Loss of job-related right to healthcare is associated with reduced quality and clinical outcomes of diabetic patients in Mexico
| Autor: | Miguel Ángel González-Block, Germán Guerra-y-Guerra, Svetlana V. Doubova, Víctor Hugo Borja-Aburto, V Nelly Salgado-de-Snyder |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty media_common.quotation_subject Cohort Studies 03 medical and health sciences 0302 clinical medicine Health care medicine Health insurance Humans Quality (business) 030212 general & internal medicine Quality of care Mexico media_common Quality of Health Care Retrospective Studies 030505 public health Insurance Health Primary Health Care business.industry Health Policy Public Health Environmental and Occupational Health Social benefits Retrospective cohort study General Medicine Continuity of Patient Care Middle Aged Social security Treatment Outcome Diabetes Mellitus Type 2 Unemployment Family medicine Female 0305 other medical science business Job loss |
| Zdroj: | International journal for quality in health care : journal of the International Society for Quality in Health Care. 30(4) |
| ISSN: | 1464-3677 |
| Popis: | Objectives The Mexican Institute of Social Security (IMSS) provides a package of health, economic and social benefits to workers employed in private firms within the formal labour market and to their economic dependants. Affiliates have a right to these benefits only while they remain contracted, thus posing a risk for the continuity of healthcare. This study evaluates the association between the time (in days) without the right to healthcare due to job loss in the formal labour market and the quality of healthcare and clinical outcomes among IMSS affiliates with Type 2 diabetes mellitus (T2DM). Design Retrospective cohort study 2013-2015. Setting Six IMSS family medicine clinics (FMC) in Mexico City. Participants T2DM patients (n = 27 217) affiliated with job-related health insurance and at least one consultation with a family doctor during 2013. Source of Information IMSS affiliation department database and electronic health records and clinical laboratory databases. Main Outcome Measure(s) Quality of the processes (eight indicators) and outcomes (three indicators) of healthcare. Results The results indicated that losing IMSS right to healthcare is frequent, occurring to one-third of T2DM patients during the follow-up period. The time without the right to healthcare in the observed period was of 120 days on average and was associated with a 43.2% loss of quality of care and a 19.2% reduction in clinical outcomes of T2DM. Conclusion Policies aimed at ensuring access and continuity of care, regardless of job status, are critical for improving the quality of processes and outcomes of healthcare for diabetic patients. |
| Databáze: | OpenAIRE |
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