Performance evaluation of Mexico's health system at the national and subnational level, 1990–2019: an analysis of the Health Access and Quality Index

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2024-08-17 DOI:10.1016/j.puhe.2024.07.009

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引用次数: 0

Abstract

Objectives

This study aimed to comprehensively evaluate Mexico's health system performance from 1990 to 2019 utilising the Health Access and Quality Index (HAQI) as a primary indicator.

Study design

A retrospective ecological analysis was performed using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) study and the National Population Council (CONAPO).

Methods

HAQI values for 1990, 2000, 2010, 2015, and 2019 were examined for each state in Mexico and three age groups (young, working, and post-working). Additionally, the marginalisation index was employed to assess inequalities in the HAQI distribution across states. The concentration index of the HAQI for each year was estimated, and the efficiency of states in producing the HAQI was evaluated using a data envelopment approach.

Results

Through the analysis of national and subnational data, results indicated an overall improvement in healthcare access and quality during the study period. Although differences in the HAQI value related to state marginalisation decreased from 1990 to 2015, by 2019, the inequality had returned to a level comparable to 2000. Efficiency in producing health (HAQI values) exhibited substantial heterogeneity and fluctuations in the ranking order over time. States such as Nuevo León consistently performed well, while others, such as Guerrero, Chihuahua, Mexico City, and Puebla, consistently underperformed.

Conclusions

The findings from this study emphasise the necessity for nuanced strategies to address healthcare disparities and enhance the overall system performance. The study provides valuable insights for ongoing discussions about the future of Mexico's healthcare system, aiming to inform evidence-based policy decisions and improve the nationwide delivery of healthcare services.

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1990-2019 年墨西哥国家和国家以下各级卫生系统的绩效评估：对卫生服务获取和质量指数的分析

研究设计使用全球疾病负担、伤害和风险因素研究（GBD）和国家人口委员会（CONAPO）的数据进行了回顾性生态分析。方法对墨西哥各州和三个年龄组（年轻、工作和工作后）1990、2000、2010、2015 和 2019 年的 HAQI 值进行了研究。此外，还采用了边缘化指数来评估各州 HAQI 分布的不平等情况。结果通过对国家和次国家数据的分析，结果表明在研究期间，医疗保健的可及性和质量得到了整体改善。虽然从1990年到2015年，与国家边缘化相关的HAQI值差异有所减少，但到2019年，不平等程度已恢复到与2000年相当的水平。健康生产效率（HAQI 值）表现出很大的不均衡性，排名顺序也随时间而波动。新莱昂州等州一直表现良好，而格雷罗州、奇瓦瓦州、墨西哥城和普埃布拉州等其他州则一直表现不佳。这项研究为正在进行的有关墨西哥医疗保健系统未来的讨论提供了有价值的见解，旨在为基于证据的政策决策提供信息，并改善全国范围内医疗保健服务的提供。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.