Assessing costs of a hypertension program in primary care: evidence from the HEARTS program in Mexico
Objective. In 2021, Mexico launched the HEARTS program to improve the prevention and control of cardiovascular disease (CVD) risk factors in 20 primary care facilities in the states of Chiapas and Yucatán. This study projects the annual cost of program implementation and discusses budgetary implicat...
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ftdoajarticles:oai:doaj.org/article:6a3eeabd5d424de2b4468ff736d1044c 2023-05-15T15:12:26+02:00 Assessing costs of a hypertension program in primary care: evidence from the HEARTS program in Mexico Carlos Chivardi Brian Hutchinson Virginia Molina Elena Moreno Ileana Fajardo Gloria P. Giraldo-Arcila Hugo Miguel Malo Pedro Ordunez Roxana Rodríguez-Franco Andrew E. Moran Deliana Kostova 2022-09-01T00:00:00Z https://doi.org/10.26633/RPSP.2022.144 https://doaj.org/article/6a3eeabd5d424de2b4468ff736d1044c EN ES PT eng spa por Pan American Health Organization https://iris.paho.org/handle/10665.2/56393 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 doi:10.26633/RPSP.2022.144 https://doaj.org/article/6a3eeabd5d424de2b4468ff736d1044c Revista Panamericana de Salud Pública, Vol 46, Iss 144, Pp 1-10 (2022) cardiovascular diseases costs and cost analyses hypertension diabetes mellitus cholesterol mexico Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles https://doi.org/10.26633/RPSP.2022.144 2022-12-31T00:30:05Z Objective. In 2021, Mexico launched the HEARTS program to improve the prevention and control of cardiovascular disease (CVD) risk factors in 20 primary care facilities in the states of Chiapas and Yucatán. This study projects the annual cost of program implementation and discusses budgetary implications for scaling up the program. Methods. We obtained district-level data on treatment protocols, medication costs, and other resources required to prevent and treat CVD. We used the HEARTS Costing Tool to estimate total and per-patient costs. A “partial implementation” scenario calculated the costs of implementing HEARTS if existing pharmacological treatment protocols are left in place. The second scenario, “full implementation,” examined costs if programs use HEARTS pharmacological protocol. Results. Respectively in the partial and full implementation scenarios, total annual costs to implement and operate HEARTS were $260 023 ($32.1 per patient/year) and $255 046 ($31.5 per patient/year) in Chiapas, and $1 000 059 ($41.3 per patient/year) and $1 013 835 ($43.3 per patient/year) in Yucatán. In Chiapas, adopting HEARTS standardized treatment protocols resulted in a 9.7 % reduction in annual medication expenditures relative to maintaining status-quo treatment approaches. In Yucatán, adoption was $12 875 more expensive, in part because HEARTS hypertension treatment regimens were more intensive than status quo regimens. Conclusion. HEARTS in the Americas offers a standardized strategy to treating and controlling CVD risk factors. In Mexico, approaches that may lead to improved program affordability include adoption of the recommended HEARTS treatment protocols with preferred medications and task shifting of services from physicians to nurses and other providers. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista Panamericana de Salud Pública 46 1 |
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ftdoajarticles |
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English Spanish Portuguese |
topic |
cardiovascular diseases costs and cost analyses hypertension diabetes mellitus cholesterol mexico Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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cardiovascular diseases costs and cost analyses hypertension diabetes mellitus cholesterol mexico Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Carlos Chivardi Brian Hutchinson Virginia Molina Elena Moreno Ileana Fajardo Gloria P. Giraldo-Arcila Hugo Miguel Malo Pedro Ordunez Roxana Rodríguez-Franco Andrew E. Moran Deliana Kostova Assessing costs of a hypertension program in primary care: evidence from the HEARTS program in Mexico |
topic_facet |
cardiovascular diseases costs and cost analyses hypertension diabetes mellitus cholesterol mexico Medicine R Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Objective. In 2021, Mexico launched the HEARTS program to improve the prevention and control of cardiovascular disease (CVD) risk factors in 20 primary care facilities in the states of Chiapas and Yucatán. This study projects the annual cost of program implementation and discusses budgetary implications for scaling up the program. Methods. We obtained district-level data on treatment protocols, medication costs, and other resources required to prevent and treat CVD. We used the HEARTS Costing Tool to estimate total and per-patient costs. A “partial implementation” scenario calculated the costs of implementing HEARTS if existing pharmacological treatment protocols are left in place. The second scenario, “full implementation,” examined costs if programs use HEARTS pharmacological protocol. Results. Respectively in the partial and full implementation scenarios, total annual costs to implement and operate HEARTS were $260 023 ($32.1 per patient/year) and $255 046 ($31.5 per patient/year) in Chiapas, and $1 000 059 ($41.3 per patient/year) and $1 013 835 ($43.3 per patient/year) in Yucatán. In Chiapas, adopting HEARTS standardized treatment protocols resulted in a 9.7 % reduction in annual medication expenditures relative to maintaining status-quo treatment approaches. In Yucatán, adoption was $12 875 more expensive, in part because HEARTS hypertension treatment regimens were more intensive than status quo regimens. Conclusion. HEARTS in the Americas offers a standardized strategy to treating and controlling CVD risk factors. In Mexico, approaches that may lead to improved program affordability include adoption of the recommended HEARTS treatment protocols with preferred medications and task shifting of services from physicians to nurses and other providers. |
format |
Article in Journal/Newspaper |
author |
Carlos Chivardi Brian Hutchinson Virginia Molina Elena Moreno Ileana Fajardo Gloria P. Giraldo-Arcila Hugo Miguel Malo Pedro Ordunez Roxana Rodríguez-Franco Andrew E. Moran Deliana Kostova |
author_facet |
Carlos Chivardi Brian Hutchinson Virginia Molina Elena Moreno Ileana Fajardo Gloria P. Giraldo-Arcila Hugo Miguel Malo Pedro Ordunez Roxana Rodríguez-Franco Andrew E. Moran Deliana Kostova |
author_sort |
Carlos Chivardi |
title |
Assessing costs of a hypertension program in primary care: evidence from the HEARTS program in Mexico |
title_short |
Assessing costs of a hypertension program in primary care: evidence from the HEARTS program in Mexico |
title_full |
Assessing costs of a hypertension program in primary care: evidence from the HEARTS program in Mexico |
title_fullStr |
Assessing costs of a hypertension program in primary care: evidence from the HEARTS program in Mexico |
title_full_unstemmed |
Assessing costs of a hypertension program in primary care: evidence from the HEARTS program in Mexico |
title_sort |
assessing costs of a hypertension program in primary care: evidence from the hearts program in mexico |
publisher |
Pan American Health Organization |
publishDate |
2022 |
url |
https://doi.org/10.26633/RPSP.2022.144 https://doaj.org/article/6a3eeabd5d424de2b4468ff736d1044c |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista Panamericana de Salud Pública, Vol 46, Iss 144, Pp 1-10 (2022) |
op_relation |
https://iris.paho.org/handle/10665.2/56393 https://doaj.org/toc/1020-4989 https://doaj.org/toc/1680-5348 1020-4989 1680-5348 doi:10.26633/RPSP.2022.144 https://doaj.org/article/6a3eeabd5d424de2b4468ff736d1044c |
op_doi |
https://doi.org/10.26633/RPSP.2022.144 |
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Revista Panamericana de Salud Pública |
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46 |
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