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Triggering factors of primary care costs in the years following type 2 diabetes diagnosis in Mexico.
Castro-Ríos, Angélica; Nevárez-Sida, Armando; Tiro-Sánchez, María Teresa; Wacher-Rodarte, Niels.
Afiliação
  • Castro-Ríos A; Unidad de Investigación en Epidemiología Clínica, Hospital de Pediatria, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, (IMSS), D.F., México.
  • Nevárez-Sida A; Unidad de Investigación en Economía de la Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, (IMSS), D.F., México. Electronic address: armando.nevarez@gmail.com.
  • Tiro-Sánchez MT; Hospital General #24, Instituto Mexicano del Seguro Social (IMSS), D.F., México.
  • Wacher-Rodarte N; Unidad de Investigación en Epidemiología Clínica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, D.F., México.
Arch Med Res ; 45(5): 400-8, 2014 Jul.
Article em En | MEDLINE | ID: mdl-24825741
BACKGROUND AND AIMS: Diabetes represents a high epidemiological and economic burden worldwide. The cost of diabetes care increases slowly during early years, but it accelerates once chronic complications set in. There is evidence that adequate control may delay the onset of complications. Management of diabetes falls almost exclusively into primary care services until chronic complications appear. Therefore, primary care is strategic for reducing the expedited growth of costs. The objective of this study was to identify predictors of primary care costs in patients without complications in the years following diabetes diagnosis. METHODS: Direct medical costs for primary care were determined from the perspective of public health services provider. Information was obtained from medical records of 764 patients. Microcosting and average cost techniques were combined. A generalized linear regression model was developed including characteristics of patients and facilities. Primary health care costs for different patient profiles were estimated. RESULTS: The mean annual primary care cost was USD$465.1. Gender was the most important predictor followed by weight status, insulin use, respiratoty infections, glycemic control and dyslipidemia. A gap in costs was observed between genders; women make greater use of resources (42.1% on average). Such differences are reduced with obesity (18.1%), overweight (22.8%), respiratory infection (20.8%) and age >80 years (26.8%). Improving glycemic control shows increasing costs but at decreasing rates. CONCLUSIONS: Modifiable factors (glycemic control, weight status and comorbidities) drive primary care costs the first 10 years. Those factors had a larger effect in costs for males than in for females.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Custos de Cuidados de Saúde / Diabetes Mellitus Tipo 2 Tipo de estudo: Diagnostic_studies / Health_economic_evaluation / Observational_studies / Prognostic_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: Mexico Idioma: En Revista: Arch Med Res Assunto da revista: MEDICINA Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Custos de Cuidados de Saúde / Diabetes Mellitus Tipo 2 Tipo de estudo: Diagnostic_studies / Health_economic_evaluation / Observational_studies / Prognostic_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: Mexico Idioma: En Revista: Arch Med Res Assunto da revista: MEDICINA Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos