Bautista-Gonzalez Elysse, Quintero Leyra Andrés, Munoz Rocha Teresa Verenice, Reyes-García Heber Tomás, Soto-Perez-de-Celis Enrique, Palafox Parrilla Alejandra, Mohar Betancourt Alejandro, Sullivan Richard
Fundación Mexicana para la salud, Anillo Perif. 4809, Arenal Tepepan, Tlalpan, Ciudad de México, 14610, México.
Institute of Epidemiology and Health care, University College London, 1-19 Torrington Pl, London, WC1E 7HB, United Kingdom.
BMC Health Serv Res. 2025 Apr 17;25(1):564. doi: 10.1186/s12913-025-12497-z.
Given the rising cancer burden, the capacity of Mexico's healthcare system to effectively address cancer care through its current available infrastructure becomes increasingly critical. Limited availability of diagnostic and therapeutic infrastructure leads to delays in diagnosis and treatment. Countries like Mexico, should undertake comprehensive assessments of infrastructure and human resources available for cancer, including its quantification and geolocation, to understand the service gaps. This study seeks to map oncological infrastructure in Mexico in five types of cancer: breast, lung, prostate, colon, and cervix.
Through a realist evaluation of publicly available databases from the High Specialty Medical Equipment National Inventory and the General Direction of Health Information, a comprehensive identification and classification of cancer resources was conducted with the intended outcome to map cancer care infrastructure in Mexico. Guided by the literature, resources necessary for diagnosis and treatment were selected by an expert consensus. Thereafter, facilities were classified by service scope into either diagnostic or diagnostic and therapeutic, and by infrastructure level into core or enhanced and then mapped geographically.
From N = 14,133 unique healthcare facilities that deliver any type of healthcare, only 5% provided cancer care. Cancer-specific infrastructure that can provide diagnosis and treatment at the national level included N = 10 brachytherapy, N = 11 cobalt-60, N = 21 linear particle accelerators and N = 188 operating rooms. Five issues were found: (1) low availability of core therapeutic infrastructure across all cancer types; (2) regional and national centralization of available therapeutic infrastructure for all cancer types, whilst no centralization found in diagnostic resources; (3) inconsistent allocation of resources in densely populated areas; (4) infrastructure disparities per cancer type i.e., Lung, prostate, and breast cancer require significant investments in diagnostic infrastructure compared to cervical and colon cancer, and (5) lack of precise and updated infrastructure data from the public health system that requires either new codes or subcodes.
Addressing disparities in cancer resources distribution in Mexico is a dual imperative-ensuring equity while seizing an opportunity to fortify the overall health system for people without social security coverage.
鉴于癌症负担不断加重，墨西哥医疗保健系统通过现有基础设施有效应对癌症护理的能力变得愈发关键。诊断和治疗基础设施的可用性有限导致诊断和治疗延误。像墨西哥这样的国家，应该对可用于癌症治疗的基础设施和人力资源进行全面评估，包括其数量和地理位置，以了解服务差距。本研究旨在绘制墨西哥乳腺癌、肺癌、前列腺癌、结肠癌和宫颈癌这五种癌症的肿瘤学基础设施地图。
通过对来自国家高专业医疗设备清单和卫生信息总司的公开可用数据库进行现实主义评估，对癌症资源进行了全面识别和分类，目的是绘制墨西哥癌症护理基础设施地图。在文献指导下，通过专家共识选择了诊断和治疗所需的资源。此后，设施按服务范围分为诊断型或诊断兼治疗型，按基础设施水平分为核心型或增强型，然后进行地理定位绘制。
在提供任何类型医疗保健的14,133家独特的医疗设施中，只有5%提供癌症护理。在国家层面能够提供诊断和治疗的癌症特定基础设施包括10台近距离放射治疗仪、11台钴 - 60治疗仪、21台直线粒子加速器和188间手术室。发现了五个问题：（1）所有癌症类型的核心治疗基础设施可用性低；（2）所有癌症类型的可用治疗基础设施在区域和国家层面集中，而诊断资源未发现集中情况；（3）人口密集地区资源分配不一致；（4）各癌症类型的基础设施存在差异，即与宫颈癌和结肠癌相比，肺癌、前列腺癌和乳腺癌需要在诊断基础设施方面进行大量投资；（5）公共卫生系统缺乏精确和最新的基础设施数据，需要新的代码或子代码。
解决墨西哥癌症资源分配不均问题有双重紧迫性——既要确保公平，又要抓住机会加强为无社会保障覆盖人群服务的整体卫生系统。
