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[Social security for health system transformation]
1Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, México, D.F. santiago.echevarria@imss.gob.mx
Abstract:
The aim of this article is to present the management and medical components within the public health institutions that can contribute to the transformation of the National Health System (NHS). It is expected that these will have an impact in the extent of the medical coverage and will improve the health care services delivered to the Mexican population. A diagnostic study revealed the existence of fragmentation in the NHS. The health institutions are vertically established and operate under isolated mechanisms of financing and administration. Additionally, it is pointed out the problematic derived from the multiplicity in the public insurance conditions among individuals and the lack of census of the insured population within the institutions. As part of the universalization of health services, it is necessary to integrate the health care system; accordingly, a variety of mechanisms for the partial and total integration are arise, such as the exchange of the health care services and the portability and convergence of the institutions. Particularly, we listed the actions carried out by the Mexican Institute of Social Security for the integration of the NHS such as, the independent management medical areas, diagnosis-related groups (DRG), the performing evaluation of the medical units, and the preventive and curative strategies in the implemented programs. Finally, is dealt some reflections in order to improve the public health care.
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