Health Needs Assessment: Chronic Kidney Disease Secondary to Type 2 Diabetes Mellitus in a Population without Social Security, Mexico 2016–2032

Author:

Martínez-Valverde Silvia1ORCID,Zepeda-Tello Rodrigo2,Castro-Ríos Angélica3ORCID,Toledano-Toledano Filiberto4ORCID,Reyes-Morales Hortensia5,Rodríguez-Matías Adrián6,Durán-Arenas Juan7ORCID

Affiliation:

1. Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Mexico City 06720, Mexico

2. Dirección de Prestaciones Económicas y Sociales, Instituto Mexicano del Seguro Social, Mexico City 06600, Mexico

3. Unidad de Investigación en Epidemiología Clínica, Hospital de Pediatría, Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico

4. Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Mexico City 06720, Mexico

5. Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Mexico

6. Servicio de Nefrología, Hospital Angeles Metropolitano, Mexico City 06760, Mexico

7. Departamento de Salud Pública, Facultad de Medicina, Universidad Autónoma de México, Mexico City 04510, Mexico

Abstract

Health needs assessment is a relevant tracer of planning process of healthcare programs. The objective is to assess the health needs of chronic kidney disease (CKD) secondary to type 2 diabetes mellitus (T2 DM) in a population without social security in Mexico. The study design was a statistical simulation model based on data at the national level of Mexico. A stochastic Markov model was used to simulate the progression from diabetes to CKD. The time horizon was 16 years. The results indicate that in 2022, kidney damage progression and affectation in the diabetic patient cohort will be 34.15% based on the time since T2 DM diagnosis. At the end of the 16-year period, assuming that the model of care remains unchanged, early renal involvement will affect slightly more than twice as many patients (118%) and cases with macroalbuminuria will triple (228%). The need for renal replacement therapy will more than double (169%). Meanwhile, deaths associated with cardiovascular risk will more than triple (284%). We concluded that the clinical manifestations of patients with CKD secondary to T2 DM without social security constitute a double challenge. The first refers to the fact that the greatest health need is early care of CKD, and the second is the urgent need to address cardiovascular risk in order to reduce deaths in the population at risk.

Funder

Hospital Infantil de México Federico Gómez

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

Reference53 articles.

1. Altschuld, J.W., and Witkin, R. (1995). Planning and Conducting Needs Assessments: A Practical Guide, Sage Publications.

2. Watkins, R., Meiers, M.W., and Visser, Y. (2012). A Guide to Assessing Needs: Essential Tools for Collecting Information, Making Decisions, and Achieving Development Results, World Bank.

3. Cavanagh, S., and Chadwick, K. (2005). Health Needs Assessment: A Practical Guide. National Institute for Health and Clinical Excellence, National Institute for Health and Clinical Excellence.

4. Donabedian, A. (1988). Los Espacios de la Salud: Aspectos Fundamentales de la Organización de la Atención Médica, Fondo de Cultura Económica.

5. Evolving importance of kidney disease: From subspecialty to global health burden;Eckardt;Lancet,2013

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