Epidemiological and financial indicators of hypertension in older adults in Mexico: challenges for health planning and management in Latin America

This study estimated the epidemiological and financial indicators of hypertension in order to identify challenges in strategic planning and management for health systems in Latin America. This is a longitudinal study with a population base of 187 326 reported cases of older adults with hypertension, diagnosed at public health institutions in Mexico. The cost-evaluation method that was used was based on the instrumentation and consensus techniques. To estimate the epidemiological changes and financial consequences for 2015-2017, time series analyses and probabilistic models were constructed according to the Box-Jenkins technique. Regarding epidemiological changes for 2015 versus 2017, an increase of 8-12% is expected (p < 0.001). Comparing the economic impact in 2015 versus 2017 (p < 0.001), there is a 22% increase in financial requirements. The total amount estimated for hypertension in 2015 (in US dollars) was $1 575 671 330. It included $747 527 259 as direct costs and $829 144 071 as indirect costs. If the risk factors and the different healthcare services for older adults remain as they are currently, the financial consequences of epidemiological changes in older adults will have a major impact on the users' pockets, following in order of importance, on social security providers and on public assistance providers. The challenges and implications of our findings in the context of universal coverage reforms in Latin America reinforce the urgent need to develop more and better strategic planning for the prevention of chronic diseases. Copyright © 2016 John Wiley & Sons, Ltd.

[1]  M. Muniyandi,et al.  Household Catastrophic Health Expenditure due to Tuberculosis , 2015 .

[2]  J. Gutiérrez,et al.  Acceso efectivo a los servicios de salud: operacionalizando la cobertura universal en salud , 2015 .

[3]  J. Rodríguez-Saldaña Quality of health care : from evidence to implementation , 2015 .

[4]  Stephen S. Lim,et al.  Effective Coverage: A Metric for Monitoring Universal Health Coverage , 2014, PLoS medicine.

[5]  A. Arredondo Type 2 diabetes and health care costs in Latin America: exploring the need for greater preventive medicine , 2014, BMC Medicine.

[6]  A. Arredondo,et al.  Hypertension and its effects on the economy of the health system for patients and society: suggestions for developing countries. , 2014, American journal of hypertension.

[7]  A. Frankland Video Q&A: Allergies and allergen immunotherapy - an interview with Alfred William Frankland , 2014, BMC Medicine.

[8]  S. Barquera-Cervera,et al.  Hipertensión arterial: prevalencia, diagnóstico oportuno, control y tendencias en adultos mexicanos , 2013 .

[9]  Carlos Fernando Corona-Sapien,et al.  Prevalencia de hipertensión arterial, sobrepeso y obesidad en poblaciones urbanas el estado de Sinaloa, México , 2012 .

[10]  Palmira Pramparo,et al.  Evaluación del riesgo cardiovascular en siete ciudades de Latinoamérica: las principales conclusiones del estudio CARMELA y de los subestudios , 2011 .

[11]  Dorte Vistisen,et al.  Global healthcare expenditure on diabetes for 2010 and 2030. , 2010, Diabetes research and clinical practice.

[12]  H. Schargrodsky,et al.  Hypertension in seven Latin American cities: the Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study , 2010, Journal of hypertension.

[13]  A. Arredondo,et al.  Epidemiologic changes and economic burden of hypertension in Latin America: evidence from Mexico. , 2006, American journal of hypertension.

[14]  P. Nájera,et al.  Who pays more for health services in middle-income countries: lessons from Mexico. , 2005, Public health.

[15]  C. Murray,et al.  Household catastrophic health expenditure: a multicountry analysis , 2003, The Lancet.

[16]  A. Barcelo,et al.  The cost of diabetes in Latin America and the Caribbean. , 2003, Bulletin of the World Health Organization.

[17]  F. Knaul,et al.  Determinantes Del Gasto De Bolsillo En Salud e Implicaciones Para el Aseguramiento Universal en México: 1992-2000 (Determinants of-Pocket Health Expenditure and Implications for Universal Insurance in Mexico: 1992-2000) , 2003 .

[18]  M. Thorogood,et al.  The prevalence and treatment of hypertension in the elderly population of the Mexican Institute of Social Security. , 2001, Salud publica de Mexico.

[19]  M. Sillero-Arenas,et al.  Health in the Americas , 2005, Nature.