Data from: Medical expenditure for chronic diseases in Mexico: the case of selected diagnoses treated by the largest care providers

Background: Chronic diseases (CD) are a public health emergency in Mexico. Despite concern regarding the financial burden of CDs in the country, economic studies have focused only on diabetes, hypertension, and cancer. Furthermore, these estimated financial burdens were based on hypothetical epidemiology models or ideal healthcare scenarios. The present study estimates the annual expenditure per patient and the financial burden for the nine most prevalent CDs, excluding cancer, for each of the two largest public health providers in the country: the Ministry of Health (MoH) and the Mexican Institute of Social Security (IMSS). Methods: Using the Mexican National Health and Nutrition Survey 2012 (ENSANUT) as the main source of data, health services consumption related to CDs was obtained from patient reports. Unit costs for each provided health service (e.g. consultation, drugs, hospitalization) were obtained from official reports. Prevalence data was obtained from the published literature. Annual expenditure due to health services consumption was calculated by multiplying the quantity of services consumed by the unit cost of each health service. Results: The most expensive CD in both health institutions was chronic kidney disease (CKD), with an annual unit cost for MoH per patient of US$ 8,966 while for IMSS the expenditure was US$ 9,091. Four CDs (CKD, arterial hypertension, type 2 diabetes, and chronic ischemic heart disease) accounted for 88% of the total CDs financial burden (US$ 1.42 billion) in MoH and 85% (US$ 3.96 billion) in IMSS. The financial burden of the nine CDs analyzed represents 8% and 25% of the total annual MoH and IMSS health expenditure, respectively. Conclusions/Significance: The financial burden from the nine most prevalent CDs, excluding cancer, is already high in Mexico. This finding by itself argues for the need to improve health promotion and disease detection, diagnosis, and treatment to ensure CD primary and secondary prevention. If the status quo remains, the financial burden could be higher.

背景：慢性疾病（Chronic Diseases, CD）是墨西哥当前的公共卫生紧急事件。尽管该国对慢性疾病带来的经济负担高度关注，但现有经济学研究仅聚焦于糖尿病、高血压与癌症。此外，此类经济负担评估均基于假设性流行病学模型或理想化医疗场景。本研究针对墨西哥两大公立医疗服务提供者——卫生部（Ministry of Health, MoH）与墨西哥社会保障研究院（Mexican Institute of Social Security, IMSS），对九种最常见的非癌症慢性疾病开展患者年度人均支出与经济负担测算。

方法：本研究以2012年墨西哥全国健康与营养调查（Mexican National Health and Nutrition Survey 2012, ENSANUT）为核心数据源，从患者报告中提取与慢性疾病相关的医疗服务消费数据；各类医疗服务（如门诊咨询、药物治疗、住院服务）的单位成本数据源自官方报告；患病率数据则来自已发表的学术文献。通过将服务使用量与对应医疗服务的单位成本相乘，计算得出因医疗服务消费产生的年度支出总额。

结果：两家医疗服务机构中，支出最高的慢性疾病均为慢性肾脏病（Chronic Kidney Disease, CKD）：卫生部的患者年度人均成本为8966美元，墨西哥社会保障研究院则为9091美元。在卫生部的统计中，四种慢性疾病（慢性肾脏病、动脉高血压、2型糖尿病与慢性缺血性心脏病）的经济负担占该机构慢性疾病总负担的88%（约14.2亿美元）；墨西哥社会保障研究院的对应占比为85%（约39.6亿美元）。本次分析的九种慢性疾病的经济负担，分别占卫生部与墨西哥社会保障研究院年度总医疗支出的8%与25%。

结论与意义：本次分析的九种非癌症常见慢性疾病所带来的经济负担，在墨西哥已处于较高水平。这一发现足以说明，亟需加强健康促进、疾病筛查、诊断与治疗工作，以保障慢性疾病的一级与二级预防。若维持现状，此类经济负担或将进一步加重。