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Socioeconomic factors and inequality in the distribution of physicians and nurses in Mexico

OBJECTIVE: To describe the human resources for health and analyze the inequality in its distribution in Mexico. METHODS: Cross-sectional study based on the National Occupation and Employment Survey (ENOE in Spanish) for the fourth quarter of 2018 in Mexico. Graduated physicians and nurses, and auxil...

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Autores principales: Montañez-Hernández, Julio César, Alcalde-Rabanal, Jacqueline, Reyes-Morales, Hortensia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculdade de Saúde Pública da Universidade de São Paulo 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274212/
https://www.ncbi.nlm.nih.gov/pubmed/32555978
http://dx.doi.org/10.11606/s1518-8787.2020054002011
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author Montañez-Hernández, Julio César
Alcalde-Rabanal, Jacqueline
Reyes-Morales, Hortensia
author_facet Montañez-Hernández, Julio César
Alcalde-Rabanal, Jacqueline
Reyes-Morales, Hortensia
author_sort Montañez-Hernández, Julio César
collection PubMed
description OBJECTIVE: To describe the human resources for health and analyze the inequality in its distribution in Mexico. METHODS: Cross-sectional study based on the National Occupation and Employment Survey (ENOE in Spanish) for the fourth quarter of 2018 in Mexico. Graduated physicians and nurses, and auxiliary/technician nurses with completed studies were considered as human resources for health. States were grouped by degree of marginalization. Densities of human resources for health per 1,000 inhabitants, Index of Dissimilarity (DI) and Concentration Indices (CI) were estimated as measures of unequal distribution. RESULTS: The density of human resources for health was 4.6 per 1,000 inhabitants. We found heterogeneity among states with densities from 2.3 to 10.5 per 1,000 inhabitants. Inequality was higher in the states with a very low degree of marginalization (CI = 0.4) than those with high marginalization (CI = 0.1), and the inequality in the distribution of physicians (CI = 0.5) was greater than in graduated nurses (CI = 0.3) among states. In addition, 17 states showed a density above the threshold of 4.5 per 1,000 inhabitants proposed in the Global Strategy on Human Resources for Health. That implies a deficit of nearly 60,000 human resources for health among the 15 states below the threshold. For all states, to reach a density equal to the national density of 4.6, about 12.6% of human health resources would have to be distributed among states that were below national density. CONCLUSIONS: In Mexico, there is inequality in the distribution of human resources for health, with state differences. Government mechanisms could support the balance in the labor market of physicians and nurses through a human resources policy.
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spelling pubmed-72742122020-06-23 Socioeconomic factors and inequality in the distribution of physicians and nurses in Mexico Montañez-Hernández, Julio César Alcalde-Rabanal, Jacqueline Reyes-Morales, Hortensia Rev Saude Publica Original Article OBJECTIVE: To describe the human resources for health and analyze the inequality in its distribution in Mexico. METHODS: Cross-sectional study based on the National Occupation and Employment Survey (ENOE in Spanish) for the fourth quarter of 2018 in Mexico. Graduated physicians and nurses, and auxiliary/technician nurses with completed studies were considered as human resources for health. States were grouped by degree of marginalization. Densities of human resources for health per 1,000 inhabitants, Index of Dissimilarity (DI) and Concentration Indices (CI) were estimated as measures of unequal distribution. RESULTS: The density of human resources for health was 4.6 per 1,000 inhabitants. We found heterogeneity among states with densities from 2.3 to 10.5 per 1,000 inhabitants. Inequality was higher in the states with a very low degree of marginalization (CI = 0.4) than those with high marginalization (CI = 0.1), and the inequality in the distribution of physicians (CI = 0.5) was greater than in graduated nurses (CI = 0.3) among states. In addition, 17 states showed a density above the threshold of 4.5 per 1,000 inhabitants proposed in the Global Strategy on Human Resources for Health. That implies a deficit of nearly 60,000 human resources for health among the 15 states below the threshold. For all states, to reach a density equal to the national density of 4.6, about 12.6% of human health resources would have to be distributed among states that were below national density. CONCLUSIONS: In Mexico, there is inequality in the distribution of human resources for health, with state differences. Government mechanisms could support the balance in the labor market of physicians and nurses through a human resources policy. Faculdade de Saúde Pública da Universidade de São Paulo 2020-06-03 /pmc/articles/PMC7274212/ /pubmed/32555978 http://dx.doi.org/10.11606/s1518-8787.2020054002011 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Montañez-Hernández, Julio César
Alcalde-Rabanal, Jacqueline
Reyes-Morales, Hortensia
Socioeconomic factors and inequality in the distribution of physicians and nurses in Mexico
title Socioeconomic factors and inequality in the distribution of physicians and nurses in Mexico
title_full Socioeconomic factors and inequality in the distribution of physicians and nurses in Mexico
title_fullStr Socioeconomic factors and inequality in the distribution of physicians and nurses in Mexico
title_full_unstemmed Socioeconomic factors and inequality in the distribution of physicians and nurses in Mexico
title_short Socioeconomic factors and inequality in the distribution of physicians and nurses in Mexico
title_sort socioeconomic factors and inequality in the distribution of physicians and nurses in mexico
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274212/
https://www.ncbi.nlm.nih.gov/pubmed/32555978
http://dx.doi.org/10.11606/s1518-8787.2020054002011
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