The transformation of the Mexican healthcare system has been focused on the objective of reducing the incidence of the largest burden on the system: chronic diseases. Through tech and new prevention methods, the country is finally materializing this goal, experts say.
Mexico’s urgent need for preventive healthcare is based on the high prevalence of chronic diseases to some extent caused by the population’s poor health habits. Chronic diseases represent seven of the 10 leading causes of death in the country, the two most relevant being diabetes and heart disease, representing 80 percent of IMSS’ budget. Due to Mexico’s obesity epidemic, millions of economically active people are at risk of developing a chronic disease, according to the study, “Mexico and the Challenge of Chronic Non-Communicable Diseases,” by José Barba Evia, Sanitary Manager of the Blood Bank at the Pan American Medical Institute.
According to INEGI, cases of Type 2 diabetes mellitus were on the rise between 2016 and 2019, with an incidence rate of 215.4 per 100,000 inhabitants. In 2020, the records showed a decrease in this rate to 157.6 cases per 100,000 inhabitants over nine years of age. However, the number of registered cases once again increased in the first half of 2021, to 183.9 cases per 100,000 inhabitants.
As for heart disease, INEGI found that in the last eight years, the incidence rate of ischemic heart disease remained stable between 2013 to 2018 at 33.2-33.4 cases per 100,000 inhabitants, registering an increase in 2019 to 37.3 cases per 100,000 inhabitants over 9 years of age, which in 2020 decreased to 23.4 cases. In 2021, the national incidence rate of ischemic heart disease was 21 cases per 100,000 inhabitants.
According to an analysis published on Health Promotion International, the country’s federal government has addressed this issue through chronic disease prevention plans, regulations and policies that seek to address social and environmental factors, led by the National Institute of Public Health and Ministry of Health in collaboration with various nongovernmental organizations.
The Specialized Medical Units for Chronic Diseases (UNEME EC) established at public hospitals and clinics were the result of these efforts, focused on providing patients with an integral approach to chronic disease prevention involving detection, education and treatment. These units follow a "modular medical-architectural program" and offer multiple outpatient services properly organized and scheduled to scale the level of care to regional demand, with particular emphasis on illnesses with a so-called “catastrophic expenditure.”
The initial goal of the UNEME ECs was to help reduce saturation rates and operating costs at hospitals, offering patients comprehensive care and personalized follow-up from medical, nursing, nutritional, psychological and social work staff. These efforts, however, have not delivered to the expected level. “Programs like UNEME EC were not enough to revert increases in the prevalence of NCD and its associated costs, which calls for additional prevention programs, regulations and policies,” says Health Promotion International. Furthermore, according to a study by the Ministry of Health, most patients at UNEME ECs were only under integral treatment for five months. After that, they stopped attending their appointments.
While strong government leadership is essential to reducing the risk and burden of chronic diseases (through policies and programs that create a healthy environment and improve access to care), effective intersectoral collaboration aimed at prevention and control of chronic diseases is just as fundamental. Mexican health leaders and entrepreneurs from the private sector have actively promoted programs on healthy habits, disease prevention and general information on health topics. Technology has become a common denominator in all these efforts.
The use of new technologies makes the patient feel engaged in the prevention of various types of diseases, explains The Healthcare Insights. This has led to a number of applications for smartphones and computers that help people better control fundamental aspects of prevention, such as diet and physical activity. Insurtech Sofía, for example, offers easy access to healthcare through an accessible plan that includes preventive care, video consultations with specialists and coverage of medical expenses, all through an app.
“Access to primary healthcare (PHC) is the foundation for good healthcare. Combining PHC with insurance, which could cover long-term diseases, is key. Prevention and timely detection of serious diseases allow us to subsidize the cost of providing PHC. This combination links the financial incentive with people being healthier and is exactly what we have built with Sofía,” says Arturo Sánchez, CEO of Sofía.
Another solution born from technology is Meddi, a digital health marketplace that allows patients to have easier and cheaper access to private healthcare services. It connects users with hospitals, doctors, pharmacies or laboratories, and additionally offers ambulance services, life insurance and benefits related to gyms, dental services, optical services and several other healthcare services. “One of our company pillars is to promote prevention. Through our services, we try to develop this necessary habit among our users,” says Pablo Aguirre, CEO and Co-Founder of Meddi.
To encourage prevention, providers like Asistensi have gone as far as creating emergency insurance products that cover chronic diseases. Chronic patients with hypertension or diabetes usually face the highest medical costs when facing complications, according to Andrés González-Silén, Executive President of Asistensi. The company helps prevent those complications by providing immediate, unlimited care and monitoring. “Making doctors and health services, like ambulances, widely and almost immediately available to patients is part of our active prevention strategy,” explains González-Silén.
Technology can be a great asset in preventing diseases and managing care, says Omar Tomey, Medical Director of AbbVie Mexico. “It can support sustainable healthcare centered around a patient using telemedicine, direct messaging tools, remote monitoring and digital platforms for medicine management, resulting in better health systems,” he says.
However, tech has not been able to fully permeate the Mexican health system. According to Eduardo Medeiros, Co-Founder and CEO of Welbe Care, two of the main problems to fully establish such solutions are the country’s fragmented system and cultural resistance among Mexicans to take ownership of their health. “Although the benefits of implementing technology in the health ecosystem are clear, these two factors are significant barriers for adoption to thrive,” says Medeiros.