Loss of job-related right to healthcare is associated with reduced quality and clinical outcomes of diabetic patients in Mexico.
Int J Qual Health Care
; 30(4): 283-290, 2018 May 01.
Article
en En
| MEDLINE
| ID: mdl-29432612
OBJECTIVES: The Mexican Institute of Social Security (IMSS) provides a package of health, economic and social benefits to workers employed in private firms within the formal labour market and to their economic dependants. Affiliates have a right to these benefits only while they remain contracted, thus posing a risk for the continuity of healthcare. This study evaluates the association between the time (in days) without the right to healthcare due to job loss in the formal labour market and the quality of healthcare and clinical outcomes among IMSS affiliates with Type 2 diabetes mellitus (T2DM). DESIGN: Retrospective cohort study 2013-2015. SETTING: Six IMSS family medicine clinics (FMC) in Mexico City. PARTICIPANTS: T2DM patients (n = 27 217) affiliated with job-related health insurance and at least one consultation with a family doctor during 2013. SOURCE OF INFORMATION: IMSS affiliation department database and electronic health records and clinical laboratory databases. MAIN OUTCOME MEASURE(S): Quality of the processes (eight indicators) and outcomes (three indicators) of healthcare. RESULTS: The results indicated that losing IMSS right to healthcare is frequent, occurring to one-third of T2DM patients during the follow-up period. The time without the right to healthcare in the observed period was of 120 days on average and was associated with a 43.2% loss of quality of care and a 19.2% reduction in clinical outcomes of T2DM. CONCLUSION: Policies aimed at ensuring access and continuity of care, regardless of job status, are critical for improving the quality of processes and outcomes of healthcare for diabetic patients.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Calidad de la Atención de Salud
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Desempleo
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Resultado del Tratamiento
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Diabetes Mellitus Tipo 2
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Seguro de Salud
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Mexico
Idioma:
En
Revista:
Int J Qual Health Care
Asunto de la revista:
SERVICOS DE SAUDE
Año:
2018
Tipo del documento:
Article
País de afiliación:
México
Pais de publicación:
Reino Unido