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Health care trajectories and barriers to treatment for patients with end-stage renal disease without health insurance in Mexico: a mixed methods approach

dc.rights.licensehttp://creativecommons.org/licenses/by/4.0es_MX
dc.creatorMarcela Agudelo Boteroes_MX
dc.creatorMARÍA CECILIA GONZÁLEZ ROBLEDOes_MX
dc.creatorHORTENSIA REYES MORALESes_MX
dc.creatorMARTHA LILIANA GIRALDO RODRIGUEZes_MX
dc.creatorMario Rojases_MX
dc.creatorDOLORES MINO LEONes_MX
dc.creatorDAYAN IRENE OCAMPO MORALESes_MX
dc.creatorRAFAEL VALDEZ ORTIZes_MX
dc.date2020
dc.date.accessioned2021-08-24T21:29:42Z
dc.date.available2021-08-24T21:29:42Z
dc.identifier.urihttp://repositorio.inger.gob.mx/jspui/handle/20.500.12100/17236
dc.descriptionBackground Mexico has the sixth-highest premature death rate from chronic kidney disease (CKD) in the world. From 1990 to 2017, the age-standardized CKD mortality rate jumped from 28.7 to 58.1 per 100,000 inhabitants, making it the second-leading cause of death that year. Medical care for the disease is inequitable, as those without health insurance have limited access to renal replacement therapy (RRT). The objective of this study is to describe the healthcare trajectories of patients with end-stage renal disease (ESRD) in a public hospital in Mexico City and the barriers they face in receiving peritoneal dialysis and haemodialysis. Methods This study uses a convergent mixed methods approach and is predominantly qualitative. Patients completed 199 surveys, and 42 semi-structured interviews with patients having ESRD and their families were conducted. The quantitative data were analysed using descriptive statistics, and the qualitative data were processed using a phenomenological approach. Results It was found that 76.9% of the patients received peritoneal dialysis or haemodialysis as their first RRT. Over 30% began their treatment at least a month after a health professional prescribed it. Almost 50% had been hospitalized for complications related to the disease in the previous year, and 36% had uncertainties about their treatment. Close to 64% of the haemodialysis patients received treatment intermittently. Barriers to accessing treatment, information, contact with health services, and treatment availability were identified. Patients and their families encountered economic and emotional difficulties at every phase of their search for medical care and treatment. Conclusion Mexico urgently needs to implement public policies related to CKD that are primarily directed at its prevention but should also implement policies directed at slowing its progression, reducing its complications, and providing funding for uninsured patients who require RRT. These policies must be based on the perspectives of human rights and equality, and the perspectives of patients, their families and the general population should be included in the policy creation process.es_MX
dc.formatAdobe PDFes_MX
dc.languageenges_MX
dc.publisherBMC & International Society for Equity in Healthes_MX
dc.relationhttps://equityhealthj.biomedcentral.com/articles/10.1186/s12939-020-01205-4es_MX
dc.relation.requiresSies_MX
dc.rightsAcceso Abiertoes_MX
dc.sourceInternational Journal for Equity in Health (1475-9276) Vol. 19 (2020)es_MX
dc.subjectMEDICINA Y CIENCIAS DE LA SALUDes_MX
dc.subjectCiencias médicases_MX
dc.subjectCiencias clínicases_MX
dc.subjectEnfermedades Urológicases_MX
dc.subjectEnfermedades renaleses_MX
dc.subjectEnfermedades renales crónicases_MX
dc.subjectCuidado de la saludes_MX
dc.subjectUrologic diseaseses_MX
dc.subjectKidney diseaseses_MX
dc.subjectChronic kidney diseaseses_MX
dc.subjectHealth carees_MX
dc.titleHealth care trajectories and barriers to treatment for patients with end-stage renal disease without health insurance in Mexico: a mixed methods approaches_MX
dc.typeArtículoes_MX
dc.audienceResearcherses_MX
dc.creator.idAUBM810307MNEGTR01es_MX
dc.creator.idGORC681208MDFNBC09es_MX
dc.creator.idREMH510406MDFYRR02es_MX
dc.creator.idGIRM750612MNERDR04es_MX
dc.creator.id0000-0001-8796-5662es_MX
dc.creator.idMILD650803MDFNNL06es_MX
dc.creator.idOAMD890510MNECRY01es_MX
dc.creator.idVAOR750823HSLLRF09es_MX
dc.creator.nameIdentifiercurpes_MX
dc.creator.nameIdentifiercurpes_MX
dc.creator.nameIdentifiercurpes_MX
dc.creator.nameIdentifiercurpes_MX
dc.creator.nameIdentifiercvues_MX
dc.creator.nameIdentifiercurpes_MX
dc.creator.nameIdentifiercurpes_MX
dc.creator.nameIdentifiercurpes_MX


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