medigraphic.com
SPANISH

Salud Pública de México

Instituto Nacional de Salud Pública
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2015, Number S2

<< Back Next >>

salud publica mex 2015; 57 (S2)

The role of supply-side characteristics of services in AIDS mortality in Mexico

Bautista-Arredondo S, Serván-Mori E, Silverman-Retana O, Contreras-Loya D, Romero-Martínez M, Magis-Rodríguez C, Uribe-Zúñiga P, Lozano R
Full text How to cite this article

Language: Spanish
References: 13
Page: 153-162
PDF size: 244.25 Kb.


Key words:

mortality, HIV, continuity of patient care, health services, Mexico.

ABSTRACT

Objective. To document the association between supplyside determinants and AIDS mortality in Mexico between 2008 and 2013. Materials and methods. We analyzed the SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Results. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Conclusions. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.


REFERENCES

  1. Palella FJ, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med 1998;338(13):853-860.

  2. Cahuana-Hurtado L, Chilian-Herrera O, Bautista-Arredondo S, Contreras- Loya D, Franco-Marina F, González-Vilchis JJ, Lozano R. Corrección de la mala clasificación de las muertes por sida en México. Análisis retrospectivo de 1983 a 2012. Salud Publica Mex 2015;57 supl 2:S142-S152.

  3. Hernández-Ávila JE, Palacio-Mejía LS, Hernández-Romieu A, Bautista- Arredondo S, Sepúlveda Amor J, Hernández-Ávila M. Effect of universal access to antiretroviral therapy on HIV/AIDS mortality in Mexico 1990- 2011. JAIDS 2015 [consultado en diciembre de 2013]. Disponible en: http://www.ncbi.nlm.nih.gob/pubmed/25886921.

  4. Hernández-Ávila JE, Palacio-Mejía LS, Agudelo-Botero M, López-Gatell H, Bautista-Arredondo S, Alpuche-Aranda CM, et al. Evolución de la mortalidad por VIH/sida en México: 1988-2010. En: 15º Congreso de Investigación en Salud Pública; 08 de marzo de 2013; Cuernavaca, Morelos.

  5. Gardner EM, McLees MP, Steiner JF, Del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis 2011;52(6):793-800.

  6. Mugavero MJ, Amico KR, Horn T, Thompson MA. The state of engagement in HIV care in the United States: from cascade to continuum to control. Clin Infect Dis 2013;57(8):1164-1171.

  7. Mayer KH. Introduction: Linkage, engagement, and retention in HIV care: essential for optimal individual- and community-level outcomes in the era of highly active antiretroviral therapy. Clin Infect Dis 2011;52(Suppl 2):S205-S207.

  8. Bloom N, Sadun R, Van Reenen J. Does Management Matter in Healthcare? [monografía en internet]. 2014:1-30 [consultado en diciembre de 2013]. Disponible en: http://www.people.hbs.edu/rsadun/Management_ Healthcare_June2014.pdf

  9. Lega F, Prenestini A, Spurgeon P. Is management essential to improving the performance and sustainability of health care systems and organizations? A systematic review and a roadmap for future studies. Value Health 2013;16(1):S46-S51.

  10. Secretaría de Salud, Subsecretaría de Prevención y Promoción de la Salud, Centro Nacional para la Prevención y el Control del VIH y el Sida. Sistema de Administración y Logística de ARV (SALVAR) [base de datos en Internet]. México: Censida, 2006 [consultado en diciembre de 2013]. Disponible en: http://www.salvar.salud.gob.mx/.

  11. Silverman-Retana O, Bautista-Arredondo S, Serván-Mori E, Lozano R. Mortalidad temprana por sida en México durante el periodo 2008-2012. Salud Publica Mex 2015;57 supl 2:S119-S126.

  12. Censida. Guía de manejo antirretroviral de la personas con VIH. México 2014 [documento en internet]. México: Censida, 2014 [consultado en marzo de 2015]. Disponible en: http://www.censida.salud.gob.mx/interior/ inicio/guia_arv2014.html

  13. Censida. Boletín de Diagnóstico y Tratamiento Antirretroviral Censida Del 1° de julio al 30 de septiembre de 2014 [documento en internet]. México: Censida , 2014 [consultado en marzo de 2015]. Disponible en: http://www.censida.salud.gob.mx/descargas/atencion/boletin_ai/Boletin_ Diagnostico_Tratamiento_Censida_Num5b_3er_Trim_2014.pdf




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

salud publica mex. 2015;57