Political Economy of Pursuing the Expansion of Social Protection in Health in Mexico.

This article uses political economy analysis to identify the factors that contributed to the adoption of policies to expand social protection in health (SPH) in Mexico in the early years of the 21st century. It focuses on the adoption stage of these policies to answer two questions: (1) Which contextual factors created the window of opportunity where SPH reforms could be adopted in Mexico? (2) What political strategies did the main actors driving the reform use to promote its adoption? Two types of analysis were developed: an analysis of the context and a stakeholder analysis. The analysis of the context was used to identify the "enabling factors" (epidemiological, political, and economic) that created the window of opportunity to place the problem of limited health care coverage in Mexico on the national policy agenda.

Waiting times for surgical and diagnostic procedures in public hospitals in Mexico.

Objective: A retrospective evaluation of waiting times for elective procedures was conducted in a sample of Mexican public hospitals from the following institutions: the Mexican Institute for Social Security (IMSS), the Institute for Social Security and Social Services for Civil Servants (ISSSTE) and the Ministry of Health (MoH). Our aim was to describe current waiting times and identify opportunities to redistribute service demand among public institutions.

Materials And Methods: We examined current waiting times and productivity for seven elective surgical and four diagnostic imaging procedures, selected on the basis of their relative frequency and comparability with other national health systems.

[Supply of essential drugs in units specialized in the treatment of chronic diseases in Mexico in 2012].

Objective: To quantify the supply of essential drugs and the fully filled-in prescription level in the Units Specialized in the Treatment of Chronic Diseases (UNEMES-EC) in Mexico.

Materials And Methods: The supply and prescription indicators were measured in 30 of the 86 existing UNEMES-EC. The supply of drugs was recorded using a list of 17 essential drugs related to the treatment of diabetes, hypertension, overweight and obesity.

[Burden of disease, injuries, risk factors and challenges for the health system in Mexico].

Objective: To present the results of the burden of disease, injuries and risk factors in Mexico from 1990 to 2010 for the principal illnesses, injuries and risk factors by sex.

Materials And Methods: A secondary analysis of the study results published by the Global Burden of Disease 2010 for Mexico performed by IHME.

Results: In 2010, Mexico lost 26.

[Transit of users between hospitals from different states and institutions].

Objective: To describe and quantify hospital services given by units of the Ministry of Health (MoH) to patients with social security or living in states different to those where the hospitals are located.

Materials And Methods: With data from the automatized system for hospital discharges patients were classified, according to the place of living, into locals or outsiders; and, according to their insurance status, into social security beneficiaries or not beneficiaries. Frequencies of services for these groups were estimated, and characteristics of patients and services were described.

[Surgical adverse events in three Mexican public health institutions].

Objective: To measure the prevalence of adverse events (AE) in surgical adult patients from the main public health institutions in Mexico.

Material And Methods: A two stage retrospective medical record review was carried out. A total of 6 119 medical records were randomly selected.

[A proposal for quality assessment through mortality data].

Objective: To introduce the Hospital Standardized Mortality Ratio (HSMR) as an alternative to assess the quality of hospital care in Mexico.

Material And Methods: Data-sets of public hospital discharges were used as source of information. The analyses were based in a logistic model to estimate the risk of hospital death adjusting by sex, age, length of stay and main diagnosis.

[Quality of health care for diabetic and hypertensive patients in primary care settings servicing Mexican Seguro Popular].

Objective: To assess health care quality provided to type-2 diabetic and hypertensive patients in primary care settings from the Mexican Ministry of Health and to evaluate whether accredited clinics providing services to the Mexican Seguro Popular performed better in terms of metabolic control of those patients compared to the non-accredited.

Material And Methods: Cross-sectional study performed on 2008. Previous year clinical measures were obtained from 5 444 diabetic and 5 827 hypertensive patient's clinical records.

[Dispensing prescriptions to persons affiliated with the Seguro Popular de Salud de México].

Objective: Measure and compare the percentage of prescriptions fully dispensed to persons with and without Popular Health Insurance (SPS in Spanish) who use ambulatory and general hospital services associated with the Mexico State Health Services (SESA in Spanish), and taking into account insurance status. SESA user satisfaction was also measured with respect to access to medication.

Material And Methods: Information for the study was taken from four surveys of SESA ambulatory and hospital units that included probabilistic samples with state representativity.

[The treatment received by public health services users in Mexico].

Objective: To document the fact that differences in the treatment received by health services users in Mexico are mainly dependent on the type of provider, regardless of the users' socioeconomic status.

Methods: The data were obtained by means of a survey of 18 018 users who visited 73 health services in 13 states within Mexico. They were asked to grade the way the institution had performed in seven of the eight domains that define appropriate user treatment (autonomy, confidentiality, communication, respectful manner, condition of basic facilities, access to social assistance networks, and free user choice).

[Responsiveness of the Mexican health system].

Objective: To present and discuss findings on the responsiveness of the Mexican health system.

Material And Methods: The data source was the 2002-2003 National Performance Assessment Survey. A descriptive analysis was performed and results were adjusted for user's expectations using vignette information.

[Caesarean sections in Mexico: tendencies, levels and associated factors].

Objective: To describe the rate of caesarean sections in Mexico in the last 10 years and evaluate its relationship with several socioeconomic variables, type of health care services, and specialists' availability.

Material And Methods: The Ministry of Health's register of births was used as source of information. The dependent variable was the type of delivery (vaginal or caesarean).

[Expenditure evaluation of the construction of health units: example of community participation].

Objective: Demonstrate the economic benefits that community participation may render in the construction of health units.

Materials And Methods: The purpose of this study was to analyze the efficiency in the construction of 21 auxiliary health units and 81 rural health built through the Program to Support the Development of Health Services for the Non-Insured Population (PASSPA) through three different construction models (national public bidding, restricted invitation and community participation). Comparisons were also made with the units built through regular construction procedures of the Ministry of Health and other institutions.

Relationship of blood and bone lead to menopause and bone mineral density among middle-age women in Mexico City.

To describe the relationship of blood lead levels to menopause and bone lead levels, we conducted a cross-sectional study on 232 pre- or perimenopausal (PreM) and postmenopausal (PosM) women who participated in an osteoporosis-screening program in Mexico City during the first quarter of 1995. Information regarding reproductive characteristics and known risk factors for blood lead was obtained using a standard questionnaire by direct interview. The mean age of the population was 54.