Departament of Epidemiology, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico.
Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
PLoS One. 2019 Mar 20;14(3):e0212841. doi: 10.1371/journal.pone.0212841. eCollection 2019.
To 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).
Based 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.
Adherence 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).
The FPGC strategy increased the adherence of physicians to the Medical-Care Guidelines for Malignant Breast Tumors in Mexico.
评估在向获得联邦灾难性健康支出基金（FPGC）补贴的认证医院分配资金之前和之后，墨西哥医师对恶性乳腺肿瘤医疗指南的遵守情况，这是为向乳腺癌（BC）妇女提供免费治疗而实施的一项策略。
基于横断面设计，我们收集了在四家 FPGC 认证医院就诊的 479 名 BC 患者的信息。分析集中在这些患者在其就诊医院获得认证的前三年或后三年内接受治疗的情况。分析的四家医院分别位于该国的北部、南部、西部和中心。从医院病历中提取了治疗过程中所有医疗程序的信息。通过对患者家庭进行面对面访谈，获取了患者社会人口特征的信息。
FPGC 认证后，医生对指南的遵守率提高了 12.8%（从 43.4%提高到 56.2%）（p<0.001），并且根据疾病的临床阶段而有所不同，在晚期阶段观察到的遵守率要低得多（p<0.05）。
FPGC 策略提高了墨西哥医师对恶性乳腺肿瘤医疗指南的遵守率。
