Cobertura Universal Efectiva en México: El acceso al control del dolor y los Cuidados Paliativos

7/22/2019 Cobertura Universal Efectiva en Mxico: El acceso al control del dolor y los Cuidados Paliativos

1/40

Pgtis lgc sghtir sfcul ergotg f

cf uomvgrsfcmzfhmo lg cis smstgdfs lg sfculDfrzi 68, 0:6


2/40

Bumo

6. Hi`grturf Womvgrsfc Geghtmvfy gc

lgsfem lg cf hriomhmlfl

0. Hi`grturf WomvgrsfcGeghtmvfgo Dxmhi8. Humlflis pfcmftmvis, dfogki lg emo lg vmlf y

hiotric lgc licir f omvgc duolmfc


3/40

Eugotg; Hgpfc, 0:60. Gc pgremc gpmlgdmicbmhi lg Fdrmhf Cftmof y gc Hfrm`g; lgsfeis, cdmtgs y fhhmiogs.

6=>: 0:6:

55%

07%

=%

2:%

6>%

60%

\rfosdmsm`cgs

Oi trfosdmsm`cgs

Cgsmiogs

Go pihi ds lg


4/40

]cfs lmhitidfs ergofo cis

smstgdfs lg sfcul

\rfosdmsm`cgs i

fsihmflfs hio moeghhmiogs

Oi \rfosdmsm`cgs

Hromhfs

UMN/XMLF (XA) Hohgr lg dfdf

Fbulfs Goegrdglflgs

lmfrrgmhfs Moeghhmiogs rgspmrftirmfs

Moefrti fbuli lg dmihfrlmi

Cguhgdmf C Fbulf moefotmc

Gtmqugtfr cf goegrdglfl pir hriomhmlfl g moeghhmo

Hohgr hrvmx-u (UZN)

Xghugcfs hromhfs x moeghhmo fbulf;

lmshfpfhmlfl emsmhf (picmi)

Hromhfs h/ gpmsilmisfbulis; Fsdf,

\rfstirois sfcul dgotfc


5/40

Gc duoli vmvg uof icf lg

rgeirdfs pfrf fchfozfr HWX

Gc i`kgtmvi lg cf hi`grturf sfomtfrmf uomvgrsfc

gs cibrfr qug tilis i`tgobfo cis sgrvmhmis lg

sfcul qug oghgsmtfoprgvgohmo,pridihmo,trftfdmgoti, rgnf`mcmtfhmo y humlflis

pfcmftmvissmo hirrgr gc rmgsbi lg rumof

ghiodmhf i gdpi`rghmdmgoti, fnirf y go gceuturi (IDX, Moeirdg lg cf Xfcul go gc

Duoli, 0:68).


6/40

Womvgrsfcmlfl lg cf hi`grturf y gc pfqugtg;

pi`cfhmo, goegrdglflgs g motgrvgohmiogs

Zi`cfhmiofc

(Nirmziotfc)

Zfqugtg-

Goegrdglflgs

(Ugrtmhfc)

Cf y Xhnrgyibb, gt fc., 0::7.


7/40

Hi`grturf uomvgrsfc geghtmvf (HWGX)

@gogemhmfrmis;

brupis vucogrf`cgs y pi`cfhmo go su hiokuoti

@gogemhmis gxpchmtis- gc pfqugtg;

Motgbrfc; Xfcul lg cf hiduomlfl, cf pgrsiof y hftfstremhi

Gxpcmhmtfr; motgrvgohmiogs, goegrdglflgs y hiolmhmiogs

Histi-geghtmvi; Hrghmgotg pgri oi gxnfustmvi

Zrifhtmvi pfrf hid`ftmr mogqumlfl y pridivgr lgrghnis Lg hfcmlfl

Hio pritghhmo emofohmgrf

M otgbrfli pir hmhci lg vmlf y hriomhmlfl


8/40

Pgspiolgr f cf hriomhmlfl rgqumgrg uo

goeiqug qug motgbrf gc hiotmouud lg cfs

motgrvgohmiogs y gc hmhci lg vmlf

6. Zrgvgohmo prmdfrmf

0. Zrgvgohmo sghuolfrmf (lgtghhmo tgdprfof)

8. Lmfbostmhi


9/40

Cf HWGX rgqumgrg uof rgspugstf smstdmhf y

pir gc hiotmouud lg cf ftgohmo y cfs

motgrvgohmiogs

Eugotg; Flfptgl erid Aofuc, E. D., Brfciw, K. P., Ftuo, P., & @nflgcmf, F. (Gls.). Hcismob tng Hfohgr Lmvmlg. Nfrvfrl

Womvgrsmty Zrgss, 0:60.

Euohmiogslgc smstgdf

lg sfcul

Hidpiogotgs lgc hiotmouud lg cf ftgohmo go sfcul

ZrgvgohmoZrmdfrmf

Zrgvgohmosghuolfrmf

LMfbostmhi \rftfdmgotiXi`rgvmlf/

Pgnf`mcmtfhmo

Humlflispfcmftmvis y

Ftgohmo lg emo lgvmlf

Gol-ie-cmeg hfrg

Pghtirmf

Emofohmfdmgoti

Zrgstfhmo

Bgogrfhmo lgrghursis g

movgstmbfhmo


10/40

Gc Goeiqug Lmfbiofceirtfcghg cis smstgdfs lg sfcul

Go cubfr lg goeihfrsg gxhcusmvfdgotg gopribrfdfs vgrtmhfcgs lglmhflis fgoegrdglflgs gspghemhfs i go cfs momhmtmvfs

nirmziotfcgssmstdmhfs, fprivghnfr smogrbmfs

Iptmdmzfr gc usi lg cis rghursis lmspiom`cgslg dili qug gc hiokuoti gs ds qug cf sudflg cfs pfrtgs.

Goergotfr cis lgsfemis lg cf hriomhmlfl y gc

hmhci lg vmlf.


11/40

Lurfotg lhflfs, ois lgsbfstfdis go hioecmhtis qug

hiotrfpiofo cis dilgcis lg prgstfhmo lg sgrvmhmis

vgrtmhfcgsgspghemhis pfrf uof goegrdglfl f cis dilgcis

nirmziotfcgsmotgbrflis. Cf hmgohmf lg cf prgstfhmo

hiosicmlf cf gvmlgohmf si`rg cfs gxpgrmgohmfs lg cis pfsgs go

rgsicvgr gstg lmcgdf dglmfotg cf mdpcgdgotfhmo lg uo

goeiqug lmfbiofc; hrgfoli, lgcm`grflfdgotg, pribrfdfsprmirmtfrmis lg cuhnf hiotrf goegrdglflgs gspghemhfs f emo lg

mdpucsfr dgkirfs fdpcmfs go gc smstgdf lg sfcul. Eumdis

tgstmbis lgc xmti qug tuvmgrio cis dilgcis lmfbiofcgs go

pfsgs tfo lmegrgotgs gotrg s hidi sio Dxmhi y Pwfolf

Lmshursi lg Kmd ]iob Amd, Zrgsmlgotg lgc Brupi lgc @fohi Duolmfc,

fotg cf Fsfd`cgf Duolmfc lg cf Xfcul

Bgogvf, Xumzf, Dfyi 06, 0:68


12/40

Bumo

6. Hi`grturf WomvgrsfcGeghtmvfy gc lgsfem lg

cf hriomhmlfl

0. Hi`grturf Womvgrsfc GeghtmvfgoDxmhi

8. Humlflis pfcmftmvis, dfogki lg emo lg vmlf y



13/40

Hi`grturf Womvgrsfc go Xfcul go

Dxmhi uo gkgdpci f omvgc duolmfc

\ng Cfohgt

Dgxmhi; hgcg`rftmob uomvgrsfc ngfctn hivgrfbg.

\ng Cfohgt, Uicudg 8>:, Mssug => Fubust 0:60.

Dxmhi fchfoz uo vgrlflgrfdgotg modgosi nmti go su

pmiogri vmfkg lg cf rgeirdf sfomtfrmf

"Dxmhi nf distrfli hdi HWX, flgds lg sgr

tmhfdgotg ci qug nfy qug nfhgr, gs cf hisf ds motgcmbgotg

qug nfhgr. Cf rgeirdf lg sfcul, ccgvfli f hf`i

hirrghtfdgotg, mdpucsf gc lgsfrricci ghiodmhi

Ufdis f hgcg`rfr gc xmti, y gspgrfdis uof icf dgxmhfof

sistgomlf lg WNH go tili gc duoli


14/40

Gc hfdmoi lg Dxmhi

nfhmf cf HWGX

6=00. Bgogrfhmo. Go cf Hiostmtuhmo sg gstf`cghg gc

lgrghni f cf pritghhmo lg cf sfcul y sg priducbf cf Cgy

Bgogrfc lg Xfcul (CBX)

6==:s8. Bgogrfhmo. Xg hiohcuyg cf lgshgotrfcmzfhmo

lg cis sgrvmhmis y sg lf cf rgeirdf emofohmgrf lgc MDXX

0::8


15/40

ZPIZIXM\I LG CF PGEIPDF LG 0::8;WO XMX\GDF LG ZPI\GHHMO XIHMFC

GO XFCWL

Z`cmhi y Zrmvfli, Xghtireirdfc, trf`fkflirgs y sus

efdmcmfs;

~7:% lg cf pi`cfhmo

Xghrgtfrf lg Xfcul

hio emofohmfdmgoti

rgsmlufc

Zi`rgs, sghtir moeirdfc,oi-fsfcfrmflis, rgfs

rurfcgs;

~7:% lg cf pi`cfhmo

6=


16/40

Lmdgosmiogs lg cf pritghhmo

sihmfc go sfcul

Zritghhmolg cispfhmgotgs

Zritghhmoemofohmgrf

Zritghhmosihmfc go

sfcul

Zritghhmohiotrf rmgsbisf cf sfcul

Gk. HIEGZPMX

Gk.HIOFDGL

Gk. Xgburi Zipucfrgo gc Xmstgdf lgZritghhmo Xihmfc

go Xfcul

Z c c Z


17/40

Hi`grturf nirmziotfc;

@gogemhmfrmisH

i`grturfuomvgrsfcHi`grturfvgrtmhfc

Goegrdglflgsgmotgrvgohmiogs;

Zfqugtg

lg

`gogemh

mis

Femcmfhmo;0::


18/40

Gvicuhmo lg cf hi`grturf lgc pfqugtg;

# fhuducfli lg motgrvgohmiogs hu`mgrtfs,

0:: 5 60 60 60 60 68 6800

>8

625 6>= 6>= 6=> 6=>

0:5 0:7

5

5

620:

686 686

:

7:

6::

67:

0::

07:

8::

87:


19/40

GOEGPDGLFL HF\FX\PEMHF, HI@GP\WPF UGP\MHFCFHGCGPFLF; hohgr, UMN/XMLF

Xgrvmhmis lg sfcul f cf hiduomlfl y sfcul p`cmhf

Zi`rgs Pmhis

Zfqugtg lg sgrvmhmis

gsgohmfcgs

@gogemhmfrmis

Xgburi Zipucfr

Hi`grturf emofohmgrf

@gogemhmis;

Motgrv

gohmiogshu`

mgrtfs

C e l 0::8


20/40

Cf rgeirdf lg 0::8 hrgf uof ougvf

frqumtghturf emofohmgrf;Eiolis lgc Xmstgdf lg Zritghhmo Xihmfc go Xfcul

* F pfrtmr lg lmhmgd`rg 0::5.

** F pfrtmr lg 0:68

Eugotg; Flfptfli lg; Ergoa K, Biozcgz-Zmgr G, Bdgz-Lfots I, Cgzfof DF, Aofuc ED. Hidprgngosmvg rgeird ti mdprivg ngfctn systgdpgreirdfohg mo Dgxmhi. Cfohgt 0::51 85>; 670


21/40

HWGX lg uof goegrdglfl hromhf;

Hohgr lg dfdf

Dxmhi; Gkgdpcfr movgrsmo go pritghhmo emofohmgrf go

cf prgvgohmo y trftfdmgoti lgc hohgr lg dfdf, pgrisgbumdis hio lgtghhmo tfrlmf y si`rgvmlf fkf.

] cf oghgsmlfl lg eirtfcghgr cf lgtghhmo tgdprfof, cf

si`rgvmlf y cis humlflis pfcmftmvis hio uo goeiqug

lmfbiofcfo go cf prgstfhmo go 6 y 0 omvgc

Hiotmouud lg cf ftgohmo f cf sfcul

Zrgvgohmoprmdfrmf

Lgtghhmotgdprfof Lmfbostmhi \rftfdmgoti Xi`rgvmlf Humlflis

pfcmftmvis

H l


22/40

Hohgr lg dfdf;

Zrieuolmlfl y Gemhfhmf lgc pfqugtg go su hiokuoti

Zrgvgohmo

prmdfrmf

Zridihmo lg gstmcis lg vmlfsfculf`cg; Pgluhhmo lgc

tf`fqumsdis, cfhtfohmf dftgrof,

Zrgvgohmo

sghuolfrmf

Gluhfhmo si`rg cf sfcul

dfdfrmf, gxfdgo hcomhi,

dfdibrfef

Lmfbostmhi Cf`irftirmi lg pfticibfs

\rftfdmgotiHmrubf, rflmi tgrfpmf,

qumdmitgrfpmf (mohc. tfdixgemo,

tfxitgrg, ngrhgptmo)1 rghiostruhtmio

Humlflis lg cf

si`rgvmlfDfogki lgc cmoeglgdf,

rgmohirpirfhmo f cf vmlf

Humlflis

pfcmftmvis

Hcomhf lgc licir, psmhicibf,

tfofticibf

Zfqugtg;sfcul f cf

hiduomlfl

HFWXGX

EZBH

HFWXGX

Hiotmouud; hiotric y humlfli Motgrvgohmiogs Eioli

Oihu`mgrti99

Oi

hu`mgrti99

Omvgc

6i

6 y 0i

8.

0 y 8i

6-8

6-8


23/40

Bumo


cf hriomhmlfl

0. Hi`grturf WomvgrsfcGeghtmvfgo Dxmhi

8. Humlflis pfcmftmvis, dfogki lg emo

lg vmlf y hiotric lgc licir f omvgc

duolmfc


24/40

Gc pirqug nfo smli uo tgdf

icvmlfli gc hiotric lgc licir y

cis humlflis pfcmftmvis

Oi sg fsihmf f omobuof goegrdglfl go

gspghemhi Cf dfyirf sg dugrgo fs qug oi tmgogo

viz y cf flvihfhy quglf hirtf

Cis vmvis prgemgrgo oi pgosfr go cf

dugrtg - dmgli


25/40

Cf ftgohmo lg

humlflis pfcmftmvis

Dgkirfr cf hfcmlfl lg vmlf lg cis pfhmgotgs y

sus efdmcmfs qug goergotfo uof goegrdglfl

qug fdgofzf cf vmlf i gc `mgogstfr, f trfvslg cfprgvgohmo y gc fcmvmi lgc suermdmgoti

pir dglmi lg cf mlgotmemhfhmo tgdprfof y

trftfdmgoti lgc liciryitris pri`cgdfsesmhis, psmhisihmfc y gspmrmtufc


26/40

Cis humlflis pfcmftmvis go gc duoli

Hflf fi, ds lg 6:: dmcciogs lg pgrsiofs rgqumgrgo humlflis

pfcmftmvis, smo gd`frbi, dgois lgc > pir hmgoti hio oghgsmlfl

tmgogo fhhgsi f gstis.

Xci 0: pfsgs go gc duoli nfo motgbrfli cis humlflis

pfcmftmvis geghtmvfdgotg go su smstgdf lg sfcul pfrf pgrdmtmr uo

dfyir fhhgsi f tilis cis hmulflfois.

> lg 6: prmohmpfcgs hfusfs lg dugrtg sg fsihmfo hio cf

oghgsmlfl lgc trftfdmgoti lgc licir fbuli y humlflis pfcmftmvis

=: pir hmgoti lg cf diremof go gc duoli gs utmcmzfli pir gc 65

pir hmgoti lg cf pi`cfhmo


27/40

Licir; uof mokustmhmf bci`fc

Hflf fi, lghgofs lg dmcciogs lg pgrsiofs suergo

mooghgsfrmfdgotg go licir dilgrfli y sgvgri, mohcuygoli 7.7

dmcciogs hio hohgr

>8% lg cis nf`mtfotgs lgc duolmfc vmvgo go pfsgs hio pihi iomobo fhhgsi f dglmhfdgotis pfrf hiotricfr gc licir

Cis pfsgs lg fctis mobrgsis rgprgsgotfo dgois lgc 67% lg cf

pi`cfhmo duolmfc pgri ds lgc =: f $7.:.

C m k tm m m mlm


28/40

Cf mokustmhmf ds mosmlmisf;Cf efctf lg fhhgsi fc hiotric lgc licir

Hiosudi lg ipmimlgs gqumvfcgotg f diremof smodgtfliof, pir dugrtg hio licir pir UMN i hohgr;

6:% ds pi`rgs ; 7< db pir dugrtg

6:% ds rmhis; =2,


29/40

\golgohmfs go gc hiosudi lg ipmimlgs

go cfs Fdrmhfs 6=57 f 0:6:

GXHFCF CIBFPM\DMHF

Dirpn

mogGqumvfcgohg

(db/hfpmtfc)

6:::

: 6=2: 6=>: 6==: 0::: 0:6:Eugotg; Zfmo & Zicmhy Xtulmgs Briup. Ipmiml Hiosudptmio Ditmio Hnfrt. Womvgrsmty ie Rmshiosmo. (nttp;//ppsb-priluhtmio.ngriau.hid/hnfrt )eir 0::2 (fhhgssgl Fprmc 00 0:66).

HfoflfWomtgl Xtftgsie Fdgrmhf

Frbgotmof@rfzmc

HnmcgHistf PmhfDgxmhiHicid`mf


30/40

Omvgc lg lgsfrricci lg cis humlflis pfcmftmvis

pir pfs f omvgc duolmfc

Eugotg; @fsfli go RZHF-IDX, 0:6


31/40

Fvfohg rghmgotg f omvgc

bci`fc 0:6


32/40

Bumo


cf hriomhmlfl

0. Hi`grturf WomvgrsfcGeghtmvfgo Dxmhi

8. Humlflis pfcmftmvis, dfogki lg emo lg vmlf y



33/40

Go Dxmhi.

Dfrhi cgbmscftmvi mooivflir f omvgc duolmfc;0::=; dilme mhfhmo CBX y Cgy go dftgr mf lg

humlflis pfcmftmvis

0:68; Xg fdpcmf cf CBX go dftgr mf lg humlflis

pfcmftmvis

Zgri..

lg cfs >8,226 dugrtgs pir hohgr i UMN/XMLF

go 0:6:, 57,


34/40

@frrgrfs fc fhhgsi humlflis pfcmftmvis

pir Euohmo lgc smstgdf lg sfcul

Eugotg; Flfptgl erid Aofuc, E. D., Brfciw, K. P., Ftuo, P., & @nflgcmf, F. (Gls.). Hcismob tng Hfohgr Lmvmlg. Nfrvfrl Womvgrsmty Zrgss, 0:60.

Euohmiogs lgcsmstgdf lgsfcul

Hidpiogotgs lgc Hiotmouud lg cf ftgohmo go sfcul

ZrgvgohmioXi`rgvmlf

Humlflis pfcmftmvis, hiotric lgc licir yFtgohmo lg emo lg vmlf

Pghtirmf

Efctf uo Zcfo/Zribrfdf Ofhmiofc uomemhflir

Dfrhis rgbucftirmis l`mcgs, rgstrmhtmvis y pihi lgemomlis

Fusgohmf lg uo smstgdf mostmtuhmiofc lg gvfcufhmo ydiomtirgi

EmofohmfdmgotiHFWXGX y EZBH; oi nfy hi`grturf gxpchmtf1

Go gc Xgburi Xihmfc uo tili

Zrgstfhmo Hfrgohmf lg uomlflgs pfrf cf ftgohmoHflgof lg f`fsti y lmstrm`uhmo mohidpcgtf bgibremhfdgotg

Bgogrfhmo lgrghursis g

movgstmbfhmo

Efctf lg pgrsiofc hfpfhmtfli

\gdir go cf prggshrmphmo

Efctf mohirpirfr hursis go cis pcfogs lg gstulmi go efhuctflgs

Fuosgohmf lg movgstmbfhmo pu`cmhflf

P m /Z c m m m ml l


35/40

Cfs pgrsiofs hio uof gxpghtftmvf lg vmlfdfyir f 5 dgsgs quglfrio lgspritgbmlfs

Gc dfrhi kurlmhi ierghg f cis pfhmgotgs

ftgohmo lg cf eirdf qug cg sgf ds hdilf,pgri om gc dfrhi rgbucftirmi, om cf hfpfhmlfl

lg `rmolfr ftgohmo eugrf lg tgrhgr omvgc lg

ftgohmo, gxmstg

Efctf lgsfrriccfr cf OID y gc rgbcfdgoti

hirrgspiolmgotgs f cf Cgy lg 0::= y lg 0:68

Pghtirmf/Zictmhf sfomtfrmf go humlfli

pfcmftmvis; Pfdf Cgbmscftmvf

Eugotg; @fsfli go Hissmi Lfz KP, 0:68 y Ftcfs lg cis Humlflis Zfcmftmvis go Cftmoifdrmhf. Dxmhi.

Zrgstfhmo; lmspiom`mcmlfl


36/40

6:%

:88%

662%0

2%

8

6:% 8%

6

62%

:

Oi. lg hcomhfs i mostmtutismolgpgolmgotgs fc gstfli

Womlflgs nispmtfcfrmfs qug lmspiogo

lg Diremof66%: 62% 6

66%

06


37/40

Xg rgqumgrg sicuhmiogs motgbrfcgs

y smstdmhis;

DFPHI

CGBMXCF\MUI ]

OIPDF\MUI

DFPHI

PGBWCF\IPMI

F@FX\I ]

LMX\PM@WHMO LG

DGLMHFDGO\IX

HFZFHM\FHMIO

LG DLMHIX

HIOHMGO\M[FHMO

LG ZFHMGO\GX

ZPGUGOHMO ]

HIO\PIC LG WXI

MCHM\I ] FZI]I

DGLMHI ZFPF

FLMHHMIOGX

GUMLGOHMF

XI@PG

LGDFOLF PGFC

] @FPPGPFX

Xg rgqumgrg uof sicuhmo lg


38/40

Xg rgqumgrg uof sicuhmo lg

\ilf-sihmglfl; Xuprgdf Hirtg lg Kustmhmf

Gc Hiobrgsi lg cf Ofhmo

Xghrgtfrmf lg cf Xfcul y HIEGZPMX y Xgburi Zipucfr

MDXX g MXXX\G y itris fsgburflirgs

Cis nispmtfcgs lg tgrhgr omvgc

Fsihmfhmiogs lg Dlmhis y priegsmiofcgs lg cf sfcul

Xghtir prmvfli gdprgsfrmfc Xihmglfl hmvmc

Mostmtuhmiogs fhfldmhfs y lg gosgfozf

Dfrhis rgbucftirmis fpripmflis f omvgc motgrofhmiofc


39/40

Fvfozfdis f brfolgs pfsis;

Xgdmofrmi motgr-mostmtuhmiofc Iht 0:68 Zridivmgoli cfsipirtuomlflgs go cis humlflis pfcmftmvis y gc hiotric lgc licirgo Dxmhi1 hidpridmsi pfrf 0:6

Cobertura Universal Efectiva en México: El acceso al control del dolor y los Cuidados Paliativos

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Transcript of Cobertura Universal Efectiva en México: El acceso al control del dolor y los Cuidados Paliativos