ABSTRACT
La diabetes mellitus es un problema de salud con alcances económicos y sociales. La prevalencia mundial está aumentando: se estima que para 1985 había 30 millones de personas con diabetes, 177 millones en el año 2000 y se estima que para el año 2030 habrá 438 millones de diabéticos. En Guatemala el 8% de la población tiene diabetes y se desconoce el porcentaje no diagnosticado y en pre-diabetes; además el país tiene índices de obesidad, sobrepeso y sedentarismo altos, situación que predispone a la aparición de la enfermedad. En el mundo cada 6 segundos muere alguien a causa de complicaciones relacionadas con diabetes y en Guatemala ocupa la tercera causa de mortalidad general. Existen varios tipos de diabetes, sin embargo, el ensayo se enfoca en la diabetes tipo 2 debido a que representa el 90% de los casos pero sobre todo por que es prevenible. Para el autor existen tres momentos importantes de los pacientes diabéticos: (1) paciente sano y con riesgo qué enfermará de diabetes, (2) paciente diabético que tendrá complicaciones y (3) pacientes con complicaciones que morirán. En los tres momentos se puede intervenir directamente, sin embargo, existen deficiencias como la ausencia de programas de prevención y la ineficiencia del sistema asistencial público. El autor propone posibles soluciones en base a evidencia científica para detener el aumento de casos de diabetes mellitus, disminuir las complicaciones micro y macro vasculares en los pacientes y principalmente, generar una cultura preventiva en Guatemala.
Diabetes is a health problem with social and economic consequences. The worldwide prevalence of diabetes is raising; by 1985 there were 30 million of people with diabetes, 177 million by the year 2000 and it is estimated that in 2030 there will be around 438 million people with diabetes. The prevalence of diabetes in Guatemala its around 8% of the population, however it is unknown the prevalence of the underdiagnosed and pre-diabetes. Guatemala has high obesity, overweight and sedentary index which increase the risk of diabetes. Worldwide every 6 seconds somebody dies as a consequence of diabetes and in Guatemala represents the third cause in general mortality. The analysis is made about type 2 diabetes which represents 90% of all diabetes and in general is preventable. The author proposes 3 moments in the diabetes natural history: (1) healthy patients that will become diabetics, (2) diabetics who will have a complication related to the disease and (3) complicated patients who will decease. During these three moments there are interventions to be done, however there are non-preventable programs and the inefficiency of the public assistant system. The author proposes possible solutions in base of scientific evidence to stop the raising of diabetes, lowering micro and macro vascular complications and overall to generate a preventive culture in Guatemala.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , /mortality , /prevention & control , Prediabetic State , Disease/economics , Obesity , OverweightABSTRACT
BACKGROUND & OBJECTIVE: In India, health services are funded largely through out-of-pocket spendings (OOPS). We carried out this study to collect data on the cost of an illness episode and parameters affecting cost in five locations in India. METHODS: The data were obtained through a household survey carried out in 2005 in five locations among resource-poor persons in rural India. The analysis was based on self-reported illness episodes and their costs. The study was based on 3,531 households (representing 17,323 persons) and 4,316 illness episodes. RESULTS: The median cost of one illness episode was INR 340. When costs were calculated as per cent of monthly income per person, the median value was 73 per cent of that monthly income, and could reach as much as 780 per cent among the 10 per cent most exposed households. The estimated median per-capita cost of illness was 6 per cent of annual per-capita income. The ratio of direct costs to indirect costs was 67:30. The cost of illness was lower among females in all age groups, due to lower indirect costs. 61 per cent of total illnesses, costing 37.4 per cent of total OOPS, were due to acute illnesses; chronic diseases represented 17.7 per cent of illnesses but 32 per cent of costs. Our study showed that hospitalizations were the single most costly component on average, yet accounted for only 11 per cent of total on an aggregated basis, compared to drugs that accounted for 49 per cent of total aggregated costs. Locations differed from each other in the absolute cost of care, in distribution of items composing the total cost of care, and in supply. INTERPRETATION & CONCLUSION: Interventions to reduce the cost of illness should be context-specific, as there is no "one-size-fits-all" model to establish the cost of healthcare for the entire sub-continent. Aggregated expenses, rather than only hospitalizations, can cause catastrophic consequences of illness.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Cost of Illness , Disease/economics , Female , Health Expenditures/statistics & numerical data , Humans , Income/statistics & numerical data , India , Male , Middle Aged , Poverty Areas , Rural Population/statistics & numerical dataABSTRACT
OBJECTIVE: To determine the pattern of morbidity and the demographic and socioeconomic characteristics of patients seeking in-patient services for noncommunicable diseases (NCDs) in medical units of a tertiary care hospital, and to estimate the economic burden imposed by these admissions on the households. METHODS: A descriptive cross-sectional study was conducted in medical units of the Colombo North Teaching Hospital, Ragama. Data were collected using a pre-tested interviewer-administered questionnaire. Morbidity patterns and demographic and socio-economic characteristics of patients with NCDs were determined. Direct and indirect components of the household cost of hospital stay were estimated. RESULTS: Fifty five per cent of the patients men male and the largest age group (11%) was 50-54 years. Seventy per cent were above 40 years of age, and 63% represented social classes 4 and 5. Diseases of the circulatory system were the commonest (31%). Median household cost of the total hospital stay was Rs. 852.00 (inter-quartile range Rs. 351.00-1885.00) of which 70% were direct costs. Median daily cost was Rs. 340.00 (interquartile range Rs.165.00-666.00). Only 44% of patients incurred an indirect cost. Cost of travelling was the main contributor (36%) to the household cost. Laboratory investigations contributed 16%. CONCLUSIONS: Most patients seeking in-patient services were from a poor socioeconomic background. The economic burden imposed by the admission to the household was mainly due to direct costs incurred for travelling and investigations.
Subject(s)
Adolescent , Adult , Aged , Child , Cost of Illness , Cross-Sectional Studies , Direct Service Costs , Disease/economics , Family Characteristics , Female , Hospitalization/economics , Hospitals, Teaching , Humans , Male , Middle Aged , Morbidity/trends , Poverty , Surveys and Questionnaires , Risk Factors , Socioeconomic Factors , Sri LankaABSTRACT
En trabajos anteriores, se han divulgado diferentes indicadores utilizados para evaluar el daño económico que la morbilidad ocasiona, así como un procedimiento para estimar éste y algunos resultados de su aplicación. En esta ocasión abordamos las pérdidas económicas, no como herramienta para medir el efecto económico de la morbilidad, sino como instrumento de pesquisaje sobre problemas de salud