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Mexico´s experience with using NHA data in the Policy-making Process Reform of the General Health Law October 2003 OECD, Paris Outline Background on the use of NHA in Mexico Setting the scene – providing evidence Objectives of the Reform SICUENTAS and the Reform Conclusions 7 6 5 4

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slide1

Mexico´s experience with using NHA data in the Policy-making Process

Reform of the General Health Law

October 2003

OECD, Paris

slide2

Outline

  • Background on the use of NHA in Mexico
  • Setting the scene – providing evidence
  • Objectives of the Reform
  • SICUENTAS and the Reform
  • Conclusions
slide3

7

6

5

4

3

2

1

0

1992

1993

1994

1995

1996

1997

1998

Public expenditure

Private expenditure

Background

FUNSALUD conducted the first NHA analysis in Mexico (1992 – 1998)

Public and private expenditure as percentage of GDP, Mexico 1992-1998

slide4

Evidence provided was used in prospective policy formulation

National Health Program 2001 – 2006 identified three challenges of the health system:

  • Equity
  • Quality
  • Financial protection
slide5

National Health Program 2001 – 2006

Strengthen the stewardship function of MOH

System of National and State Health Accounts (SICUENTAS)

General Direction for Information and Health System Performance Asssessment

(National Health Information System)

slide6

Setting the scene

Providing evidence

FINANCIAL IMBALANCES

  • Level

Insufficient investment 5.8% of GDP

  • Origin of expenditure

Out-of-pocket expenditure (55%)

  • Distribution

Between institutions:one and half times between insured and uninsured population

Between States: 11 to 1 between highest and lowest

  • State effort

A difference of 119 to 1 between highest and lowest

slide7

Objectives of the reform

  • Order the current allocation of resources
  • Correct the financial imbalances and historic inercia
  • Move towards a framework of public insurance to finance medical care
  • Establish co-responsibility between different levels of government and the population
  • Provide effective content to the full exercise of social rights as part of the reform of the State
slide8

Public Insurance Schemes

Contributors

IMSS – Medical insurance

Employee

Employer

Nation

ISSSTE – Medical insurance

Employee

Federal

Government

Nation

Popular Health Insurance

Family

State Gov.

Nation

Federal Gov.

Proposal – towards a new financial architecture of the health system

slide9

Epi surveillance

  • Environmental health
  • Collective services
  • Disaster management

Public Goods

Health Goods

Individual health services (medical care)

SICUENTAS and the Reform

Classification of health services

  • Stewardship
  • Information and research
  • Community health services
  • Prevention
  • Diagnosis
  • Treatment
  • Rehabilitation
slide11

Examples of modifications

National Health Accounts

  • To train personnel
  • To conduct scientific and technologic research
  • To conduct sanitary regulation

Ministry of Health Classification

  • Health Related Expenditures
  • HC.R.2 Education formation of health care provider institutions
  • HC.R.3 Research and development in health
  • HC.R.4 Food, hygiene and drinking water control

TOTAL HEALTH EXPENDITURE

slide12

Stewardship has been added to the list of functions of the health system, AS A DIFFERENT FUNCTION FROM ADMINISTRATION

  • MOF has agreed to a health expenditure reporting format that is more closely related to the functions of the health system, including stewardship
  • Health related functions are included as part of the total health expenditure
  • Improve quality of reporting on pharmaceuticals
  • Include information from municipalitites
  • Manual for the Mexican SICUENTAS
  • Informatio to be produced every three months
slide13

SICUENTAS, as part of the National Information System, is an important tool providing evidence for policy formulation, accountability, resource allocation

INFORMATION THAT IS NOT USEFUL IS NOT USED