Cost-effectiveness analysis of a multidisciplinary health-care model for patients with type-2 diabetes implemented in the public sector in Mexico: A quasi-experimental, retrospective evaluation.

OBJECTIVE: In 2007, the Ministry of Health (MoH) in Mexico implemented a multidisciplinary health-care model (MHC) for patients with type-2 diabetes (T2D), which has proven more effective in controlling this condition than the conventional health-care model (CHC). RESEARCH DESIGN AND METHODS: We compared the cost-effectiveness of the MHC vs. the CHC for patients with T2D using a quasi-experimental, retrospective design. Epidemiologic and cost data were obtained from a randomly selected sample of health-care units, using medical records as well as patient- and facility-level data. We modelled the cost-effectiveness of the MHC at one, 10 and 20 years using a simulation model. RESULTS: The average cumulative costs per patient at 20 years were US$4,225 for the MHC and US$4,399 for the CHC. With a willingness to pay one gross domestic product (GDP) per capita per quality-adjusted life year (QALY) (US$8,910), the incremental net benefits per patient were US$1,450 and US$3,737 at 10 and 20 years, respectively. The MHC was cost-effective from the third year onward; however, increasing coverage to 500 patients per year rendered it cost-effective at year one. CONCLUSIONS: The MHC is cost-effective at 10 and 20 years. Cost-effectiveness can be achieved in the short term by increasing MHC coverage.

Health information technologies for sexual and reproductive health: Mapping the evidence in Latin America and the Caribbean.

In Latin America and the Caribbean (LAC), the sexual and reproductive health (SRH) of populations is a high priority for governments. Health information technologies (HITs) have been proposed as tools to close access gaps for SRH services. We developed an "evidence map" through a systematic search of articles published between 2005 and 2015 about the use of HITs to enhance SRH services in LAC countries. Two hundred and thirty-two registries were identified and screened. Thirty-one were eligible for full-text assessment. Most of the documents retrieved correspond to information provided by technology developers, targeting primarily the prevention of sexually transmitted infections and adolescent health. Although there has been clear progress in the use of HITs for SRH in the region, many institutional and technological challenges persist. Further studies should be carried out to test the beneficial effects of HITs on improving access to SRH services.