Salud Pública de México
versión impresa ISSN 0036-3634
TAPIA-CRUZ, José Antonio. Mexico health care system's objectives: importance to its population and determining factors. Salud pública Méx [online]. 2006, vol.48, n.2, pp. 113-126. ISSN 0036-3634.
OBJECTIVE: To document the importance to Mexico´s population of the five intrinsic objectives of Mexico´s present health care system (SS) and describe some of the determinants of its evaluation; the purpose is to contribute elements for defining priorities and to support the fulfillment of said objectives. MATERIAL AND METHODS: This is a cross-sectional study to the importance for Mexican population of the five objectives of SS, considered intrinsic or final in the National Evaluation and Performance Survey. The dependent variable was the ranking given by the population surveyed to each one of the objectives, based on the question: Which SS objective do you believe is most important? The independent variables (nominal and categorical) were: state of residence, type of locality, gender, age, education, present employment, quality of present state of health, last occurrence when medical assistance was needed but not received, grade of satisfaction with the operation of the country´s medical care system and satisfaction with one´s own health. A univaried analysis was conducted and summarized using percentages. The chi square test was used to validate or reject the hypothesis according to whether the rank assigned by the population to the SS objectives is the same, regardless of which variables were used in the comparison. A multinomial (politomic) logistical regression model was also developed to correlate the effect of the independent variables employed in the study with the importance assigned by the population to the SS objectives. The reference category of the model was the objective of improving the health of the population. The analysis was conducted using the statistical package STATA version 7.0. RESULTS: From the population studied, 31.8% reported that the most important objective is to improve treatment within the health care system. In rural areas, 31.46% of the population thinks the most important objective is to improve health, a result related with the self-perception of one´s present state of health and lack of medical care. The probability of preferring the objective of improving treatment over improving health, between the populations with average education and higher levels of education is, respectively, 10% and 16% greater than the population with no education. Among the population that works independently, 31.2% consider improving health the most important objective, a greater percentage than that reported by the population of business owners and the one consisting of public and private employees. CONCLUSIONS: In general terms, the population analyzed by this study considered the improvement of treatment within the health care system to be most important, which differs from that suggested by the PRONASA 2001-2006. It was indicated that the importance assigned to the objectives can vary according to the group analyzed, its characteristics and the influence of diverse external factors on the individual, as a result of which the null hypothsesis is rejected. Variations among the populations´ evaluations occurred, in particular, between the objective of improving treatment within the health care system and that of the improvement of the population´s health. The obtained results guide the steps for communication and the strengthening of the health care system in order to adjust itself to the expectations of the population and support the fulfillment of the established objectives.
Palabras llave : program evaluation; organizational objectives; consumer satisfaction; health administration and planning; Mexico.