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Barriers and opportunities to improve the foundations for high-quality healthcare in the Mexican Health System

This study aimed to describe the foundations for quality of care (QoC) in the Mexican public health sector and identify barriers to quality evaluation and improvement from the perspective of the QoC leaders of the main public health sector institutions: Ministry of Health (MoH), the Mexican Institut...

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Autores principales: Doubova, Svetlana V, García-Saisó, Sebastián, Pérez-Cuevas, Ricardo, Sarabia-González, Odet, Pacheco-Estrello, Paulina, Leslie, Hannah H, Santamaría, Carmen, Torres-Arreola, Laura del Pilar, Infante-Castañeda, Claudia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415720/
https://www.ncbi.nlm.nih.gov/pubmed/30544258
http://dx.doi.org/10.1093/heapol/czy098
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author Doubova, Svetlana V
García-Saisó, Sebastián
Pérez-Cuevas, Ricardo
Sarabia-González, Odet
Pacheco-Estrello, Paulina
Leslie, Hannah H
Santamaría, Carmen
Torres-Arreola, Laura del Pilar
Infante-Castañeda, Claudia
author_facet Doubova, Svetlana V
García-Saisó, Sebastián
Pérez-Cuevas, Ricardo
Sarabia-González, Odet
Pacheco-Estrello, Paulina
Leslie, Hannah H
Santamaría, Carmen
Torres-Arreola, Laura del Pilar
Infante-Castañeda, Claudia
author_sort Doubova, Svetlana V
collection PubMed
description This study aimed to describe the foundations for quality of care (QoC) in the Mexican public health sector and identify barriers to quality evaluation and improvement from the perspective of the QoC leaders of the main public health sector institutions: Ministry of Health (MoH), the Mexican Institute of Social Security (IMSS) and the Institute of Social Security of State Workers (ISSSTE). We administered a semi-structured online questionnaire that gathered information on foundations (governance, health workforce, platforms, tools and population), evaluation and improvement activities for QoC; 320 leaders from MoH, IMSS and ISSSTE participated. We used thematic content and descriptive analyses to analyse the data. We found that QoC foundations, evaluation and improvement activities pose essential challenges for the Mexican health sector. Governance for QoC is weakly aligned across MoH, IMSS and ISSSTE. Each institution follows its own agenda of evaluation and improvement programmes and has distinct QoC indicators and information systems. The institutions share similar barriers to strengthening QoC: poor organizational structure at a facility level, scarcity of financial resources, lack of training in QoC for executive/managerial staff and health professionals and limited public participation. In conclusion, a stronger legal framework and policy dialogue is needed to foster governance by the MoH, to define and align health sector-wide QoC policies, and to set common goals and articulate QoC improvement actions among institutions. Robust QoC organizational structure with designated staff and clarity on their responsibilities should be established at all levels of healthcare. Investment is necessary to fund formal and in-service QoC training programmes for health professionals and to reinforce quality evaluation and improvement activities and quality information systems. QoC evaluation results should be available to healthcare providers and the population. Active public participation in the design and implementation of improvement initiatives should be strengthened.
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spelling pubmed-64157202019-03-19 Barriers and opportunities to improve the foundations for high-quality healthcare in the Mexican Health System Doubova, Svetlana V García-Saisó, Sebastián Pérez-Cuevas, Ricardo Sarabia-González, Odet Pacheco-Estrello, Paulina Leslie, Hannah H Santamaría, Carmen Torres-Arreola, Laura del Pilar Infante-Castañeda, Claudia Health Policy Plan Original Articles This study aimed to describe the foundations for quality of care (QoC) in the Mexican public health sector and identify barriers to quality evaluation and improvement from the perspective of the QoC leaders of the main public health sector institutions: Ministry of Health (MoH), the Mexican Institute of Social Security (IMSS) and the Institute of Social Security of State Workers (ISSSTE). We administered a semi-structured online questionnaire that gathered information on foundations (governance, health workforce, platforms, tools and population), evaluation and improvement activities for QoC; 320 leaders from MoH, IMSS and ISSSTE participated. We used thematic content and descriptive analyses to analyse the data. We found that QoC foundations, evaluation and improvement activities pose essential challenges for the Mexican health sector. Governance for QoC is weakly aligned across MoH, IMSS and ISSSTE. Each institution follows its own agenda of evaluation and improvement programmes and has distinct QoC indicators and information systems. The institutions share similar barriers to strengthening QoC: poor organizational structure at a facility level, scarcity of financial resources, lack of training in QoC for executive/managerial staff and health professionals and limited public participation. In conclusion, a stronger legal framework and policy dialogue is needed to foster governance by the MoH, to define and align health sector-wide QoC policies, and to set common goals and articulate QoC improvement actions among institutions. Robust QoC organizational structure with designated staff and clarity on their responsibilities should be established at all levels of healthcare. Investment is necessary to fund formal and in-service QoC training programmes for health professionals and to reinforce quality evaluation and improvement activities and quality information systems. QoC evaluation results should be available to healthcare providers and the population. Active public participation in the design and implementation of improvement initiatives should be strengthened. Oxford University Press 2018-12 2018-12-12 /pmc/articles/PMC6415720/ /pubmed/30544258 http://dx.doi.org/10.1093/heapol/czy098 Text en © The Author 2018. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Doubova, Svetlana V
García-Saisó, Sebastián
Pérez-Cuevas, Ricardo
Sarabia-González, Odet
Pacheco-Estrello, Paulina
Leslie, Hannah H
Santamaría, Carmen
Torres-Arreola, Laura del Pilar
Infante-Castañeda, Claudia
Barriers and opportunities to improve the foundations for high-quality healthcare in the Mexican Health System
title Barriers and opportunities to improve the foundations for high-quality healthcare in the Mexican Health System
title_full Barriers and opportunities to improve the foundations for high-quality healthcare in the Mexican Health System
title_fullStr Barriers and opportunities to improve the foundations for high-quality healthcare in the Mexican Health System
title_full_unstemmed Barriers and opportunities to improve the foundations for high-quality healthcare in the Mexican Health System
title_short Barriers and opportunities to improve the foundations for high-quality healthcare in the Mexican Health System
title_sort barriers and opportunities to improve the foundations for high-quality healthcare in the mexican health system
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415720/
https://www.ncbi.nlm.nih.gov/pubmed/30544258
http://dx.doi.org/10.1093/heapol/czy098
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