2015, Number S2
The role of supply-side characteristics of services in AIDS mortality in Mexico
Language: Spanish
References: 13
Page: 153-162
PDF size: 244.25 Kb.
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
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.
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/.
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