p < 0.001). CONCLUSION: Elderly patients who were inappropriately hospitalized had a higher rate of inappropriate patient days. The average of inappropriate patient days cost is considerably higher than appropriate days. In this study, inappropriate hospital-stay causes could be attributable to physicians and current organizational management.

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.

Economic family burden of metabolic control in children and adolescents with type 1 diabetes mellitus.

AIM: To appraise the economic burden for families of patients with type 1 diabetes mellitus (DM1) at the Instituto Nacional de Pediatria in Mexico City. PATIENTS AND METHODS: DM1 family direct costs were obtained from a standardized economic survey in 59 children with no chronic severe complications such as kidney failure in 2002-3. RESULTS: Mean family annual direct cost of treatment and monitoring was US $1689.87 which includes government funding given to both outpatients and inpatients. Despite this, DM1 out-of-pocket cost for families is very high compared to the minimum official wage of approximately $4.00 dollar/day versus $4.06 cost DM1/day. No correlation between parents' age, education or socio-economic level and direct cost was statistically significant. CONCLUSIONS: The highest economic burden was due to self-monitoring of blood glucose (SMBG) 53.0% and insulin 14.8%. The costs were higher in children with poor metabolic control who performed SMBG less often.