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从新一代医疗保险的首次评估中吸取的经验教训:弥合研究与政策之间的差距。

Lessons learned from the first evaluation of the Medical Insurance for a New Generation: bridging research and policy.

机构信息

Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de México Federico Gómez, México.

出版信息

Salud Publica Mex. 2012;54 Suppl 1:S90-7. doi: 10.1590/s0036-36342012000700012.

Abstract

The first evaluation of the Medical Insurance for a New Generation program (SMNG) was conducted in 2009. A mixed-method approach was used to obtain a comprehensive picture of SMNG members and the program itself. The evaluation comprised: 1) Program design; 2) Social and health conditions of its members; 3); Evaluation of SMNG's performance by measuring coverage, productivity and efficiency; 4) Families health expenditures. The lessons learned for the program are that SMNG is focused on a vulnerable segment of the population with pervasive unmet health needs; prevalence of malnutrition, anemia and other conditions remains high. Further efforts are necessary to deploy the program where it is most needed, particularly in rural areas; most of its members are urban dwellers. However, more needs to be done to educate members about the importance of preventive care and to build the capability of health providers to provide high quality care. Families are still experiencing hardship to provide medical care to their children, so additional efforts are needed to decrease out-of-pocket and catastrophic expenditures. The lessons learned for the evaluation allow concluding that this first evaluation set the groundwork for better-targeted subsequent interventions and evaluations aimed at showing the impact of SMNG to bridge existing gaps in equity, access, coverage, and health status of Mexican children.

摘要

新一代医疗保险(SMNG)计划于 2009 年进行了首次评估。采用混合方法来全面了解 SMNG 成员和该计划本身。评估包括:1)计划设计;2)其成员的社会和健康状况;3)通过衡量覆盖范围、生产力和效率来评估 SMNG 的绩效;4)家庭医疗支出。该计划吸取的经验教训是,SMNG 专注于人口中一个脆弱的群体,他们普遍存在未满足的健康需求;营养不良、贫血和其他状况的患病率仍然很高。需要进一步努力将该计划部署到最需要的地方,特别是在农村地区;其大多数成员是城市居民。然而,需要做更多的工作来教育成员预防保健的重要性,并提高卫生提供者提供高质量护理的能力。家庭在为孩子提供医疗护理方面仍然困难重重,因此需要进一步努力减少自费和灾难性支出。评估中吸取的经验教训表明,首次评估为后续更有针对性的干预和评估奠定了基础,旨在展示 SMNG 的影响,以弥合墨西哥儿童在公平、获得、覆盖和健康状况方面的现有差距。

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