From Quantity to Quality: Assuring Access to ServicesThu, 09/07/2017 - 12:15
A high percentage of the population in Mexico has access to healthcare through public institutions such as IMSS and Seguro Popular but the system has yet to guarantee universal access to state-of-the-art care or to offer an integrated package of services, both preventive and curative, told Mexico Health Summit 2017 on Thursday. Germán Fajardo, Dean of the School of Medicine at UNAM, opened and moderated the panel, The Challenges in Accessing Healthcare, by emphasizing the need to eliminate the wide array of barriers between patients and doctors in Mexico.
During the discussion at Hotel Sheraton Maria Isabel in Mexico City, Paulino Decanini, Director General go SisNova, explained that access to modern healthcare continues to be a privileged service for the few. “The public healthcare system was created in 1943 when the main problems in Mexico were diarrhea and maternity-related issues, among others. We recently experienced an explosion of information that has widened our knowledge of the industry but the system has yet to adapt itself to this new context.” He urged the industry to focus on more than just quantitative data and to focus on quality to measure true access to healthcare. “We have one of the lowest rankings in terms of healthcare in the OECD as 50 percent of healthcare costs in the country comes out of pocket.”
Fajardo added that public healthcare suffers from fragmentation as access to services depends on employment status. “This can become a nightmare for a patient as every time they change institutions a new record needs to be created when transitioning throughout IMSS, Seguro Popular and private health insurance.”
Aside from the responsibility that governmental institutions encompass, Paul Doulton, Founder and Managing Partner of Oriundo, urged leaders of the industry to take into consideration the responsibility of the patient as well. “Universal healthcare can create a dependence on the system. A smoker can feel assured by the fact that someone else is going to pay for the consequences of their behavior. We need to think about creating more consciousness among patients and changing habits through incentives.”
Patient education is also of importance as a high percentage of the population is dying from preventable diseases and illnesses. “An estimated 70 percent of the causes of mortality among the lower socioeconomic branch of the Mexican population are preventable, such as diabetes,” said Decanini.
Bureaucratic filters in approval processes and certifications are additional obstacles between the health industry and patients. “New medical treatments have to go through several filters before entering the country and additional filters are required for them to enter each institution such as IMSS,” said Fajardo. “Sometimes thousands of days can pass between the time a medical treatment enters the country and the patient has access to the medicine. We need to create methods that can shorten the process.”
A new perspective was added to the conversation by Omar Viveros, Director of Health at Willis Towers Watson, who compared access to healthcare in urban and rural areas. “Bureaucratic filters are equally slowing down the construction of clinics and hospitals in the country. Smaller towns could have greater access to services if the approval process was simplified.”
Innovative solutions from the private sector are helping close gaps between patients and doctors such as the incorporation of medical consultations in pharmacies, with so-called Docs-in-a-Box, stated Doulton. “Pharmaceutical doctors were regarded with hesitation at first but it has had surprisingly great results. For many, medical consultations in pharmacies are their first contact with a trained practitioner and an estimated 20 percent of patients go directly to doctors in the pharmacy. It helps alleviate the oversaturated healthcare system and reduces costs for the public sector”
Pharmaceutical doctors are only a short-term solution, countered Fajardo, because the services do not contemplate a wide array of indicators such as blood pressure. “The industry needs to find ways of offering a more integrated healthcare service to patients through pharmacies. We need to take advantage of its accessibility to the public and connect it to long-term care providers.”