12 results on '"Roque, Carlos"'
Search Results
2. Inequalities in access to safe drinking water in Peruvian households according to city size: an analysis from 2008 to 2018
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Hernández-Vasquéz, Akram, Rojas-Roque, Carlos, Marques Sales, Denise, Santero, Marilina, Bendezu-Quispe, Guido, Barrientos-Gutiérrez, Tonatiuh, and Miranda, J. Jaime
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- 2021
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3. Geographic and Socioeconomic Determinants of Full Coverage COVID-19 Vaccination in Peru: Findings from a National Population-Based Study.
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Hernández-Vásquez, Akram, Vargas-Fernández, Rodrigo, and Rojas-Roque, Carlos
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VACCINATION coverage ,COVID-19 vaccines ,SOCIOECONOMIC factors ,VACCINATION status ,VACCINATION - Abstract
Despite the fact that vaccination coverage against COVID-19 has made great progress in Peru, there is still a quarter of the population that has not been fully vaccinated. This study aims to determine the factors associated with complete vaccination in Peruvian adults. An analysis of the National Household Survey 2022 in Peru was performed. Prevalence ratios with their 95% confidence intervals (95% CI) were estimated to assess the factors associated with vaccination with three or more doses of the COVID-19 vaccine. A total of 58,471 participants were included in the study and 75.8% of the surveyed population were found to have received full vaccination. Significant differences in complete coverage were observed according to sex, age, educational level, ethnicity, poverty status, and geographic location. In the adjusted analysis, individuals aged 60 years or older, those with higher educational attainment, the non-poor, and those living in urban areas were more likely to be fully vaccinated. Native individuals and people who live in households without media are less likely to be fully covered. These results highlight the importance of considering demographic and socioeconomic factors when analyzing COVID-19 vaccination coverage. Additional strategies are needed to address vaccination gaps and ensure better vaccination coverage. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Hospitalizations and mortality of patients with heart failure in the COVID-19 era in Peru.
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Hernández-Vásquez, Akram, Visconti-Lopez, Fabriccio J., Alburqueque-Cruz, Renato, and Rojas-Roque, Carlos
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The worldwide heart failure (HF) prevalence is 8.52 per 1000 inhabitants, with a global economic burden of 346.17 billion dollars. With the COVID-19 pandemic, the focus of medical care has changed to treating the morbidity and mortality of patients with COVID-19 and reducing medical procedures or visits to patients with HF, with the impact being greater in low- and middle-income countries. We performed an interrupted time series analysis of HF to determine the changes in the trend of hospitalizations and in-hospital mortality of HF patients before and after the mandatory lockdown in Peru. A total of 18,514 adults were included in the analysis. Monthly hospital admissions immediately decreased by 599 (95% confidence interval [CI]: 113 to 1085) and the difference in slope before and after the lockdown was 6.4 hospital admissions (95% CI: −4 to 18). In-hospital mortality increased by 18% (95% CI: −8%–43%) and the difference in slope before and after the lockdown was −0.3% (95% CI: −0.9%–0.25%). There was a reduction in hospitalizations and an increase in the in-hospital mortality of patients with HF before and after the mandatory lockdown due to the COVID-19 pandemic in Peru. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Measuring the Protective Effect of Health Insurance Coverage on Out-of-Pocket Expenditures During the COVID-19 Pandemic in the Peruvian Population.
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Hernández-Vásquez, Akram, Rojas-Roque, Carlos, Barrenechea-Pulache, Antonio, and Bendezu-Quispe, Guido
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HEALTH insurance ,COVID-19 pandemic ,COVID-19 ,TIME series analysis ,FINANCIAL planning - Abstract
Background: Health insurance coverage is expected to protect individuals from out-of-pocket (OOP) expenditures, potentially preventing them from falling into poverty. However, to date, the effect of health insurance on OOP spending during the coronavirus disease 2019 (COVID-19) pandemic has not been fully explored. This study aimed to estimate differences in the proportion and the amount of OOP expenditures among Peruvians during the pre- and post-mandatory lockdown response to COVID-19 in 2020 according to the health insurance coverage status. Methods: This study utilized repeated cross-sectional data from the National Household Survey on Living and Poverty Conditions (ENAHO) from the first quarter of 2017 until the fourth quarter of 2020. The outcomes were (i) the proportion of individuals who incurred OOP expenditures and (ii) the monetary value of OOP expenditures. An interrupted time series analysis (ITS) and a quasi-experimental difference-in-difference (DID) analysis were performed to examine the outcomes among the control (individuals without health insurance) and treatment groups (individuals with health insurance) after the COVID-19 pandemic. Results: ITS analysis showed that the proportion of individuals reporting OOP expenditures after implementation of mandatory lockdown due to COVID-19 in Peru decreased in both groups, but no difference in the slope trend was found (P = .916). The average quarterly amount of OOP spending increased in both groups, but no difference in the slope trend was found (P = .073). Lastly, the DID analysis showed that the mandatory lockdown was associated with a higher amount of OOP, but there was no evidence to indicate that the higher amount was different between the control and treatment groups. Conclusion: The mandatory lockdown in response to the COVID-19 was associated with a higher amount of OOP expenditures and a lower likelihood of incurring OOP expenditures. However, our findings suggest that health insurance coverage does not lower OOP expenditures or reduce the likelihood of incurring OOP expenditures. [ABSTRACT FROM AUTHOR]
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- 2022
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6. Socioeconomic inequalities in abdominal obesity among Peruvian adults
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Farro-Maldonado, Marioli Y., Gutiérrez-Pérez, Glenda, Hernández-Vásquez, Akram, Barrenechea-Pulache, Antonio, Santero, Marilina, Rojas-Roque, Carlos, Azañedo, Diego, and Universitat Autònoma de Barcelona
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Male ,Rural Population ,Urban Population ,Physiology ,Economics ,Social Sciences ,Educational attainment ,Rural areas ,Geographical locations ,Body Mass Index ,0302 clinical medicine ,Sociology ,Peru ,Medicine and Health Sciences ,Socioeconomic aspects of health ,Medicine ,Public and Occupational Health ,030212 general & internal medicine ,Urban areas ,Abdominal obesity ,Geographic Areas ,Body mass index ,media_common ,Multidisciplinary ,Geography ,Middle Aged ,Socioeconomic Aspects of Health ,Physiological Parameters ,Obesity, Abdominal ,Female ,medicine.symptom ,Research Article ,Urban Areas ,Adult ,medicine.medical_specialty ,Inequality ,Adolescent ,media_common.quotation_subject ,Science ,030209 endocrinology & metabolism ,Human Geography ,Education ,Urban Geography ,03 medical and health sciences ,Health Economics ,Sex Factors ,Adults ,Humans ,Obesity ,Socioeconomic status ,Educational Attainment ,business.industry ,Public health ,Body Weight ,Biology and Life Sciences ,South America ,medicine.disease ,Health Care ,Socioeconomic Factors ,Age Groups ,Earth Sciences ,Population Groupings ,Rural area ,People and places ,business ,Demography - Abstract
Objectives Abdominal obesity (AO) has become a public health issue due to its impact on health, society and the economy. The relationship between socioeconomic disparities and the prevalence of AO has yet to be studied in Peru. Thus, our aim was to analyze the socioeconomic inequalities in AO distribution defined using the International Diabetes Federation (IDF) cut-off points in Peruvian adults in 2018–2019. Methods This was a cross-sectional study using data from the 2018–2019 Demographic and Family Health Survey (ENDES) of Peru. We analyzed a representative sample of 62,138 adults over 18 years of age of both sexes from urban and rural areas. Subjects were grouped into quintiles of the wealth to calculate a concentration curve and the Erreygers Concentration Index (ECI) in order to measure the inequality of AO distribution. Finally, we performed a decomposition analysis to evaluate the major determinants of inequalities. Results The prevalence of AO among Peruvian adults was 73.8%, being higher among women than men (85.1% and 61.1% respectively, p < 0.001). Socioeconomic inequality in AO was more prominent among men (ECI = 0.342, standard error (SE) = 0.0065 vs. ECI = 0.082, SE = 0.0043). The factors that contributed most to inequality in the prevalence of AO for both sexes were having the highest wealth index (men 37.2%, women 45.6%, p < 0.001), a higher education (men 34.4%, women 41.4%, p < 0.001) and living in an urban setting (men 22.0%, women 57.5%, p < 0.001). Conclusions In Peru the wealthy concentrate a greater percentage of AO. The inequality gap is greater among men, although AO is more prevalent among women. The variables that most contributed to inequality were the wealth index, educational level and area of residence. There is a need for effective individual and community interventions to reduce these inequalities.
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- 2021
7. Changes in the prevalence of hypertension in Peru using the new guideline of the American College of Cardiology
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Hernández-Vásquez, Akram, Rojas-Roque, Carlos, Santero, Marilina, Ruiz-Maza, Juan Carlos, Casas-Bendezú, Mixsi, and Miranda, J Jaime
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Cross-Sectional Studies ,Epidemiology ,Hypertension ,Peru ,Prevalence - Abstract
Introduction and Objective: There is little evidence in Latin America about the impact of the ACC/AHA 2017 guideline. Taking as reference the JNC 7 guideline, the objective of our study is to estimate changes in the prevalence of arterial hypertension (HBP) according to socio-demographic characteristics and geographic regions, applying the criteria of the new ACC / AHA guide 2017. Methods: Cross-sectional study of the Demographic and Family Health Survey conducted in Peru in 2017. Standardized weighted hypertension prevalence’s were estimated for the WHO population according to both guidelines, and absolute differences with 95% CI. Results: We included 30,682 people aged 18 years and over, with an average age of 42.3 years, 51.1% women. The standardized prevalence of HBP for 2017 according to JNC 7 was 14.4% (95% CI: 13.8-15.1) and according to ACC / AHA 2017 it was 32.9% (95% CI: 32.0-33.7), so the prevalence increase is 18.5 percentage points, being higher in males than females (24.2 vs 12.9 respectively). In people with obesity and / or who consume tobacco, the increases were higher (24.3 and 24.1 percentage points respectively). In the regions of Tacna, Ica and Metropolitan Lima, the increase, in comparison with the JNC 7 guidelines, overcome the national average (22.4, 20.7 and 20.4, percentage points, respectively). Conclusions: Considering the context of a Latin American country and knowing the epidemiology of hypertension in Peru, the potential adoption of the ACC/AHA 2017 guidelines for the prevention, detection, evaluation, and management of hypertension should be accompanied by an evaluation of the impact at the individual, system and social level.
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- 2019
8. Dynamics of depressive symptoms and within-country migration among Peruvian women.
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Hernández-Vásquez, Akram, Rojas-Roque, Carlos, Vargas-Fernández, Rodrigo, and Bendezu-Quispe, Guido
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Introduction: Peru has experienced a significant internal migration from rural to urban areas in recent years. This study estimates the prevalence of depressive symptoms in Peruvian women of childbearing age and their probability of having these symptoms according to the condition of internal migration. Methods: Data from the 2014-2018 Demographic and Family Health Survey (ENDES) was used. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9). Adjusted odds ratios and the marginal effects were estimated to assess associated factors and the probability of having depressive symptoms in relation to internal migration status, respectively. Results: The prevalence of depressive symptoms (PHQ-9≥10 points) decreased from 2014 to 2018, as did the prevalence of these symptoms for all the internal migration status. There was a positive relationship between the post-migration residence time and the probability of having depressive symptoms. Furthermore, compared to women in rural areas who never migrated, all of the other migrant statuses were associated with an increased probability of depressive symptoms. Other factors such as being the head of the household, being married/cohabiting or separated/divorced/widowed, smoking, alcohol consumption, diabetes, having an impairment and living at levels of altitude greater than 500 m were associated with a higher probability of having depressive symptoms. Conclusion: Despite a reduction in the overall burden of depressive symptoms, the migrant subgroup population has a higher probability of presenting these symptoms. Mental health strategies for migrant women are a priority in Peru. [ABSTRACT FROM AUTHOR]
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- 2020
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9. SATISFACCIÓN DEL USUARIO EXTERNO CON LA ATENCIÓN EN ESTABLECIMIENTOS DEL MINISTERIO DE SALUD DE PERÚ Y SUS FACTORES ASOCIADOS.
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Hernández-Vásquez, Akram, Rojas-Roque, Carlos, Javier Prado-Galbarro, Francisco, and Bendezu-Quispe, Guido
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Objectives. To estimate satisfaction with the healthcare received at facilities of the Ministry of Health (MINSA) of Peru and determine its associated factors in Peruvian adults. Materials and Methods. Analytical cross-sectional study using data from the National Household Survey on Living Conditions and Poverty (ENAHO) 2018. Satisfaction with healthcare received was rated as very bad, bad, good, and very good. The characteristics of the study population were described using weighted frequencies and proportions. To determine the factors associated with satisfaction with the care received, a generalized ordinal logistic model was estimated. Results. The study included a total of 14,206 adults (expanded population: 7,684,602) who reported having been treated at a MINSA healthcare facility. At the national level, 74.3% of users reported satisfaction with the service received as "good or very good". Having a chronic illness, having a native mother tongue, or living in a population with agglomerations of more than 2000 people were associated with lower satisfaction with the care received. Living in the jungle area was associated with a report of greater satisfaction with the care. Conclusions. Three out of four external users rate the care received at MINSA facilities as good or very good. There are population subgroups with less satisfaction with the care received. Improving the satisfaction of these users would improve the quality of care at the facilities of MINSA, the largest health provider in Peru. [ABSTRACT FROM AUTHOR]
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- 2019
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10. GASTO DE BOLSILLO EN SALUD EN ADULTOS MAYORES PERUANOS: ANÁLISIS DE LA ENCUESTA NACIONAL DE HOGARES SOBRE CONDICIONES DE VIDA Y POBREZA 2017.
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Hernández-Vásquez, Akram, Rojas-Roque, Carlos, Santero, Marilina, Javier Prado-Galbarro, Francisco, and Rosselli, Diego
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Objectives. To estimate out-of-pocket spending on health (GBS) and identify its associated factors in Peruvian older adults. Materials and Methods. Analytical cross-sectional study of the National Household Survey on Living Conditions and Poverty (ENAHO) 2017. Older adults were considered to be all individuals aged 60 and over and the GBS was considered the main study variable. Prevalence ratios (PR) and adjusted prevalence ratios (PRa) were estimated for each of the factors associated with GBS. GBS means were estimated using a generalized linear model with gamma distribution and log binding function. All confidence intervals (95%) of the estimators were calculated by bootstrapping with the normal-based method. Results. Eighteen 386 older adults were included, of which 56.5% reported GBS. The mean and median GBS is S/. 140.8 (USD 43.2) and S/. 34.5 (USD 10.6), respectively. Factors such as urban origin, a higher level of education, chronic diseases and higher per capita expenses increase the probability of GBS by up to 1.6 times. In those affiliated to the Integral Health Insurance (SIS), the GBS is reduced by 63.0 soles (USD 19.3) compared to those without any health insurance. Conclusions. Six out of ten older Peruvian adults reported GBS to attend to their health needs. This generates an access inequity in terms of health services, mainly for socially-vulnerable groups. We suggest researching into the economic impact of health insurance and the preventive-promotional approach to chronic diseases, in order to reduce GBS and improve the efficiency of the Peruvian health system. [ABSTRACT FROM AUTHOR]
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- 2018
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11. FACTORES ASOCIADOS A LA NO UTILIZACIÓN DE SERVICIOS DE SALUD EN INMIGRANTES VENEZOLANOS EN PERÚ.
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Hernández-Vásquez, Akram, Vargas-Fernández, Rodrigo, Rojas-Roque, Carlos, and Bendezu-Quispe, Guido
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Objective. To estimate the prevalence and determine the factors associated with the non-utilization of healthcare facilities (NUHCF) among adult Venezuelan migrants in Peru. Materials and Methods. An analytical cross-sectional study of the "Survey of the Venezuelan Population Residing in Peru" 2018. We calculated the proportion of immigrants with NUHCF (immigrants with some symptom or malaise, illness, relapse of chronic illness, accident and discomfort, or other problem such as depression, fear, anger, anxiety, and stress, and who did not consider that it was serious or that they needed to visit a healthcare facility). Raw and adjusted (PRa) prevalence ratios (PR) for presenting NUHCF were estimated using generalized linear models. Results. The study included 2,144 Venezuelan migrants: 57.2% presented NUHCF, reporting reasons such as: not having money (64.5%), lack of health insurance (24.3%), self-medication (12.8%), and not having time (8.4%). Living in Arequipa (PRa: 0.69; 95% CI: 0.57-0.83) or Trujillo (PRa: 0.87; 95% CI: 0.76-0.99), suffering from a chronic disease (PRa: 0.83; 95% CI: 0.71-0.97), and being enrolled in the Seguro Integral de Salud (SIS) insurance (PRa: 0.28; 95% CI: 0.13-0.61) was associated with a lower probability of NUHCF. Belonging to an age group under 60 years was associated with a higher probability of NUHCF. Conclusions. One out of two Venezuelan migrants in Peru presents NUHCF. Having SIS increases the likelihood of Venezuelan migrants in Peruvian territory seeking medical attention. Increasing public health insurance for this population, which is currently low, could increase the utilization of health services. [ABSTRACT FROM AUTHOR]
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- 2019
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12. FACTORES ASOCIADOS AL USO DE SERVICIOS DE SALUD ORAL EN ADULTOS MAYORES PERUANOS: ANÁLISIS SECUNDARIO DE ENCUESTA POBLACIONAL, 2018.
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Azañedo, Diego, Vargas-Fernández, Rodrigo, and Rojas-Roque, Carlos
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Objectives. To identify the prevalence and factors associated with the use of oral health services in Peruvian older adults (OA) during 2018. Materials and Methods. Secondary analysis of data on 4,874 Peruvian OAs from the Demographic and Family Health Survey (ENDES) carried out in 2018. The use of oral health services was considered (yes/no) based on the six months prior to the application of the survey as a dependent variable. The independent variables were sex, age, area of residence, educational level, marital status, geographical domain, physical limitation, health insurance, spoken language, and welfare index quintile. A descriptive analysis was performed using absolute frequencies and weighted proportions, and a multivariate analysis using generalized linear models (Poisson regression). Results. From the total of OAs, 52.6% were women, 52.9% belonged to the 60-69 age group, 77% belonged to the urban area, and 81.1% had a health insurance. The prevalence of the use of dental care services in the last six months was 24.9%. Multivariate analysis found association with area of residence (p<0.001), higher educational level (p=0.001), health insurance affiliation (p<0.001), geographic domain (p=0.019), and all welfare index quintiles (p<0.001). Conclusions. The prevalence of the use of dental care services in OAs was low, and its associated factors were the area of residence, educational level, health insurance, geographic domain, and welfare index quintiles. [ABSTRACT FROM AUTHOR]
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- 2019
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