墨西哥的医疗保险覆盖:迈向UHC2030的进展,不平等和剩余的挑战
Edson Serván-Mori1, Diego Cerecero-García1,2, Sergio Meneses-Navarro1
1Center for Health Systems Research, The National Institute of Public Health, Avenida Universidad 655, Colonia Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
Health research policy and systems
|October 31, 2025
概括
墨西哥到2015年实现了显著的医疗保险收益,但拆除Seguro Popular和大流行导致到2023年无保险费率急剧上升. 重建全民健康覆盖 (UHC) 需要解决不平等问题并恢复公众的信任.
科学领域:
- 公共卫生 公共卫生
- 卫生政策 卫生政策
- 卫生经济学 卫生经济学
背景情况:
- 全民健康覆盖 (UHC) 取决于制度能力,公平,政治意愿和公众信任.
- 墨西哥的卫生系统面临着长期的公众信任问题,影响了UHC的进展.
- 该研究将墨西哥的健康覆盖轨迹与UHC2030目标联系起来.
研究的目的:
- 提供2000年至2023年墨西哥医疗保险覆盖范围的综合,分类和纵向评估.
- 确定墨西哥在实现全民健康覆盖的过程中取得的成就和挫折.
- 在重大政策改革和颠覆的背景下分析覆盖率趋势.
主要方法:
- 利用来自墨西哥国家家庭收入和支出调查 (ENIGH) (2000-2022,预计2023) 的全国代表性数据.
- 根据机构附属关系将家庭分为相互排斥的医疗保险类别.
- 分析了国家和地方覆盖率的趋势,并结合了距离到边境的指标来评估与历史最大值相比的进展.
主要成果:
- 墨西哥在2000年至2015年间将未保险的人口从55%降至6.2%,主要是通过Seguro Popular (SP) 的扩张.
- 在SP拆除和COVID-19大流行之后,到2023年,无保险率升至29.1%,不成比例地影响南方州和边缘化群体.
- 系统的分散和公众信任的下降是显而易见的,几个州需要超过两倍的覆盖率才能达到以前的水平.
结论:
- 如果没有强大的制度基础,政治共识和社会合法性,医疗覆盖的收益是可逆的.
- 维持UHC需要解决结构性不平等,加强机构和重建公众信任.
- 墨西哥的经验强调了在追求UHC的低收入和中等收入国家需要适应性,以公平为重点的机构重组的需要.
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