El Fondo de Protección contra Gastos Catastróficos: tendencia, evolución y operación

Aracena-Genao, Belkis; González-Robledo, María Cecilia; González-Robledo, Luz María; Palacio-Mejía, Lina Sofía; Nígenda, Gustavo

doi:10.1590/s0036-36342011001000004

Cited by 15 publications

(14 citation statements)

References 8 publications

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“…From 2010 to 2012, the Mexican government spent nearly US $400 million for ART and ambulatory care for PLHIV covered by SP. [ 30 , 31 ] The increasing numbers of PLHIV covered by SP and entering care each year may reflect important advances in universal coverage for ART in Mexico, highlighting the improvements in access to HIV care and treatment in the country. However, our findings reveal that late entry into care is highly prevalent among PLHIV, with critical inequities between sex, age, and state MI.…”

Section: Discussionmentioning

confidence: 99%

CD4 Counts at Entry to HIV Care in Mexico for Patients under the “Universal Antiretroviral Treatment Program for the Uninsured Population,” 2007–2014

Hernández-Romieu¹,

Rı́o²,

Hernández-Ávila³

et al. 2016

PLoS ONE

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In Mexico, public health services have provided universal access to antiretroviral therapy (ART) since 2004. For individuals receiving HIV care in public healthcare facilities, the data are limited regarding CD4 T-lymphocyte counts (CD4e) at the time of entry into care. Relevant population-based estimates of CD4e are needed to inform strategies to maximize the impact of Mexico’s national ART program, and may be applicable to other countries implementing universal HIV treatment programs. For this study, we retrospectively analyzed the CD4e of persons living with HIV and receiving care at state public health facilities from 2007 to 2014, comparing CD4e by demographic characteristics and the marginalization index of the state where treatment was provided, and assessing trends in CD4e over time. Our sample included 66,947 individuals who entered into HIV care between 2007 and 2014, of whom 79% were male. During the study period, the male-to-female ratio increased from 3.0 to 4.3, reflecting the country's HIV epidemic; the median age at entry decreased from 34 years to 32 years. Overall, 48.6% of individuals entered care with a CD4≤200 cells/μl, ranging from 42.2% in states with a very low marginalization index to 52.8% in states with a high marginalization index, and from 38.9% among individuals aged 18–29 to 56.5% among those older than 50. The adjusted geometric mean (95% confidence interval) CD4e increased among males from 135 (131,142) cells/μl in 2007 to 148 (143,155) cells/μl in 2014 (p-value<0.0001); no change was observed among women, with a geometric mean of 178 (171,186) and 171 (165,183) in 2007 and 2014, respectively. There have been important gains in access to HIV care and treatment; however, late entry into care remains an important barrier in achieving optimal outcomes of ART in Mexico. The geographic, socioeconomic, and demographic differences observed reflect important inequities in timely access to HIV prevention, care, and treatment services, and highlight the need to develop contextual and culturally appropriate prevention and HIV testing strategies and linkage programs.

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Section: Discussionmentioning

confidence: 99%

CD4 Counts at Entry to HIV Care in Mexico for Patients under the “Universal Antiretroviral Treatment Program for the Uninsured Population,” 2007–2014

Hernández-Romieu¹,

Rı́o²,

Hernández-Ávila³

et al. 2016

PLoS ONE

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“…Another important discovery is that this study established that the average direct medical costs/year in diagnosis and treatment relate to 45% of the total expenditure of the fund for the protection against catastrophic expenses (FPGC) in the current scenario (SPSS) when analysed with figures reported by SPSS [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Costs of breast cancer care in Mexico: analysis of two insurance coverage scenarios

González-Robledo

Wong²,

Ornelas³

et al. 2015

ecancer

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BackgroundBreast cancer (BC) is a major cause of disease and death worldwide. In addition to its contribution to mortality and disability, it is a major economic burden both public and private.ObjectiveTo estimate the average direct medical cost/year of care for the diagnosis and treatment of BC in two coverage scenarios in Mexico: What is ‘ideal’ based on service usage patterns according to international guidelines and what is ‘current’ using the service usage patterns of suppliers in Mexico.Material and MethodsThe pattern and intensity of use of procedures for the care of BC in the Mexican Social Security Institute (IMSS) for 2009 were identified and prices were associated using the guidelines from the System of Social Protection in Health (SPSS) and the IMSS for the current scenario and the ideal scenario, international patterns (Breast Health Global Initiative BHGI after its acronym in English) were used and prices were associated from the SPSS guidelines.ResultsThe annual average direct medical cost per patient in the ‘current’ scenario was 8557 US$, while the cost in the ‘ideal’ scenario was 4554 US$. There are differences in costs between ‘what we do’ and ‘what should be done’, due to differences in the implementation of the interventions for the treatment of the different stages of the disease. A proportional increase in the average cost was also identified as the diagnosis stage advanced (from I to III).ConclusionsGiven that in Mexico there is universal insurance coverage for the treatment of BC, it is necessary to use economic resources more efficiently. It is necessary to continue to examine this topic in more depth and the next step will be to assess the effectiveness of both scenarios in order to provide enough evidence for the decision-making process.

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“…On the downside, however, we found that a high percentage of women with positive results for estrogen and/or Her2/neu receptors remained without adequate treatment: 17.9 percent did not receive hormonotherapy and 59.4 percent were not prescribed trastuzumab medication. As reported by other studies, these findings may be attributable to a lack of knowledge among physicians regarding the SPSS Guidelines [7, 29]. Additionally, a shortage of supplies and/or medication (e.g.…”

Section: Discussionmentioning

confidence: 73%

“…In 2004, the SPSS , a voluntary public health insurance program, was created in order to provide access to health-care services and financial protection to all those without Social Security coverage. The SPSS manages two major operations: (a) the Seguro Popular , its key component, offers a package of primary- and secondary-care services to its beneficiaries who [ 5 ], by 2017, had reached 60.5 million, or 43.2% of the Mexican population [ 6 ]; and (b) the FPGC finances expensive health-care treatments with a view to reducing the economic strain imposed by disease on the poorest sectors of the population [ 5 , 7 ]. Incorporated as part of the FPGC catalog since 2007 [ 2 ], BC treatment is provided to women free of charge through the intermediary of hospitals accredited on the basis of criteria concerning capacity, safety and quality in patient care [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Adherence of Mexican physicians to clinical guidelines in the management of breast cancer: Effect of the National Catastrophic Health Expenditure Fund

2019

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AimTo assess the adherence of physicians to the Medical-Care Guidelines for Malignant Breast Tumors in Mexico, before and after the allocation of federal subsidies from the Catastrophic Health Expenditure Fund (FPGC by its Spanish initials) to accredited hospitals, a strategy implemented with the view of offering free treatment to women with breast cancer (BC).Material and methodsBased on a cross-sectional design, we gathered information on 479 BC patients who had been attended to at in four FPGC-accredited hospitals. Analysis centered on those treated within either three years before or three years after the accreditation of their attending hospitals. The four hospitals analyzed were located in the North, South, West and Center of the country. Information on all medical procedures performed during treatment was drawn from hospital medical records. Information on the socio-demographic characteristics of the patients was obtained by means of face-to-face interviews conducted in their homes.ResultsAdherence of physicians to the Guidelines grew by 12.8 percent (from 43.4 to 56.2 percent) after FPGC accreditation (p<0.001) and varied according to the clinical stage of the disease, with much lower levels of adherence observed in the advanced stages (p<0.05).ConclusionsThe FPGC strategy increased the adherence of physicians to the Medical-Care Guidelines for Malignant Breast Tumors in Mexico.

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El Fondo de Protección contra Gastos Catastróficos: tendencia, evolución y operación

Cited by 15 publications

References 8 publications

CD4 Counts at Entry to HIV Care in Mexico for Patients under the “Universal Antiretroviral Treatment Program for the Uninsured Population,” 2007–2014

CD4 Counts at Entry to HIV Care in Mexico for Patients under the “Universal Antiretroviral Treatment Program for the Uninsured Population,” 2007–2014

Costs of breast cancer care in Mexico: analysis of two insurance coverage scenarios

Adherence of Mexican physicians to clinical guidelines in the management of breast cancer: Effect of the National Catastrophic Health Expenditure Fund

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