REAL-WORLD EVIDENCE OF DENGUE BURDEN ON HOSPITALS IN MEXICO: INSIGHTS FROM THE AUTOMATED SUBSYSTEM OF HOSPITAL DISCHARGES (SAEH) DATABASE

Rev Invest Clin. 2019;71(3):168-177. doi: 10.24875/RIC.18002681.

Abstract

Background: The incidence of dengue in Mexico has increased in recent decades. It has been suggested that dengue outbreaks may compromise treatment quality in hospitals.

Objective: The objective of the study was to quantify the burden imposed by dengue on hospital services in Mexico.

Methods: We analyzed 19.2 million records contained in the database of hospital services of the Mexican Ministry of Health between 2008 and 2014. The number of admissions due to dengue was compared to other potentially preventable hospitalizations. Hospital departments were categorized to reflect dengue-related activity as high dengue activity (HDA), low dengue activity (LDA), or zero dengue activity departments, and the impact of dengue activity on general in-hospital mortality in HDA departments was assessed.

Results: Dengue was the cause of more hospital admissions than most of the potentially preventable prevalent acute and chronic conditions and other infectious diseases. In HDA departments, dengue patient load was found to be a significant risk factor for overall in-hospital mortality. There was an approximately two-fold higher dengue case-fatality rate in LDA versus HDA departments, irrespective of dengue severity.

Conclusions: This study confirms that dengue is an important cause of hospitalization in Mexico and highlights the impact of dengue activity not only on dengue case-fatality rate but also on the overall in-hospital mortality.

Keywords: Burden; Dengue; Hospitalization; Mexico.

MeSH terms

  • Cost of Illness*
  • Databases, Factual
  • Dengue / epidemiology*
  • Dengue / mortality
  • Hospital Mortality
  • Hospitalization / statistics & numerical data*
  • Hospitals / statistics & numerical data
  • Humans
  • Incidence
  • Mexico / epidemiology
  • Patient Discharge