Effective access to health care in Mexico.
BACKGROUND
Effective access measures are intended to reflect progress toward universal health coverage. This study proposes an operative approach to measuring effective access: in addition to the lack of financial protection, the willingness to make out-of-pocket payments for health care signifies a lack of effective access to pre-paid services.


METHODS
Using data from a nationally representative health survey in Mexico, effective access at the individual level was determined by combining financial protection and effective utilization of pre-paid health services as required. The measure of effective access was estimated overall, by sex, by socioeconomic level, and by federal state for 2006 and 2012.


RESULTS
In 2012, 48.49% of the Mexican population had no effective access to health services. Though this represents an improvement since 2006, when 65.9% lacked effective access, it still constitutes a major challenge for the health system. Effective access in Mexico presents significant heterogeneity in terms of federal state and socioeconomic level.


CONCLUSIONS
Measuring effective access will contribute to better target strategies toward universal health coverage. The analysis presented here highlights a need to improve quality, availability, and opportuneness (location and time) of health services provision in Mexico.
Center for Evaluation Research & Surveys, National Institute of Public Health (INSP), Cuernavaca, Mexico. jpgutier@correo.insp.mx.
Juan Pablo
JP
Gutiérrez
Sebastián
S
García-Saisó
Germán Fajardo
GF
Dolci
Mauricio
M
Hernández Ávila
D016001:Confidence Intervals; D005260:Female; D005382:Financing, Personal; D006297:Health Services Accessibility / Q000191:economics* / Q000639:trends*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008800:Mexico; D019472:Universal Health Insurance