ministry of health, mexico sicuentas mexico´s experience with using nha data in the policy-making...

Ministry of Health, Mexico

SICUENTAS

Mexico´s experience with using Mexico´s experience with using

NHA data in the Policy-making NHA data in the Policy-making

ProcessProcess

October 2003OECD, Paris

Reform of the General Health Reform of the General Health

LawLaw


SICUENTAS

Outline

Background on the use of NHA in Mexico

Setting the scene – providing evidence

Objectives of the Reform

SICUENTAS and the Reform

Conclusions


SICUENTAS

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

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

0

1

2

3

4

5

6

7

1992 1993 1994 1995 1996 1997 1998

Public expenditure Private expenditure


SICUENTAS

Evidence provided was used in prospective policy formulation

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

1. Equity2. Quality3. Financial protection


SICUENTAS

General Direction for Information and Health System Performance Asssessment

(National Health Information System)

National Health Program 2001 – 2006 National Health Program 2001 – 2006

System of National and State Health Accounts (SICUENTAS)

Strengthen the stewardship function of MOH


SICUENTAS

Setting the scene Providing evidence

FINANCIAL IMBALANCESFINANCIAL 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 populationBetween States: 11 to 1 between highest and lowest

• State effort A difference of 119 to 1 between highest and lowest


SICUENTAS

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


SICUENTAS

Proposal – towards a new financial architecture of the health system

Employee

FamilyPopular Health Insurance

ISSSTE – Medical insurance

IMSS – Medical insurance

Nation

Nation

Nation

State Gov.

FederalGovernmen

t

EmployerEmployee

ContributorsPublic Insurance Schemes

Federal Gov.


SICUENTAS

Classification of health services

• Prevention• Diagnosis• Treatment• Rehabilitation

Health Goods

• Stewardship• Information and

research• Community health

services

Public Goods

Individual health services (medical care)

• Epi surveillance

• Environmental health

• Collective services

• Disaster management

SICUENTAS and the Reform


SICUENTAS

Public Health Expenditure by Function and Source of Funds, Mexico 2002

0%

10%

20%

30%

40%

50%

60%

70%

Health administration Prevention and publichealth

Personal health care Resourse generation

Federal contributions State contributions


SICUENTAS

•To train personnel

•To conduct scientific and technologic research

•To conduct sanitary regulation

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

Examples of modificationsNational Health Accounts

Ministry of Health Classification

TOTAL HEALTH EXPENDITURE


SICUENTAS

• 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


SICUENTAS

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


SICUENTAS

ministry of health, mexico sicuentas mexico´s experience with using nha data in the policy-making...

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