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

Salud Publica Mex. 2015:57 Suppl 2:s153-62.
[Article in Spanish]

Abstract

Objective: To document the association between supply-side 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.

MeSH terms

  • Acquired Immunodeficiency Syndrome / economics
  • Acquired Immunodeficiency Syndrome / mortality*
  • Acquired Immunodeficiency Syndrome / prevention & control
  • Adult
  • Algorithms
  • Ambulatory Care Facilities / economics
  • Ambulatory Care Facilities / supply & distribution
  • Anti-HIV Agents / supply & distribution
  • Anti-HIV Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Continuity of Patient Care
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / economics
  • Health Services / economics
  • Health Services / supply & distribution*
  • Health Services Accessibility* / economics
  • Health Services Administration* / economics
  • Health Services Needs and Demand
  • Humans
  • Logistic Models
  • Male
  • Mexico / epidemiology
  • Models, Economic
  • Mortality, Premature
  • National Health Programs / economics
  • National Health Programs / organization & administration
  • Viral Load

Substances

  • Anti-HIV Agents