Impact of decentralization on health financing in Mexico

Abstract

OBJECTIVE: To identify trends and to describe the impact of health care decentralization on health financing policies in Mexico. METHODS: The study population comprised four states selected according with six technical criteria: socioeconomic development, implementation of decentralization process, database on economical features, data consistency and reliability, and technical support from a multidisciplinary team. In-depth interviews with key personnel as well as analysis of technical reports of state budgets for health in the period 1990-2000 were conducted. RESULTS: The analysis model applied allowed to determine the trends and the impact of health care decentralization on main financing sources: householders, and federal, state and municipal governments. There was evidence of different change effectiveness, especially regarding trends of financing per source. CONCLUSIONS: There are states where householders and state and municipal governments effectively increased financing support for health care system. But there are also states where householders and state and municipal governments do not agree on the increase of financing support for health care system.