<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2007-7459</journal-id>
<journal-title><![CDATA[Horizonte sanitario]]></journal-title>
<abbrev-journal-title><![CDATA[Horiz. sanitario]]></abbrev-journal-title>
<issn>2007-7459</issn>
<publisher>
<publisher-name><![CDATA[Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2007-74592021000200218</article-id>
<article-id pub-id-type="doi">10.19136/hs.a20n2.3891</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Indice de vulnerabilidad del sector salud en México: La infraestructura hospitalaria ante la COVID-19]]></article-title>
<article-title xml:lang="en"><![CDATA[Vulnerability index of the health sector in México; Hospital infrastructure in the face of COVID-19]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Candia Calderon]]></surname>
<given-names><![CDATA[Alethea Gabriela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Olivera-Villarroel]]></surname>
<given-names><![CDATA[Sazcha-Marcelo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Facultad Latinoamericana de Ciencias Sociales- México.  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional Autónoma de México  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2021</year>
</pub-date>
<volume>20</volume>
<numero>2</numero>
<fpage>218</fpage>
<lpage>225</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2007-74592021000200218&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2007-74592021000200218&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2007-74592021000200218&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Objetivo:  Construir un índice general de vulnerabilidad del sector salud y un índice específico de vulnerabilidad en enfermedades neumológicas, que identifiquen a los municipios con menor capacidad de respuesta a la pandemia provocada por el virus SARS-CoV-2.  Materiales y métodos:  Para generar los índices, nos basamos en tres componentes: la infraestructura y el personal disponible; la demanda sanitaria; el alcance del seguro social y de salud, todo ello mediante el método de descomposición de Shapley.  Resultados:  Los municipios que presentan una mayor capacidad de resiliencia ante la pandemia, en su mayoría son municipios capitales, dato que resalta la mala distribución espacial de los servicios sanitarios. Además, por las características socio económicas del país, los municipios de la región sur oeste (Oaxaca, Guerrero y Puebla); de la sierra Tarahumara (Chihuahua) y la Huasteca (San Luis de Potosí, Querétaro e Hidalgo) son los que presentan un alto índice de vulnerabilidad, al no contar con los recursos sanitarios suficientes y por tener una gran proporción de población sensible a la pandemia. Otro hallazgo importante es que, los municipios capitales, a pesar de contar con un número considerable de infraestructura hospitalaria y personal médico, poseen una alta densidad demográfica, lo que ocasiona que estén más expuestos al virus y por ende se encaminan a la saturación total de su sistema de salud; tal es el caso de municipios como Iztapalapa o Ecatepec que tras la segunda ola de pandemia rebasaron su capacidad hospitalaria.  Conclusión:  La vulnerabilidad del sector salud vista a través de los índices desarrollados, se agrava si se analiza la capacidad específica de atención a enfermedades respiratorias, en particular en los municipios de alta y media exposición a la pandemia por COVID-19, los hallazgos muestran la importancia de desarrollar políticas focalizadas de protección y mitigación de estos municipios.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Objective:  To build a general index of vulnerability of the health sector and a specific index of vulnerability in pneumological diseases that identify the municipalities with the least capacity to respond to the pandemic caused by the SARS-CoV-2 virus.  Materials and methods:  To generate the indices, we rely on three components: infrastructure and available personnel, health demand, and the scope of social and health insurance, all using the Shapley decomposition method.  Results:  The municipalities that present a greater resilience capacity in the face of the pandemic are mostly capital municipalities, a fact that highlights the poor spatial distribution of health services. Besides, due to the socio-economic characteristics of the country, the municipalities of the southwest region (Oaxaca, Guerrero, and Puebla); of the Sierra Tarahumara (Chihuahua) and the Huasteca (San Luis de Potosí, Querétaro, and Hidalgo) are those that present a high index of vulnerability due to not having sufficient health resources and having a large proportion of the population sensitive to the pandemic. Another critical finding is that the capital municipalities, despite having a considerable number of hospital infrastructure and medical personnel, have a high demographic density, which causes them to be more exposed to the virus. Therefore, they are heading towards the total saturation of their population. Healthcare system: such is the case of municipalities such as Iztapalapa or Ecatepec who exceeded their hospital capacity after the second wave of the pandemic.  Conclusion:  The vulnerability of the health sector seen through the developed indices is aggravated if the specific capacity to care for respiratory diseases is analyzed, particularly in municipalities with high and medium exposure to the COVID-19 pandemic; the findings show the importance of developing targeted protection and mitigation policies for these municipalities.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Pandemia COVID-19, desarrollo de capacidades, camas de hospital, poblaciones vulnerables]]></kwd>
<kwd lng="es"><![CDATA[México]]></kwd>
<kwd lng="en"><![CDATA[COVID-19 pandemic]]></kwd>
<kwd lng="en"><![CDATA[Capacity Building]]></kwd>
<kwd lng="en"><![CDATA[Hospital Bed]]></kwd>
<kwd lng="en"><![CDATA[Vulnerable Populations]]></kwd>
<kwd lng="en"><![CDATA[México]]></kwd>
</kwd-group>
</article-meta>
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