[Priority setting for health interventions in Mexico's System of Social Protection in Health].
Explicit priority setting presents Mexico with the opportunity to match the pressure and complexity of an advancing epidemiological transition with evidence-based policies driven by a fundamental concern for how to make the best use of scarce resources to improve population health. The Mexican priority-setting experience describes how standardised analytical approaches to decision making, mainly burden of disease and cost-effectiveness analyses, combine with other criteria -eg, being responsive to the legitimate non-health expectations of patients and ensuring fair financing across households- to design and implement a set of three differentiated health intervention packages. This process is a key element of a wider set of reform components aimed at extending health insurance, especially to the poor. The most relevant policy implications include lessons on the use of available and proven analytical tools to set national health priorities, the usefulness of priority-setting results to guide long-term capacity development, the importance of favouring an institutionalised approach to cost-effectiveness analysis, and the need for local technical capacity strengthening as an essential step to balance health-maximising arguments and other non-health criteria in a transparent and systematic process.
González-Pier
Eduardo
E
Unidad de Análisis Económico, Secretaría de Salud, México, Paseo de la Reforma 450, PH, Col. Juárez, 06600 México, DF, México. egpier@salud.gob.mx
Gutiérrez-Delgado
Cristina
C
Stevens
Gretchen
G
Barraza-Lloréns
Mariana
M
Porras-Condey
Raúl
R
Carvalho
Natalie
N
Loncich
Kristen
K
Dias
Rodrigo H
RH
Kulkarni
Sandeep
S
Casey
Anna
A
Murakami
Yuki
Y
Ezzati
Majid
M
Salomon
Joshua A
JA
D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D005544:Forecasting; D018166:Health Care Reform / Q000191:economics; D006292:Health Priorities; D006801:Humans; D007223:Infant; D008297:Male; D008800:Mexico; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009026:Mortality / Q000639:trends; D011203:Poverty; D011634:Public Health; D012307:Risk Factors; D012737:Sex Factors