mexican health system - ministero salute · •influenza ah1/n1.byproduct of the epidemic, the...
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SALUD
Mexican Health System
SALUDMexico
•Health Protection is a constitutional right.•Nowadays health care services are available for 95 million Mexicans in 32states through social insurance and public decentralized services.•Universal coverage will be achived at the end of 2011, early 2012. 1
•Birth rate: 18 per 1,000 inhabitants. 2
•Life expectancy: 73/78 3
•Per capita GDP 2010: US$ 9,030.00 4
•Total expenditure on health as % of GDP (2009) 3: 6.5
Sources: 1. Comisión Nacional de Protección Social en Salud, CNPSS, 2010. Ministry of Health, Mexico; 2. Consejo Nacional de Población, CONAPO.Proyecciones de la población de México, 2005-2050. www.conapo.gob.mx; 3. Global Health Observatory, WHO, www.who.int/countries/mex/en;4. Instituto Nacional de Estadística y Geografía. INEGI. Encuesta Nacional de Ingreso y Gastos de los Hogares, 2008. México.
SALUD
Unemployment,Insecurity, Education,
Migration and Poverty
Proliferation of Vectors
Dyslipidemia
Incomplete Vaccination
Overcrowding
Under-utilization of Services
Insufficient coverage of services
Alcoholism and Tobacco
Consumption
Environmental pollution
Obesity
Sedentary behavior
and stress
Hipertensionand Diabetes
Malnutrition
No HealthyConducts
Accidents and Disability
Aging
Demographic and epidemiological transitions
SALUDChronic Diseases: Mortality in Mexico 1985-2010
Diabetes Mellitus
Ischemic Heart Disease
Brain vascular disease
Cirrhosis and other liver illnesses
Hypertension
Population Aging
0
2
4
6
8
10
12
14
16
2005 2010 2015 2020
Percentage of population consisting of senior adults, by age
60 a 64
65 a74
75 a84
85 o más
Source: ECLAC and CONAPO, updated with
2010 CENSUS
The Institute of Geriatrics was created in 2008
SALUDHealth Interventions
• NCDs: Obesity prevalence among adults has tripled since 1980. Health care forNCD s related to obesity costs 0.3% of GDP and 13% of total healthexpenditure (2008). National Agreement for Nutritional Health. Intersectoralinterventions.
• Maternal & Infant Mortality. Maternal mortality rate has dropped 40.8% from1990 to 2010 (90.41 to 53.5 deaths per 100 thousand living).
• Influenza AH1/N1.Byproduct of the epidemic, the national surveillance systemwas strengthened. Mexico is better prepared to deal with global epidemics.
• Tobacco and Alcohol Consumption.
• IMESEVI. Mexican Initiative for Road Safety.
• HIV/AIDS Prevention. 35,000 patients without social security receive freetreatment through Seguro Popular’s Catastrophic Protection Fund.
SALUD
Benefits Package
Population
Financing
Management
Users
Service provision
SS IMSS
Formal workers in the private sector
Public Sector
General taxes States
Population without social security, to be
affiliated
ISSSTE Private insurance
Medicines
Doctors
Hospitals
Without social security and with no interest to be affiliated
Formal workers in the private sector
Public Sector
Population without social security, to be
affiliated
Without social security and with no interest to be affiliated
Social contribution
Workers’ and employers’ contributions
SESASFPGC
•Maternity and illness insurance•Health Benefits Package•universal 266•catastrophic 49•New generation 128
Mexican Health System Today
Social contribution Social contribution
Workers’ and employers’ contributions
SALUD
• System Fragmentation
• Duplicities and inefficiencies
• Offer of differentiated services
• Variability of medical attention
• Heterogeneity in the funding and administration
NEED TO HOMOLOGATESERVICES
• Right to health protection
• Descentralization of services to federal entities
• Health equity
• Creation of the Social Protection System in Health
REFORMSFEDERALISM AND UNIVERSALIZATION
Opportunities and Huge Challenges
SALUDMexican Health Reform with SeguroPopular
2003: 49 millions ; 2011: 96 millions of total public health coverage
2006
2008
2011
Population
Interventions
Popular Health Insurance including:- All primary-care and child interventions- Universal access to medical drugs for chronic diseasesand Universal coverage for cancer in pediatric and woman’s (breast and cervical)
45,0
46,0
47,0
48,0
49,0
50,0
51,0
52,0
2005 2006 2007 2008 2009
51,7 51,3
50,9
49,3
47,7
Out of Pocked Expense as a % of Total Health Expenditure 2005-2009
%
Source: Ministry of Health, Dirección General de Información en Salud. Sistema de Cuentas en Salud a NivelFederal y Estatal (SICUENTAS), México 2010. 10
SALUDPaving the way for the future: Functional
Integration
Population covered Others
Health Benefits Package
Single financial source
Benefits Package
Population
Financing
Management
Users
Service provision
Private insurance
Medicines
Doctors
Hospitals
Population coveredOthers
SALUD
Enriched by experience, strengthening prevention and health promotion.
Universal coverage
Preventive- early detection of risks and damages
Integral
Focused in risk groups
Community and family focused
Strengthened health promotion and the educative process. Modify behaviors
Use of multiple medicines (efficiency)
Interdisciplinary teams
Paving the way for the future: A New Model
Strategy 2007-2012
• National health registry of covered population
• Electronic file network
• Standardized medical attention
• Systematic service exchange among public institutions
• Sectorial use of resources
• Consolidated buying of medicines
• Human Resource Formation
Improve availability and use of resources to cope with challenges
Towards Functional Integration
SALUD
Thank you