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To compare the differences in treatment coverage of patients with systemic arterial hypertension and the proportion of patients with controlled AHT, between December 2020 and December 2021 in health facilities that implemented the HEARTS Initiative, and to explore the facilitators and barriers related to information systems in Mexico.Descriptive ecological observational study. The results at health facilities that have begun implementing the HEARTS Initiative (n=29) in Chiapas and Sonora were compared, with respect to the variables of treatment coverage and control of AHT, across four periods (semesters) in 2020 and 2021.There were more women than men in treatment and with controlled AHT in the different age groups. Some barriers were identified in information systems (e.g., multiplicity of systems, lack of interoperability, limited internet connectivity in health facilities), as well as facilitators (e.g., free access to information, availability of data from previous years, generation of estimates and projections).Sixteen (55%) of the implementing facilities improved the proportion of patients with controlled AHT in the period covered by the study. It is important to monitor indicators at the process level, and this should be accompanied by a redistribution of functions in health teams. It is also important to ensure a supply of medicines to enhance the effectiveness of the strategy. It is suggested to strengthen implementation with the key drivers for the control of arterial hypertension.Comparar a diferença de cobertura e proporção de pacientes com hipertensão arterial sistêmica controlada entre dezembro de 2020 e dezembro de 2021 em estabelecimentos de saúde que implementam a Iniciativa HEARTS, e explorar os facilitadores e as barreiras relacionados aos sistemas de informação no México.Estudo observacional ecológico descritivo. Os resultados dos estabelecimentos de saúde que iniciaram a implementação da Iniciativa HEARTS (n=29) em Chiapas e Sonora foram comparados em relação às variáveis de cobertura de atenção e controle da hipertensão, em 4 períodos (semestres) de 2020 a 2021.Há um maior número de mulheres em tratamento e controladas em relação aos homens nas diferentes faixas etárias. Foram identificadas algumas barreiras (por exemplo, multiplicidade de sistemas, falta de interoperabilidade e conexão limitada à internet nos estabelecimentos de saúde) e facilitadores (por exemplo, livre acesso à informação, disponibilidade de dados de anos anteriores e geração de estimativas e projeções) nos sistemas de informação.Cinquenta e cinco por cento dos estabelecimentos em implementação (16 estabelecimentos) melhoraram a proporção de pacientes controlados no período analisado. É importante monitorar os indicadores no nível de processos –tal monitoramento deve ser acompanhado por uma redistribuição das funções das equipes de saúde. Deve-se também assegurar o fornecimento de medicamentos para aumentar a eficácia da estratégia. Sugere-se fortalecer a implementação com os principais impulsionadores para o controle da hipertensão.

As part of the actions implemented by the Mexican government, to address chronic diseases most prevalent in the country, since 2008 the Ministry of Health launched the Medical Specialty Units Chronic Disease (UNEMES EC), which under Model "Prevention Clinic" provides care to patients referred to the first level and reagents for the treatment of diabetes mellitus, hypertension, overweight or obesity, metabolic syndrome and dyslipidemia. In this model converge several components: the medical-pharmacological care focused on disease control, prevention and early detection of complications, an education process for users and involving a multidisciplinary team composed of medical specialists, registered nurses, nutrition, psychology and social work and administrative staff; trained specifically for patient care and involve your family. Moreover, within primary care actions performed early detection, providing interventions to the population in risk detected. The extension component of good practice to the primary care level, provides training and advice to staff referral units. To implement the model in the 100 units in operation, were trained for multidisciplinary team, to publicize the operational model, define processes, responsibilities and made use of electronic medical record HAD doc care for these diseases. Through an exploratory qualitative study for five years consulting and continuous monitoring by various media was given, supervisory visits were conducted, with a charter application of structured, weighted and interviews with team members and executives program. Development in the implementation of the model. Results: The results show that there is a correlation between the proposed theoretical model and operating model, with good clinical integration within the team resulting in comprehensive, multidisciplinary care to patients and their families is given, highlighting satisfaction users. 3 World Congress on Integrated Care, Mexico City, Mexico, 19-21 November, 2015 International Journal of Integrated Care – Volume 15, 17 Nov – URN:NBN:NL:UI:10-1-117372 – http://www.ijic.org The findings to identify difficulties at various levels for the insertion and articulation of this model in the continuum of care. At the national level, although this protocolized the care of these patients in the UNEMES EC, there is a lack of regulations on the articulation of these units with primary and secondary, to allow proper transit of chronic patient care, according to their clinical need . Statewide, the difficulties are related on the one hand mechanisms job instability personnel serving in these units, and on the other, monitoring mechanisms and oriented to meeting targets assessment, rather than an integrated factor analysis approach that contribute to non-compliance with them and the dilution of responsibilities. At the national level, a lack of knowledge, adoption of the model and dilution of responsibilities, leading to greater disruption at this level and operational fragmentation was detected. Conclusion: As a result of these structural difficulties, UNEMES EC should make additional efforts to achieve care coverage, trigger actions model and achieve its objective of contributing to slow the trend of major chronic diseases. Conference abstract Spanish Como parte de las acciones que implemento el Estado Mexicano, para atender las enfermedades cronicas de mayor prevalencia en el pais, a partir del ano 2008 la Secretaria de Salud puso en marcha las Unidades de Especialidades Medicas de Enfermedades Cronicas (UNEMEs EC), que bajo el Modelo de “Prevencion Clinica” otorga atencion a pacientes referidos del primer nivel y reactivos al tratamiento de diabetes mellitus, hipertension arterial, sobrepeso u obesidad, sindrome metabolico y dislipidemias. En este modelo confluyen varios componentes: la atencion medico-farmacologica enfocada al control del padecimiento, la prevencion y deteccion oportuna de complicaciones, un proceso educativo para los usuarios y, la participacion de un equipo multidisciplinario integrado por medicos especialistas, licenciados en enfermeria, nutricion, psicologia y trabajo social y personal administrativo; entrenado ex profeso para atender al paciente e involucrar a su familia. Ademas, dentro de sus acciones de atencion primaria realiza deteccion oportuna, otorgando intervenciones a la poblacion en riesgo detectada. El componente de extension de buenas practicas hacia el primer nivel de atencion, brinda capacitacion y asesoria al personal de unidades de referencia. Para la implementacion del modelo en las 100 unidades funcionando, para se capacito al equipo multidiciplinario, para dar a conocer el modelo operativo, definir los procesos, responsabilidades y uso del expediente clinico electronico hecho had doc para la atencion de estas enfermedades. A traves de un estudio exploratorio de caracter cualitativo, por cinco anos se dio asesoria y monitoreo continuo por diferentes medios de comunicacion, se realizaron visitas de supervision, con aplicacion de una cedula estructurada, ponderada y con entrevistas con los integrantes del equipo y directivos del programa. Desarrollo en la implementacion del modelo. Resultados: Los resultados muestran que existe una concordancia entre el modelo teorico planteado y el modelo operativo, con buena integracion clinica al interior del equipo que se traduce en atencion integral y multidisciplinaria que se otorga a los pacientes y sus familias, resaltando la satisfaccion de los usuarios. Los hallazgos permiten identificar dificultades en diversos niveles para la insercion y articulacion de este modelo en el continuo de atencion. En el nivel nacional, si bien esta protocolizado la atencion de estos pacientes en las UNEMEs EC, se carece de normatividad sobre la articulacion de estas unidades con las de atencion primaria y secundaria, que permita el transito adecuado del paciente cronico, segun su necesidad clinica. A nivel estatal, las dificultades estan relacionadas por un lado con mecanismos de inestabilidad laboral del personal que atiende en estas unidades, y por otro, a mecanismos de seguimiento y evaluacion orientada al cumplimiento de metas, mas que a un enfoque integrado de analisis de factores que contribuyen al no cumplimiento de las mismas y a la dilucion de responsabilidades. En el nivel jurisdiccional se detecto una falta de conocimiento, adopcion del modelo y dilucion de responsabilidades, lo que genera a ese nivel mayor desarticulacion y fragmentacion operativa. 3 World Congress on Integrated Care, Mexico City, Mexico, 19-21 November, 2015 International Journal of Integrated Care – Volume 15, 17 Nov – URN:NBN:NL:UI:10-1-117372 – http://www.ijic.org Conclusion: Como consecuencia de estas dificultades estructurales, las UNEMEs EC deberan realizar esfuerzos adicionales para lograr la cobertura de atencion, disparador de las acciones del modelo y lograr su objetivo de contribuir a desacelerar la tendencia de las principales enfermedades cronicas.

OBJECTIVE—To describe the clinical characteristics of the diabetic population that formed part of a population-based survey conducted in México. RESEARCH DESIGN AND METHODS—In 2000, information was obtained from 42,886 subjects aged ≥20 years using a multistage sampling procedure. Standardized questionnaires were used. Anthropometric measurements, blood pressure, and capillary glucose concentrations were taken. RESULTS—Type 2 diabetes was found in 3,597 subjects (age-adjusted prevalence 8.18%), of which 2,878 (80%) had previously been diagnosed. The average age of the diabetic participants was 55.2 ± 13.5 years; 13% were 10 years. The average BMI was 29.2 ± 5.7 kg/m2; three-quarters of the cases had BMI >25 kg/m2. The average waist circumference was 102 ± 13.4 cm, and increased waist circumference was more common among women. Arterial hypertension was found in half of the cases and, of those on treatment, only one-third had a blood pressure CONCLUSIONS—Diabetes affects a large proportion of Mexican adults (8.18%). This figure may be underestimated. The majority of the subjects had modifiable risk factors for the chronic complications of diabetes. Only a few achieved adequate blood pressure control and other treatment goals.

To describe the clinical characteristics of the diabetic population that formed part of a population-based survey conducted in México.In 2000, information was obtained from 42,886 subjects agedor =20 years using a multistage sampling procedure. Standardized questionnaires were used. Anthropometric measurements, blood pressure, and capillary glucose concentrations were taken.Type 2 diabetes was found in 3,597 subjects (age-adjusted prevalence 8.18%), of which 2,878 (80%) had previously been diagnosed. The average age of the diabetic participants was 55.2 +/- 13.5 years; 13% were40 years of age. Nine percent had been diagnosed for10 years. The average BMI was 29.2 +/- 5.7 kg/m(2); three-quarters of the cases had BMI25 kg/m(2). The average waist circumference was 102 +/- 13.4 cm, and increased waist circumference was more common among women. Arterial hypertension was found in half of the cases and, of those on treatment, only one-third had a blood pressure140/90 mmHg. Smoking was reported in 34% of the diabetic group, a higher rate than in the nondiabetic subjects. There was at least one modifiable coronary risk factor in 67.6% of the cases. Very few followed an exercise or dietary regimen and a small percentage used insulin.Diabetes affects a large proportion of Mexican adults (8.18%). This figure may be underestimated. The majority of the subjects had modifiable risk factors for the chronic complications of diabetes. Only a few achieved adequate blood pressure control and other treatment goals.