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dc.creatorSalomón, Joshua A.
dc.creatorCarvalho, Natalie
dc.creatorGutiérrez-Delgado, Cristina
dc.creatorOrozco, Ricardo
dc.creatorMancuso, Anna
dc.creatorHogan, Daniel R.
dc.creatorLee, Diana
dc.creatorMurakami, Yuki
dc.creatorSridharan, Lakshmi
dc.creatorMedina-Mora, María Elena
dc.creatorGonzález-Pier, Eduardo
dc.date.accessioned2017-06-30T03:42:02Z
dc.date.available2017-06-30T03:42:02Z
dc.date.issued2012es_ES
dc.identifier2125es_ES
dc.identifier.issn0959-8138es_ES
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/6783
dc.identifier.urihttps://doi.org/10.1136/bmj.e355es_ES
dc.description.abstractObjective To inform decision making regarding intervention strategies against non-communicable diseases in Mexico, in the context of health reform. Design Cost effectiveness analysis based on epidemiological modelling. Interventions 101 intervention strategies relating to nine major clusters of non-communicable disease: depression, heavy alcohol use, tobacco use, cataracts, breast cancer, cervical cancer, chronic obstructive pulmonary disease, cardiovascular disease, and diabetes. Data sources Mexican data sources were used for most key input parameters, including administrative registries; disease burden and population estimates; household surveys; and drug price databases. These sources were supplemented as needed with estimates for Mexico from the WHO-CHOICE unit cost database or with estimates extrapolated from the published literature. Main outcome measures Population health outcomes, measured in disability adjusted life years (DALYs); costs in 2005 international dollars ($Int); and costs per DALY. Results Across 101 intervention strategies examined in this study, average yearly costs at the population level would range from around ?$Int1m (such as for cataract surgeries) to >$Int1bn for certain strategies for primary prevention in cardiovascular disease. Wide variation also appeared in total population health benefits, from <1000 DALYs averted a year (for some components of cancer treatments or aspirin for acute ischaemic stroke) to >300 000 averted DALYs (for aggressive combinations of interventions to deal with alcohol use or cardiovascular risks). Interventions in this study spanned a wide range of average cost effectiveness ratios, differing by more than three orders of magnitude between the lowest and highest ratios. Overall, community and public health interventions such as non-personal interventions for alcohol use, tobacco use, and cardiovascular risks tended to have lower cost effectiveness ratios than many clinical interventions (of varying complexity). Even within the community and public health interventions, however, there was a 200-fold difference between the most and least cost effective strategies examined. Likewise, several clinical interventions appeared among the strategies with the lowest average cost effectiveness ratios—for example, cataract surgeries. Conclusions Wide variations in costs and effects exist within and across intervention categories. For every major disease area examined, at least some strategies provided excellent value for money, including both population based and personal interventions.es_ES
dc.language.isoenges_ES
dc.publisherBMJ Publishing Group Ltdes_ES
dc.relation344-355 p.es_ES
dc.relationversión del editores_ES
dc.rightsacceso cerradoes_ES
dc.subject.meshFemalees_ES
dc.subject.meshHumanses_ES
dc.subject.meshMalees_ES
dc.subject.meshMexicoes_ES
dc.subject.meshPrimary Prevention-economicses_ES
dc.titleIntervention strategies to reduce the burden of non-communicable diseases in Mexico: cost effectiveness analysises_ES
dc.typearticlees_ES
dc.contributor.affiliationDepartment of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USAes_ES
dc.contributor.emailjsalomon@hsph.harvard.edues_ES
dc.relation.jnabreviadoBMJes_ES
dc.relation.journalBritish medical journales_ES
dc.identifier.placeEnglandes_ES
dc.date.published2012es_ES
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñizes_ES
dc.identifier.eissn1756-1833es_ES
dc.identifier.doi10.1136/bmj.e355es_ES
dc.description.monthMares_ES
dc.subject.meshmCost-Benefit Analysises_ES


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