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1.
Salud Publica Mex ; 53 Suppl 4: 470-9, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-22282209

RESUMO

OBJECTIVE: To analyze the availability of drugs in public hospitals, the prescription-filling patterns for in-patients when they are discharged and their out-of-pocket expenditure during their hospitalization. MATERIAL AND METHODS: Using the National Satisfaction and Responsiveness Survey (ENSATA) 2009, which includes a representative sample of public hospitals in Mexico in 2009, the availability of 83 essential medicines in the hospital pharmacies at the day of visit, the proportion of prescriptions completely filled for patients when they are discharged and their out-of-pocket expenditure during their hospitalization were analyzed. RESULTS: A total of 26 271 patients in 160 public hospitals were interviewed. The mean availability of drugs was 82% for all hospitals, with the lowest availability for the Ministry of Health (SESA) hospitals (77%, with a range of 30 to 96%). Patients discharged at social security hospitals received in 97% of cases a complete prescription filling, while in SESA hospitals the average was only 56.2%, with a large variance among states (13 to 94%). The median inpatient spending was 150 pesos in national currency (1% spent over 10 000 pesos). CONCLUSIONS: The lack of medicines in public hospitals may increase in-patient morbidity and mortality and has an economic impact on household spending, particularly in those with scarce resources.


Assuntos
Gastos em Saúde , Hospitais Públicos , Serviço de Farmácia Hospitalar/economia , Medicamentos sob Prescrição/economia , Medicamentos sob Prescrição/provisão & distribuição , Humanos , México
2.
Salud pública Méx ; 53(supl.4): 470-479, 2011. ilus
Artigo em Espanhol | LILACS | ID: lil-611836

RESUMO

OBJETIVO. Analizar la disponibilidad de medicamentos en las farmacias hospitalarias, el surtimiento de prescripciones a pacientes egresados y el gasto de bolsillo en medicamentos de pacientes hospitalizados. MATERIAL Y MÉTODOS. Análisis descriptivo de la Encuesta Nacional de Satisfacción y Trato Adecuado (ENSATA) de 2009 con una muestra representativa de hospitales públicos sobre disponibilidad de una lista de 83 medicamentos en el momento de la visita a la farmacia, la proporción del surtimiento de recetas a pacientes en el momento de su alta y su gasto de bolsillo durante su estancia hospitalaria. RESULTADOS. En total se entrevistó a 26 271 pacientes egresados de los 160 hospitales públicos visitados. La disponibilidad de medicamentos en el ámbito nacional fue de 82 por ciento. Los hospitales de los Servicios Estatales de Salud (SESA) mostraron una disponibilidad de 77 por ciento (variación de 30 a 96 por ciento). El surtimiento completo de recetas fue de 97 por ciento en las instituciones de seguridad social, cifra que contrasta con 56.2 por ciento de los hospitales de los SESA, que además presentaron una gran varianza entre estados (13 a 94 por ciento) La mediana del gasto de pacientes hospitalizados fue de 150 pesos moneda nacional (1 por ciento gastó más de 10 000 pesos. CONCLUSIONES. La falta de los medicamentos en los hospitales tiene un impacto económico en el gasto de los hogares, particularmente en aquellos que cuentan con pocos recursos, y puede aumentar la morbilidad o mortalidad de los pacientes hospitalizados en las instituciones públicas.


OBJECTIVE. To analyze the availability of drugs in public hospitals, the prescription-filling patterns for in-patients when they are discharged and their out-of-pocket expenditure during their hospitalization. MATERIAL AND METHODS. Using the National Satisfaction and Responsiveness Survey (ENSATA) 2009, which includes a representative sample of public hospitals in Mexico in 2009, the availability of 83 essential medicines in the hospital pharmacies at the day of visit, the proportion of prescriptions completely filled for patients when they are discharged and their out-of-pocket expenditure during their hospitalization were analyzed. RESULTS. A total of 26 271 patients in 160 public hospitals were interviewed. The mean availability of drugs was 82 percent for all hospitals, with the lowest availability for the Ministry of Health (SESA) hospitals (77 percent, with a range of 30 to 96 percent). Patients discharged at social security hospitals received in 97 percent of cases a complete prescription filling, while in SESA hospitals the average was only 56.2 percent, with a large variance among states (13 to 94 percent). The median inpatient spending was 150 pesos in national currency (1 percent spent over 10 000 pesos). CONCLUSIONS. The lack of medicines in public hospitals may increase in-patient morbidity and mortality and has an economic impact on household spending, particularly in those with scarce resources.


Assuntos
Humanos , Gastos em Saúde , Hospitais Públicos , Serviço de Farmácia Hospitalar/economia , Medicamentos sob Prescrição/economia , Medicamentos sob Prescrição/provisão & distribuição , México
3.
Eur J Health Econ ; 11(5): 437-47, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19756796

RESUMO

The goal of Seguro Popular (SP) in Mexico was to improve the financial protection of the uninsured population against excessive health expenditures. This paper estimates the impact of SP on catastrophic health expenditures (CHE), as well as out-of-pocket (OOP) health expenditures, from two different sources. First, we use the SP Impact Evaluation Survey (2005-2006), and compare the instrumental variables (IV) results with the experimental benchmark. Then, we use the same IV methods with the National Health and Nutrition Survey (ENSANUT 2006). We estimate naïve models, assuming exogeneity, and contrast them with IV models that take advantage of the specific SP implementation mechanisms for identification. The IV models estimated included two-stage least squares (2SLS), bivariate probit, and two-stage residual inclusion (2SRI) models. Instrumental variables estimates resulted in comparable estimates against the "gold standard." Instrumental variables estimates indicate a reduction of 54% in catastrophic expenditures at the national level. SP beneficiaries also had lower expenditures on outpatient and medicine expenditures. The selection-corrected protective effect is found not only in the limited experimental dataset, but also at the national level.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Seguro Saúde/economia , Área Carente de Assistência Médica , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Seguro Saúde/estatística & dados numéricos , Masculino , México , Pessoa de Meia-Idade , Modelos Estatísticos , Análise Multivariada , Estatística como Assunto
4.
Salud Publica Mex ; 47 Suppl 1: S27-36, 2005.
Artigo em Espanhol | MEDLINE | ID: mdl-16101204

RESUMO

OBJECTIVE: Present information on the magnitude and composition of private health expenditure (PHE) in Mexico. MATERIAL AND METHODS: Total PHE by state was calculated using the System of National Health Accounts and National Performance Assessment Survey 2002-2003 by means of elasticities and growth relative contributions. RESULTS: 58% of the total PHE was private and 90% of this was out-of-pocket expenditure. Most of the latter is expenditure in ambulatory care and drugs. 60% of the PHE was concentrated in only six states. PHE was lower than public expenditure in six states. CONCLUSIONS: The magnitude of out-of-pocket expenditure in health is worrying, since it is the most unfair, inefficient and regressive way of financing health care. Health authorities should look for alternative ways to finance health care, like the Popular Health Insurance.


Assuntos
Financiamento Pessoal/estatística & dados numéricos , Gastos em Saúde , Assistência Ambulatorial/economia , Custos de Medicamentos , Financiamento Pessoal/economia , Previsões , Pesquisas sobre Atenção à Saúde , Gastos em Saúde/estatística & dados numéricos , Humanos , Seguro Saúde/tendências , México , Modelos Teóricos
5.
Salud Publica Mex ; 47 Suppl 1: S37-46, 2005.
Artigo em Espanhol | MEDLINE | ID: mdl-16101205

RESUMO

OBJECTIVE: To describe the magnitude, distribution, and determinants of catastrophic health expenditures in Mexico. MATERIAL AND METHODS: The information source was the National Performance Assessment Survey and the methodology, the one developed by the World Health Organization for assessing fair financing. Households with catastrophic expenditures were defined as those with health expenditures over 30% of their ability to pay. Multivariate analysis by logistic and linear regression were used to identify the determinants of catastrophic expenditures. RESULTS: A total of 3.8% of the households incurred in catastrophic health expenditures. There were huge differences by state. The uninsured, poor, and rural households showed a higher impoverishment risk. Sixty percent of the catastrophic expenditures were attributable to outpatient care and medication. A 10% increase of insured households could result in a 9.6% decrease in catastrophic expenditures. Disability, adults 60 years of age and older, and pregnancy increased the probability of catastrophic expenditures. CONCLUSIONS: The insurance of older adults, pregnant women, and persons with disabilities could reduce catastrophic health expenditures in Mexico.


Assuntos
Doença Catastrófica/economia , Financiamento Pessoal , Gastos em Saúde , Seguro Saúde , Adulto , Pessoas com Deficiência , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Modelos Lineares , Modelos Logísticos , Masculino , Pessoas sem Cobertura de Seguro de Saúde , México , Pessoa de Meia-Idade , Modelos Teóricos , Análise Multivariada , Pobreza , Gravidez , População Rural , Organização Mundial da Saúde
6.
Salud Publica Mex ; 47 Suppl 1: S47-53, 2005.
Artigo em Espanhol | MEDLINE | ID: mdl-16101206

RESUMO

OBJECTIVE: To describe the differences in catastrophic health expenditures in five Mexican states. MATERIAL AND METHODS: This study included five states selected by convenience according to their social exclusion level. Household catastrophic health expenditures attributable to the three components of out of pocket health expenditures (ambulatory care, medication, and inpatient care) were calculated. RESULTS: The risk of impoverishment at the national level was greater in the most vulnerable households, namely, in the 20% poorest, rural, and uninsured households. Nevertheless, in states like Aguascalientes, Guerrero, Sinaloa, and Morelos the results were different. Over 70% of catastrophic health expenditures were attributable to medication and outpatient care expenditures in the poorest states. CONCLUSIONS: The differences found among states show that the implementation of local health policies to reduce catastrophic health expenditures should be based on evidence generated from analyses at the state level.


Assuntos
Doença Catastrófica/economia , Financiamento Pessoal , Gastos em Saúde , Seguro Saúde , Adulto , Assistência Ambulatorial/economia , Intervalos de Confiança , Custos e Análise de Custo , Custos de Medicamentos , Feminino , Política de Saúde , Hospitalização/economia , Humanos , Pacientes Internados , Masculino , Pessoas sem Cobertura de Seguro de Saúde , México , Pobreza , População Rural , População Urbana
7.
Salud Publica Mex ; 44 Suppl 1: S76-81, 2002.
Artigo em Espanhol | MEDLINE | ID: mdl-12055749

RESUMO

OBJECTIVE: To analyze selected determinants of tobacco consumption in Mexican homes. MATERIAL AND METHODS: Data from the National Household Income and Expenditure Survey, 1984-2000, were analyzed. The analysis was conducted for the years 1984-1992 and 1994-2000. The likelihood of tobacco consumption in households was estimated with a logistic regression model. RESULTS: Tobacco consumption during the first period was two times more likely from decile six (OR = 2.03, 95%, CI: 2.03-2.04) and during the second period from decile eight (OR = 2.06, 95%, CI: 2.05-2.07). Households from decile one spent on average 9-22% of their income on tobacco; almost all of the households from decile ten spent only 1% of their income on tobacco. CONCLUSIONS: Households with higher income consumed more tobacco than households with low income; nevertheless, households with the lowest income devoted a greater proportion of income to tobacco consumption.


Assuntos
Fumar/epidemiologia , Coleta de Dados , Humanos , Renda , México/epidemiologia
8.
Salud Publica Mex ; 44 Suppl 1: S82-92, 2002.
Artigo em Espanhol | MEDLINE | ID: mdl-12055750

RESUMO

OBJECTIVE: This paper aims at describing the behavior of tobacco's demand in Mexico across four one-year periods: 1992, 1994, 1996, and 1998, as well as to estimate a cigarette demand function. MATERIAL AND METHODS: A cross-sectional study with longitudinal analysis was conducted. Information sources were the Encuesta Nacional de Ingreso y Gasto de los Hogares (ENIGH) (National Survey of Household Income and Spending) (NHSIS) and the tobacco pack prices reported by the Procuraduría Federal del Consumidor (Profeco) (Federal Office of Consumer's Protection) (FOCP). Spending, income, and prices were deflated to 1994 prices; the population was stratified into quintiles of real income, by rural and urban areas. Indicators of daily consumption of cigarettes and packs were constructed and prices per pack calculated. Adjusted prevalence figures were estimated. Logistic and linear regression models were used for statistical inference; a cigarette demand function was estimated using multivariate logistic regression, to find socioeconomic determinants of cigarette consumption. RESULTS: The adjusted prevalence of household tobacco spending fell from 22.4 to 9.9% between 1992 and 1998. Households allocated more than 4% of their income to tobacco consumption. A trend between income level and cigarette spending was observed, with the first quintile (the poorest population) allocated a greater share of their income than higher quintiles. The average daily consumption of cigarettes increased from 7.5 to 9.8 between 1992 and 1998. It was estimated that 90% of "smoker homes" consumed up to one package per day. The proportion of non-filter cigarettes increased from 0.4 to 4.8% between 1992-1998, with a bigger increase in 1996. Finally, it was found that the most important determinants of spending were prices and income. CONCLUSIONS: Policies focusing on tobacco prices would help to reduce tobacco consumption and improve the health of the Mexican population.


Assuntos
Fumar/epidemiologia , Custos e Análise de Custo , Estudos Transversais , Humanos , México , Indústria do Tabaco/economia , Indústria do Tabaco/estatística & dados numéricos
9.
Salud pública Méx ; 44(supl.1): s76-s81, 2002. graf
Artigo em Espanhol | LILACS | ID: lil-464234

RESUMO

Objetivo. Analizar algunos de los determinantes del consumo de tabaco en los hogares en México. Material y métodos. Los datos provienen de la Encuesta Nacional de Ingresos y Gastos de los Hogares (1984-2000). El análisis se realizó en dos periodos: 1984-1992 y 1994-2000. Las posibilidades de consumo de tabaco en hogares (PCTH) fueron estimadas mediante un modelo de regresión logística. Resultados. La PCTH durante el primer periodo fue superior a dos veces a partir del decil 6 (RM=2.03, IC 95 por ciento, 2.03-2.04) y durante el segundo periodo a partir del decil 8 (RM=2.06, IC 95 por ciento, 2.05-2.07). Los hogares del decil 1 gastaron en promedio de 9 a 22 por ciento de sus ingresos en tabaco; casi todos los hogares del decil 10, solamente 1 por ciento. Conclusiones. Los hogares con mayores ingresos consumieron más tabaco que los hogares de menores ingresos, sin embargo, los hogares de más bajos ingresos destinaron un porcentaje más importante de éstos al consumo de tabaco.


Objective. To analyze selected determinants of tobacco consumption in Mexican homes. Material and Methods. Data from the National Household Income and Expenditure Survey, 1984-2000, were analyzed. The analysis was conducted for the years 1984-1992 and 1994-2000. The likelihood of tobacco consumption in households was estimated with a logistic regression model. Results. Tobacco consumption during the first period was two times more likely from decile six (OR=2.03, 95 percent, CI: 2.03-2.04) and during the second period from decile eight (OR=2.06, 95 percent, CI: 2.05-2.07). Households from decile one spent on average 9-22 percent of their income on tobacco; almost all of the households from decile ten spent only 1 percent of their income on tobacco. Conclusions. Households with higher income consumed more tobacco than households with low income; nevertheless, households with the lowest income devoted a greater proportion of income to tobacco consumption.


Assuntos
Humanos , Fumar/epidemiologia , Coleta de Dados , Renda , México/epidemiologia
10.
Salud pública Méx ; 44(supl.1): s82-s92, 2002. graf, tab
Artigo em Espanhol | LILACS | ID: lil-464235

RESUMO

Objetivo. Describir el comportamiento de la demanda de tabaco en México para cuatro momentos en el tiempo: 1992, 1994, 1996 y 1998, y adicionalmente estimar una función de demanda de cigarrillos. Material y métodos. Se realizó un estudio transversal con análisis longitudinal, tomando como fuentes de información la Encuesta Nacional de Ingreso y Gasto de los Hogares (ENIGH) y la lista de precios de los cigarrillos de la Procuraduría Federal del Consumidor (Profeco). El gasto, el ingreso y los precios se deflactaron a precios de 1994. Se estratificó a la población en quintiles de ingreso real, y solamente se tomaron en cuenta las áreas rurales y urbanas. Se construyeron indicadores para el consumo diario de cigarrillos y cajetillas y se calcularon los precios por cajetilla. Se calculó la prevalencia ajustada. Mediante análisis de regresión logísticos y lineales se estableció la inferencia estadística. Se estimó una función de demanda de cigarrillos mediante una regresión lineal multivariada, para encontrar los determinantes socioeconómicos del consumo de cigarrillos. Resultados. La prevalencia ajustada de los hogares que reportaron algún gasto en tabaco disminuyó de 22.4 a 9.9 por ciento entre 1992 y 1998. Los hogares asignaron poco más de 4 por ciento de su ingreso a la adquisición de tabaco. Se observó un gradiente entre nivel de ingreso y gasto en cigarrillos. El quintil I (el más pobre) destinó una mayor proporción de su ingreso que los quintiles superiores. El promedio de cigarrillos consumidos diariamente pasó de 7.5 a 9.8 entre 1992 y 1998. Se estimó que más de 90 por ciento de los "hogares fumadores" consumió hasta una cajetilla diaria. La demanda estimada de cigarrillos sin filtro aumentó entre 1992 a 1998, pasando de 0.4 a 4.8 por ciento, registrándose así el mayor incremento en 1996. Finalmente, se encontró que, tanto los precios como el ingreso, fueron los determinantes más importantes del gasto en tabaco. Conclusiones. Una...


Objective. This paper aims at describing the behavior of tobacco's demand in Mexico across four one-year periods: 1992, 1994, 1996, and 1998, as well as to estimate a cigarette demand function. Material and Methods. A cross-sectional study with longitudinal analysis was conducted. Information sources were the Encuesta Nacional de Ingreso y Gasto de los Hogares (ENIGH) (National Survey of Household Income and Spending) (NHSIS) and the tobacco pack prices reported by the Procuraduría Federal del Consumidor (Profeco) (Federal Office of Consumer's Protection) (FOCP). Spending, income, and prices were deflated to 1994 prices; the population was stratified into quintiles of real income, by rural and urban areas. Indicators of daily consumption of cigarettes and packs were constructed and prices per pack calculated. Adjusted prevalence figures were estimated. Logistic and linear regression models were used for statistical inference; a cigarette demand function was estimated using multivariate logistic regression, to find socioeconomic determinants of cigarette consumption. Results. The adjusted prevalence of household tobacco spending fell from 22.4 to 9.9 percent between 1992 and 1998. Households allocated more than 4 percent of their income to tobacco consumption. A trend between income level and cigarette spending was observed, with the first quintile (the poorest population) allocated a greater share of their income than higher quintiles. The average daily consumption of cigarettes increased from 7.5 to 9.8 between 1992 and 1998. It was estimated that 90 percent of "smoker homes" consumed up to one package per day. The proportion of non-filter cigarettes increased from 0.4 to 4.8 percent between 1992-1998, with a bigger increase in 1996. Finally, it was found that the most important determinants of spending were prices and income. Conclusions. Policies focusing on tobacco prices would help to reduce tobacco consumption and improve the health...


Assuntos
Humanos , Fumar/epidemiologia , Custos e Análise de Custo , Estudos Transversais , México , Indústria do Tabaco/economia , Indústria do Tabaco/estatística & dados numéricos
11.
Ciudad de Mexico; Secretaría de Salud; s.f. 10 p. tab, graf.(Síntesis Ejecutiva, 8).
Monografia em Espanhol | LILACS | ID: lil-392664

RESUMO

®Se muestran los resultados del porcentaje de hogares con gastos catastróficos por motivos de salud por entidad federativa de acuerdo con la ENIGH de 1996. En esta encuesta, 8 de las 32 entidades gozaron de representatividad subnacional (estatal). El porcentaje de hogares con gastos catastróficos por motivos de salud en México en 1996 fue de 4.07 porciento, que es la cifra más baja en el periodo 1994 - 2000. El Estado de México fue la entidad con mayor proporción de hogares en riesgo de empobrecimiento (10.58 porciento), mientras que Coahuila mostró la menor proporción (2.95 porciento). La población más propensa a padecer gastos catastróficos se ubicó en los estratos socioeconómicos más bajos (quintiles I y II, hogares rurales y no asegurados). La inversión pública y los esquemas de aseguramiento funcionaron como factores protectores contra el riesgo de empobrecimiento por atender necesidades de salud¼ (AU). Contenido: 1) Introducción. 2) Material y métodos. 3) Resultados. 4) Conclusiones


Assuntos
Custos de Cuidados de Saúde , Gastos em Saúde
12.
Ciudad de México; México. Secretaría de Salud; s.f. 9 p. graf.(Síntesis Ejecutiva, 11).
Monografia em Espanhol | LILACS | ID: lil-392671

RESUMO

®El porcentaje de hogares que incurrió en gastos catastróficos por motivos de salud a nivel nacional en México en el último trimestre de 2002 fue 3.89; Chiapas, Zacatecas y Michoacán fueron las entidades que presentaron las cifras más altas, y Aguascalientes, Colima y Yucatán las más bajas. Es importante resaltar que los hogares pobres, no asegurados y rurales presentaron gastos catastróficos por motivos de salud con mayor frecuencia que sus contrapartes urbanos, asegurados y de mayores recursos. Las variables más estrechamente asociadas a gastos catastróficos son la presencia en el hogar de una persona con discapacidad, jefes del hogar mayores de 60 años, jefes del hogar de género femenino y la ocurrencia de un parto. Llama también la atención que 60 porciento de los gastos catastróficos son atribuidos a gastos en atención ambulatoria y medicamentos.¼ (AU). Contenido: 1) Introducción. 2) Material y métodos. 3) Resultados. 4) Conclusiones


Assuntos
Efeitos Psicossociais da Doença , Gastos em Saúde
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