Biomedical subjects

Esteban Puentes-Rosas

Publications and source records attributed to Esteban Puentes-Rosas.

6 recordsLinked to original sources

PubMed2005

[Prevalence and diagnosis of depression in Mexico].

OBJECTIVE: To present the prevalence of depressive episodes, as well as the percentage of the population with medical diagnosis. MATERIAL AND METHODS: The definition of depression was based on a schedule with DSM IV diagnostic criteria. Using data from the 2002-2003 National Assessment Performance Survey, the prevalence of depression was estimated at the national level, by sex, age, education, size of residence community, and state. The percentage of individuals with medically diagnosed depression and the percentage of those under treatment were also estimated. RESULTS: The national prevalence of depression was 4.5%: 5.8% in women and 2.5% in men. The prevalence of depression increased with age and decreased with higher education. Among males, the prevalence was higher in rural than urban communities. A large percentage of affected individuals have no medical diagnosis. CONCLUSIONS: Depression is a frequent disease in adults.A higher prevalence is associated with social vulnerability. The low percentage of diagnosis represents a challenge for mental health service planning and provision.

Adolescent↗

PubMed2005

[Responsiveness of the Mexican health system].

OBJECTIVE: To present and discuss findings on the responsiveness of the Mexican health system. MATERIAL AND METHODS: The data source was the 2002-2003 National Performance Assessment Survey. A descriptive analysis was performed and results were adjusted for user's expectations using vignette information. Final results were disaggregated by sex, provider, age, and education level. RESULTS: Responsiveness scores given by women and senior individuals were higher than those provided by men and young adults. Major differences were observed when provider comparisons were made. In ambulatory care, the Ministry of Health and private providers were better rated than major social security institutions. For in-patient care, private providers were better rated than public health institutions. CONCLUSIONS: Responsiveness of the Mexican health system requires improvements in certain areas in order to meet one of the basic goals of all health systems.

Adolescent↗

PubMed2005

[Medical insurance coverage in Mexico].

OBJECTIVE: To present estimates of health insurance coverage in Mexico and discuss the differences among some sources of information. MATERIAL AND METHODS: Based on a national survey performed in 2002, the percentage of insurance coverage was estimated by state, rural condition, and expenditure level. RESULTS: The percentage of the population without medical insurance is 59.9%. The main insurance institution is the Mexican Institute for Social Security (Instituto Mexicano del Seguro Social, IMSS), with a coverage of 29.5%. Private insurance agencies cover 1.5% of the total population. There are huge differences in insurance coverage by state, expenditure level and social exclusion level. CONCLUSIONS: Data on insurance coverage provided by Mexico's main social security institution differ from that obtained through population-based studies. Some of these differences may be due to probabilistic reasons and others to macroeconomic changes. However, these reasons had not been sufficiently explored. In depth studies are needed in order to explain the observed differences.

Data Collection↗

PubMed2005

[Catastrophic health expenditures in Mexico: comparative study by social exclusion level].

OBJECTIVE: To describe the differences in catastrophic health expenditures in five Mexican states. MATERIAL AND METHODS: This study included five states selected by convenience according to their social exclusion level. Household catastrophic health expenditures attributable to the three components of out of pocket health expenditures (ambulatory care, medication, and inpatient care) were calculated. RESULTS: The risk of impoverishment at the national level was greater in the most vulnerable households, namely, in the 20% poorest, rural, and uninsured households. Nevertheless, in states like Aguascalientes, Guerrero, Sinaloa, and Morelos the results were different. Over 70% of catastrophic health expenditures were attributable to medication and outpatient care expenditures in the poorest states. CONCLUSIONS: The differences found among states show that the implementation of local health policies to reduce catastrophic health expenditures should be based on evidence generated from analyses at the state level.

Adult↗

PubMed2004

[Mortality from suicides: Mexico, 1990-2001].

OBJECTIVE: To describe mortality from suicides in Mexico in 2001, as well as the main changes in the methods used to commit suicide and in trends by age and gender that have been observed since 1990, both for the country as a whole and for each state. METHODS: For this descriptive study we utilized as information sources the official mortality records of the National Institute of Statistics, Geography, and Informatics (Instituto Nacional de Estadística, Geografía e Informática) for the period of 1990 through 2001. To calculate mortality rates we used the populations estimated in 2002 by the National Population Council (Consejo Nacional de Población). Mortality was described by sex, age group, and state, along with the changes seen over the period of 1990 through 2001 in the rates and methods of suicide. We used the direct method to standardize the rates, using as a reference the population data for the year 2000. To make statistical comparisons of the trends by age group and gender we used a test of parallelism utilizing the F statistic. The level of statistical significance of differences in suicide methods was determined with the chi-square test. RESULTS: During 2001, 3,784 suicides were registered (3,110 of them in men and 674 in women), which represents a rate of 3.72 deaths from suicide per 100,000 persons, in a total national population of 101.8 million inhabitants. The states with the highest suicide mortality were Campeche and Tabasco (9.68 and 8.47 per 100,000, respectively). The lowest rates were seen in Chiapas and the state of Mexico (1.03 and 1.99 per 100,000, respectively). In 2001, mortality from suicides per 100,000 persons was 6.14 in men and 1.32 in women. The greatest increase by age group was seen in women 11-19 years old (from 0.8 per 100,000 in 1990 to 2.27 per 100,000 in 2001). The largest increase in men also occurred among those 11-19 years old (from 2.6 per 100,000 in 1990 to 4.5 per 100,000 in 2001). The highest rate (13.62 per 100,000 persons) was seen in men over 65 years of age. There were changes in suicide methods, with hanging now being the method most frequently used by both men and women. CONCLUSIONS: Suicide is a growing problem in Mexico, and controlling it requires immediate steps. The rapid increase in this phenomenon, particularly among young men and young women, should produce a call to action to quickly implement measures aimed at reducing the magnitude of suicide.

Adolescent↗

PubMedDate not supplied

[Caesarean sections in Mexico: tendencies, levels and associated factors].

OBJECTIVE: To describe the rate of caesarean sections in Mexico in the last 10 years and evaluate its relationship with several socioeconomic variables, type of health care services, and specialists' availability. MATERIAL AND METHODS: The Ministry of Health's register of births was used as source of information. The dependent variable was the type of delivery (vaginal or caesarean). The independent variables were: gross domestic product, human development index, illiteracy percentage among women, social exclusion index and, gynecology and obstetrics specialists supply. Correlations between variables were evaluated using Pearson's parametric test and Spearman range test. A lineal multiple regression was used to model the national caesarean data of 1999. RESULTS: National caesarean percentage increased in the last 10 years at an annual rate of 1%. It was considerably higher in social security institutions and the private sector. Caesareans percentages in 1999 were slightly above 35%. The highest values were those of the private sector with 53%, followed by social security institutions, with 38.2%. The variables more strongly associated with C sections were GDP, specialists' availability and human development index. CONCLUSIONS: It seems reasonable to advocate for a widespread descent in caesarean sections in Mexico. Important declines in certain contexts have been witnessed by implementing measures such as a second opinion before any C-section, a precise definition of the reasons for using it, and the monitoring of individual caesarean percentage among hospital obstetricians.

Cesarean Section↗