Exploring the burden of treatment in patients' experiences of chronic condition management: A mixed-method study in Mendoza, Argentina.
Javier Roberti, Mar��a Beliz��n, Natali Ini, Juan P Alonso, Agustina Mazzoni, Marina Guglielmino, Yanina Mazzaresi, Andrea Falaschi, Juan Manuel G��mez-Portillo, Gabriela Masier, Federico Baigorria, Ana Mar��a Nadal, Ezequiel Garc��a-Elorrio
Author Information
Javier Roberti: Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina. ORCID
Mar��a Beliz��n: Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina.
Natali Ini: Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina.
Juan P Alonso: Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina.
Agustina Mazzoni: Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina.
Marina Guglielmino: Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina.
Yanina Mazzaresi: Ministry of Health, Social Development, and Sports, Mendoza, Argentina.
Andrea Falaschi: Ministry of Health, Social Development, and Sports, Mendoza, Argentina. ORCID
Juan Manuel G��mez-Portillo: Social Security of Public Employees of Mendoza (Obra Social de Empleados P��blicos) OSEP, Mendoza, Argentina.
Gabriela Masier: Social Security of Public Employees of Mendoza (Obra Social de Empleados P��blicos) OSEP, Mendoza, Argentina.
Federico Baigorria: Ministry of Health, Social Development, and Sports, Mendoza, Argentina.
Ana Mar��a Nadal: Ministry of Health, Social Development, and Sports, Mendoza, Argentina.
Ezequiel Garc��a-Elorrio: Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina.
OBJECTIVE: This study investigated how patients managed their chronic diseases, focusing on burden of treatment, within the primary care level in Mendoza Province, Argentina. METHOD: The study used a mixed-methods approach, including a qualitative component with a purposive sampling of patients with diabetes, hypertension, or depression using primary care services, and a quantitative component with secondary analysis of databases from public and social security. Ten focus group sessions were conducted at primary healthcare centers in urban and rural areas. The Burden of Treatment theory was used to frame the analysis. RESULTS: The study found that accessing care was difficult due to appointment difficulties and long waiting times, and obtaining medication and laboratory tests at secondary centers was also problematic. Non-emergency hospital care required primary care referrals, and users in rural areas faced access problems. Financial constraints were significant, with co-payments in social security sector, transportation costs, and lost work revenue. Strategies employed included networking, emergency service use, careful planning, and taking loans. CONCLUSION: This study underscores the complex implications of chronic disease management in a subnational healthcare system and provides insights for policymakers and healthcare providers.
