Multimorbidity and health expenditure in El Salvador
A study of chronic-disease multimorbidity across three hospital micronetworks (Apastepeque, La Palma, Jiquilisco), conducted for the Ministry of Health under a World Bank–funded non-communicable diseases project.
I was responsible for the full data pipeline and quantitative analysis: integrating three administrative health record systems covering population registries, outpatient consultations and hospital admissions; classifying 12,618 ICD-10 subcategories into 123 chronic condition groups; estimating disease clusters using two independent methods — structural equation models for conditional probabilities and K-means clustering — cross-validated across subsamples by sex, age group and region; applying network analysis to inter-facility referral flows to identify gaps in the care network; and estimating service costs for the priority clusters. Results informed the Ministry's recommendations on targeting health expenditure toward prevention.