Factores asociados a la demanda de servicios para la atención del parto en México

González-Block, Miguel Ángel; Sauceda-Valenzuela, Alma Lucila; Ana-Téllez, Yared Santa

doi:10.1590/s0036-36342010000500009

Cited by 10 publications

(6 citation statements)

References 5 publications

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“…Seguro Popular impact assessment studies have demonstrated its protective effect against catastrophic health spending among its beneficiaries [12]–[14], [16]–[18], and analyses on health care utilization have sighted a number of contributions [19], [20]. However, evidence regarding performance in rural indigenous communities at the lowest economic levels [21], [22] suggests that results have been less favorable among these beneficiaries.…”

Section: Introductionmentioning

confidence: 99%

Primary Health Care Utilization by the Mexican Indigenous Population: The Role of the Seguro Popular in Socially Inequitable Contexts

et al. 2014

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ObjectiveTo analyze the relationship between primary health care utilization and extended health insurance coverage under the Seguro Popular (SP) among Mexican indigenous people.MethodologyA cross-sectional analysis was conducted using data from the Mexican National Nutrition Survey 2012 (n = 194,758). Quasi-experimental matching methods and nonlinear regression probit models were used to estimate the influence of SP on primary health care utilization.Results25% of the Mexican population reported having no health insurance coverage, while 59% of indigenous versus 35% of non-indigenous reported having SP coverage. Health problems were reported by 13.9% of indigenous vs. 10.5% of non-indigenous; of these, 52.8% and 57.7% respectively, received primary health care (p<0.05). Economic barriers were the most frequent reasons for not using primary health care services. The probability of utilizing primary health care services was 11.5 percentage points higher (p<0.01) for indigenous SP affiliates in comparison with non-indigenous, in similar socioeconomic conditions.ConclusionSocioeconomic conditions, not ethnicity per-se, determine whether people utilize primary health care services. Therefore, SP can be conceived as a public policy strategy which acts as a social buffer by enhancing health care utilization regardless of ethnicity. Further analysis is required to explore the potential gaps as a result of SP coverage among socially vulnerable groups.

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Section: Introductionmentioning

confidence: 99%

Primary Health Care Utilization by the Mexican Indigenous Population: The Role of the Seguro Popular in Socially Inequitable Contexts

et al. 2014

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“…The results of these actions have been documented: SP financing has enhanced the possibility for women to attend at least four antenatal care appointments and to receive birth care by trained personnel . Furthermore, SP enrollment has increased access to health care for women with lower schooling, reducing their risk for preterm birth .…”

Section: Introductionmentioning

confidence: 99%

“…The results of these actions have been documented: SP financing has enhanced the possibility for women to attend at least four antenatal care appointments 4 and to receive birth care by trained personnel. 5,6 Furthermore, SP enrollment has increased access to health care for women with lower schooling, reducing their risk for preterm birth. 7 On the negative side, however, it has been noted that service production varies significantly among states with comparable public expenditure, particularly as regards to the delivery of opportune and frequent antenatal care with adequate content.…”

Section: Introductionmentioning

confidence: 99%

A spatio‐temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México

Serván‐Mori

Mendoza

Chivardi³

et al. 2019

Health Planning & Management

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Summary Objective To analyze the formation of spatial clusters of technical efficiency (TE) in the production of outpatient maternal health services in México for the period 2008 to 2015. Methods We performed a longitudinal analysis of administrative and structural data related to the 243 Mexican health jurisdictions. We use window data envelopment analysis and spatial and econometric techniques. Structural correlates of each TE cluster obtained were identified estimating a pooled multinomial logit model. Results We observed an increase in the overall TE, accompanied by a reduction in its standard deviation. Furthermore, we identified positive TE spatial dependence both globally and locally. Multiple regression analysis showed that the maximum‐performance TE cluster was composed of health jurisdictions located in the North of México and characterized by social marginalization, a reduced indigenous population, and a low demand for maternal health services. Conclusions The identification of TE clusters can provide elements to induce decision makers to innovative in ways of allocating resources and manage their utilization. In México as other low‐ and middle‐income countries, it is key to develop targeting strategies to implement specific health services innovations putting to the population to be served at the front of the strategy. This implies testing new modalities to strengthen primary health services, the empowerment of community participation, the training and allocation of health personnel that could respond adequately to population's demand, and the active involvement of competent state and local authorities in the assessment of the results of these innovations.

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“…However, Levy-Algazy [ 5 ] reported that, within a one-year period between 2005 and 2006, up to 20% of IMSS workers moved from the formal labour market segment to informality or to economic inactivity, thus losing access to IMSS healthcare. Furthermore, insured workers often utilise private healthcare providers or Ministry of Health facilities, leading to service duplication, high out-of-pocket expenditure and decreased incentives to improve insured services [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Loss of job-related right to healthcare associated with employment turnover: challenges for the Mexican health system

Guerra

Calderón

Snyder

et al. 2018

BMC Health Serv Res

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BackgroundThe Mexican health system segments access and right to healthcare according to worker position in the labour market. In this contribution we analyse how access and continuity of healthcare gets interrupted by employment turnover in the labour market, including its formal and informal sectors, as experienced by affiliates to the Mexican Institute of Social Security (IMSS) at national level, and of workers with type 2 diabetes (T2DM) in Mexico City.MethodsUsing data from the National Employment and Occupation Survey, 2014, and from IMSS electronic medical records for workers in Mexico City, we estimated annual employment turnover rates to measure the loss of healthcare access due to labour market dynamics. We fitted a binary logistic regression model to analyse the association between sociodemographic variables and employment turnover. Lastly we analysed job-related access to health care in relation to employment turnover events.ResultsAt national level, 38.3% of IMSS affiliates experienced employment turnover at least once, thus losing the right to access to healthcare. The turnover rate for T2DM patients was 22.5%. Employment turnover was more frequent at ages 20–39 (38.6% national level; 28% T2DM) and among the elderly (62.4% national level; 26% T2DM). At the national level, higher educational levels (upper-middle, OR = 0.761; upper, OR = 0.835) and income (5 minimum wages or more, OR = 0.726) were associated with lower turnover. Being single and younger were associated with higher turnover (OR = 1.413). T2DM patients aged 40–59 (OR = 0.655) and with 5 minimum wages or more (OR = 0.401) experienced less turnover. Being a T2DM male patient increased the risk of experiencing turnover (OR = 1.166). Up to 89% of workers losing IMSS affiliation and moving on to other jobs failed to gain job-related access to health services. Only 9% gained access to the federal workers social security institute (ISSSTE).ConclusionsTurnover across labour market sectors is frequently experienced by the workforce in Mexico, worsening among the elderly and the young, and affecting patients with chronic diseases. This situation needs to be prospectively addressed by health system policies that aim to expand the financial health protection during an employment turnover event.

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Factores asociados a la demanda de servicios para la atención del parto en México

Abstract: The utilization of an institution of delivery that differed from the one with which the women were affiliated indicates the existence of a de facto functional integration between health institutions in Mexico.

Cited by 10 publications

References 5 publications

Primary Health Care Utilization by the Mexican Indigenous Population: The Role of the Seguro Popular in Socially Inequitable Contexts

Primary Health Care Utilization by the Mexican Indigenous Population: The Role of the Seguro Popular in Socially Inequitable Contexts

A spatio‐temporal cluster analysis of technical efficiency in the production of outpatient maternal health services and its structural correlates in México

Loss of job-related right to healthcare associated with employment turnover: challenges for the Mexican health system

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