Equity and fairness in the Mexican health system reform
Equity and fairness in the Mexican health system reform
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DOI：
10.1590/s0036-36342004000500006
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发表时间：
2004-10-01
期刊：
影响因子：
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通讯作者：
Inclán, Cristina
中科院分区：
文献类型：
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作者：
Gómez-Dantés, Octavio;Gómez-Jáuregui, Jesica;Inclán, Cristina
Objective.评估20世纪90年代末墨西哥卫生系统改革的公平性和公正性。材料和方法。墨西哥的改革进程进行了评估，使用的基准系统设计的丹尼尔斯等人。对墨西哥的改革进程进行了文件审查，以便对每一基准的业绩进行评分。结果除住房和营养部分外，改革几乎没有采取与健康决定因素有关的行动。在保健方面，主要的改革举措涉及扩大基本保健服务的覆盖面和将保健服务下放到各州。改革举措中几乎没有涉及公平供资、分级、强调二级和三级护理、问责制和透明度的活动。结论. 90年代末墨西哥卫生系统的改革对穷人获得卫生保健和行政效率产生了一些积极影响，但对公平筹资、保健质量和民主治理影响甚微。本文件的英文本可在以下网址查阅：http://www.insp.mx/salud/index.html。
Objective. To assess the equity and fairness of the Mexican health system reform that occurred in the late 1990's. Material and Methods. The Mexican reform process was evaluated using the benchmark-system designed by Daniels et al. This benchmark system was adapted to the Mexican setting by adding specific indicators. A documentary review of the Mexican reform process was conducted to score its performance for each benchmark. Results. Except for housing and nutrition components, the reform included few actions related to health determinants. For health care, the main reform initiatives were those related to extending the coverage of essential health services and decentralizing health care provision to the states. Reform initiatives included few activities related to fair financing, tiering, emphasis on second and third level care, accountability, and transparency. Conclusions. The late nineties reform of the Mexican health system had some positive effect on access of the poor to health care and administrative efficiency, but little impact on fair financing, quality of care, and democratic governance. The English version of this paper is available at: http://www.insp.mx/salud/index.html.