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APHA Scientific Session and Event Listing

Christopher Murray, MD, PhD¹, Chunling Lu, PhD², Rafael Lozano³, and cecilia Vidal². (1) Harvard Initiative for Global Health, 104 Mount Auburn Street, 3rd Floor, Cambridge, MA 02139, 617.495.8300, christopher_murray@harvard.edu, (2) Global Health Initiative, Harvard University, 104 Mt. Auburn Street, Cambridge, MA, MA 02138, (3) Ministry of Health, Ministry of Health, 104 Global Health Initiative street, Mexico city, Mexico

Measuring health system performance over time is critical to Mexico which is currently undergoing health system reform aimed at improving its performance. Based on the evidence, policy makers are able to monitor the reform and adjust policy accordingly to ensure that the goal of the reform has been achieved. This study examines the efficiency of the Mexican health system across states. The World Health Organization has presented a framework for assessing the performance of health systems over time and across countries. The method used in this study is a modified version of the WHO method, with the major differences being that the output variable of the health system is taken to be effective coverage, and a sub-national analysis is conducted which allows controlling for confounding factors resulting from the heterogeneity of health system, as well as societal and cultural differences across countries. The major data sources include the National Health Survey 2000, the National Performance Evaluation Survey 2003, hospital discharge data from the Ministry of Health, and indicators on socio-economic development across states from the National Institute of Statistics, Geography and Informatics. We investigate the performance of the health system across states using a two-stage stochastic production frontier method. The results of this analysis suggest that health expenditure of each state has significant positive effects on the level of efficiency. Among exogenous factors, the percentage of population living in remote areas imposes a negative effect on efficiency estimates. This indicates an important role of the socio-economic environment within which health system functions.

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