[Performance of the Mexican Health System: analysis of reforms between 1980 and 2024]

To analyze variations in the performance of the Mexican health system (measured through life expectancy and premature mortality, as well as geographical inequality in these indicators) based on reforms to the General Health Law (LGS) carried out between 1984 and 2023..

A retrospective longitudinal study using health outcome indicators (standardized rate of potentially avoidable premature mortality [PAPM] and life expectancy at birth [LE]) as performance measures and establishing their association with reforms to the LGS through interrupted time series analysis.

LE increased by 14% in the period analyzed, but this was unrelated to the reforms to the LGS in 1984, 2003, and 2019, which are more closely associated with a reduction in LE. With regard to geographical inequality in EV, after an initial downward trend, a shift toward greater inequality was identified from 2003 and 2019 onwards, with greater inequality among men. In terms of the PAPM, the 2003 reform was associated with a significant decrease in the rate for the total population and by sex, while the 2019 reform did not show an immediate effect. Geographic inequality in the PAPM remained stable after the 2003 reform, but increased from 2019 onwards for the total population and among women.

The various reforms implemented in the Mexican health system have been insufficient to generate substantive improvements in the health status of the population and, on the contrary, are associated with an increase in inequalities. It is necessary to move toward a comprehensive reform that structurally addresses the challenges of the system and allows progress toward universal health with equity.