Salud Pública de México

Gaps between supply and demand of acute myocardial infarction treatment in Mexico

Ricardo Pérez-Cuevas, Saúl Eduardo Contreras-Sánchez, Svetlana V Doubova, Sebastián García-Saisó, Odet Sarabia-González, Paulina Pacheco-Estrello, Alexandra Arias-Mendoza

Resumen


Objective. To analyze acute myocardial infarction (AMI) admissions and in-hospital mortality rates and evaluate the competence of the Ministry of Health (MOH) hospitals to provide AMI treatment. Materials and methods. We used a mixed-methods approach: 1) Joinpoint analysis of hos­pitalizations and in-hospital mortality trends between 2005 and 2017; 2) a nation-wide cross-sectional MOH hospital survey. Results. AMI hospitalizations are increasing among men and patients aged >60 years; women have higher mortal­ity rates. The survey included 527 hospitals (2nd level =471; 3rd level =56). We identified insufficient competence to diagnose AMI (2nd level 37%, 3rd level 51%), perform pharmacological perfusion (2nd level 8.7%, 3rd level 26.8%), and mechanical reperfusion (2nd level 2.8%, 3rd level 17.9%). Conclusions. There are wide disparities in demand, supply, and health outcomes of AMI in Mexico. It is advisable to build up the competence with gender and age perspectives in order to di­agnose and manage AMI and reduce AMI mortality effectively.


Palabras clave


acute myocardial infarction; hospitalizations; in-hospital mortality; supply capacity; reperfusion

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DOI: http://dx.doi.org/10.21149/11032

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Salud Pública de México es una publicación periódica electrónica, bimestral, publicada por el Instituto Nacional de Salud Pública (con domicilio en Avenida Universidad núm. 655, col. Santa María Ahuacatitlán, Cuernavaca, Morelos, C.P. 62100, teléfono 329-3000, página web, www.insp.mx), con ISSN: 1606-7916 y Reserva de Derechos al Uso Exclusivo con número: 04-2012-071614550600-203, ambos otorgados por el Instituto Nacional del Derecho de Autor. Editor responsable: Carlos Oropeza Abúndez. Responsable de la versión electrónica: Subdirección de Comunicación Científica y Publicaciones, Avenida Universidad núm. 655, planta baja, col. Santa María Ahuacatitlán, Cuernavaca, Morelos, C.P. 62100, teléfono 329 3000. Fecha de última modificación: 16 de julio de 2020. D.R. © por el sitio: Instituto Nacional de Salud Pública.