目的:本研究旨在利用健康获取和质量指数(HAQI)作为主要指标,全面评估墨西哥1990年至2019年的卫生系统绩效。
方法:使用来自全球疾病负担的数据进行了回顾性生态分析,伤害和风险因素研究(GBD)研究和国家人口委员会(CONAPO)。
方法:对墨西哥每个州和三个年龄组(年轻,工作,和后期工作)。此外,边缘化指数被用来评估各州之间HAQI分布的不平等。估算了各年HAQI的浓度指数,并使用数据包络方法评估了生产HAQI的状态效率。
结果:通过对国家和国家以下数据的分析,结果表明,在研究期间,医疗服务的可及性和质量均有整体改善.尽管与国家边缘化相关的HAQI值差异从1990年到2015年有所下降,但到2019年,不平等已恢复到与2000年相当的水平。生产健康的效率(HAQI值)随着时间的推移表现出很大的异质性和排序顺序的波动。像新莱昂这样的国家一直表现良好,而其他人,比如格雷罗,吉娃娃,墨西哥城,还有普埃布拉,一直表现不佳。
结论:这项研究的结果强调了采取细微差别策略来解决医疗保健差距并提高整体系统性能的必要性。这项研究为正在进行的关于墨西哥医疗保健系统未来的讨论提供了有价值的见解,旨在为基于证据的政策决定提供信息,并改善全国范围内的医疗保健服务。
OBJECTIVE: This study aimed to comprehensively evaluate Mexico\'s health system performance from 1990 to 2019 utilising the Health Access and Quality Index (HAQI) as a primary indicator.
METHODS: A retrospective ecological analysis was performed using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) study and the National Population Council (CONAPO).
METHODS: HAQI values for 1990, 2000, 2010, 2015, and 2019 were examined for each state in Mexico and three age groups (young, working, and post-working). Additionally, the marginalisation index was employed to assess inequalities in the HAQI distribution across states. The concentration index of the HAQI for each year was estimated, and the efficiency of states in producing the HAQI was evaluated using a data envelopment approach.
RESULTS: Through the analysis of national and subnational data, results indicated an overall improvement in healthcare access and quality during the study period. Although differences in the HAQI value related to state marginalisation decreased from 1990 to 2015, by 2019, the inequality had returned to a level comparable to 2000. Efficiency in producing health (HAQI values) exhibited substantial heterogeneity and fluctuations in the ranking order over time. States such as Nuevo León consistently performed well, while others, such as Guerrero, Chihuahua, Mexico City, and Puebla, consistently underperformed.
CONCLUSIONS: The findings from this study emphasise the necessity for nuanced strategies to address healthcare disparities and enhance the overall system performance. The study provides valuable insights for ongoing discussions about the future of Mexico\'s healthcare system, aiming to inform evidence-based policy decisions and improve the nationwide delivery of healthcare services.