墨西哥卫生系统融资的碎片化和孕产妇死亡率的转变,2000-2022年
Edson Serván-Mori1, Carlos Pineda-Antúnez2, Diego Cerecero-García1,3
1Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
International journal for equity in health
|January 29, 2025
概括
自2019年以来,墨西哥的孕产妇死亡率急剧上升,特别是在没有社会保障的人群中,这凸显了持续的健康不平等. 社会保障不再是一个保护因素,这表明在获得孕产妇医疗保健方面存在系统性问题.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 社会学 社会学 社会学
背景情况:
- 全球范围内,医疗系统融资的分散性越来越令人担忧.
- 了解其对孕产妇健康结果的影响对于政策制定至关重要.
- 墨西哥人口和医疗保健系统的多样性是一个独特的案例研究.
研究的目的:
- 分析过去二十年来墨西哥卫生系统融资分散和产妇死亡率之间的时间和地区关系.
- 确定与孕产妇死亡相关的人口特征和地理差异.
- 评估社会保障在孕产妇死亡率趋势中的作用.
主要方法:
- 采用了生态纵向研究设计,分析了墨西哥所有32个州的2000-2022年的数据.
- 孕产妇死亡率 (MMR) 估计在全国和各州,根据医疗保险状况分层.
- 已故妇女的人口统计特征和居住数据与有和没有社会保障的妇女进行了比较.
主要成果:
- 墨西哥的MMR降低到2018年,但从2019年到2022年显著增加 (从48.7到72.4每10万活产).
- 虽然大多数死亡发生在没有保险的人群中 (2000年至2018年),但没有保险的人群比例在2019年后下降.
- 从2019年开始,MMR在社会保障人口中更高,无保险死亡集中在年轻,受教育程度较低,农村和边缘化的女性中.
结论:
- 孕产妇死亡率与墨西哥的社会不平等密切相关.
- 社会保障隶属不再是孕产妇死亡风险的重要差异化因素.
- 量化这些不平等对于设计有效的政策来改善孕产妇获得医疗保健和减少可预防的死亡是必不可少的.
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