Evaluation of inequality and technical efficiency of federal health financing for population without social security per Federal Entity, 2004–2012 in México

Abstract

The main goal of this paper is evaluate inequality and technical efficiency of federal health financing for population without social security per federative entity. Were estimated two inequality measures of federal financing for population without social security per Federal Entity: the Gini coefficient and the Theil entropy index. Four stochastic frontier models were calculated to measure technical efficiency of health production per federative entity (2004–2012). Information on health expenditure, physical and human resources yielded by the Ministry of Health through SINAIS was used. The federal financing for population without social security has reduced inequality among Federal Entities due to the incorporation of the SPSS (Mexican system of social protection in terms of health). The estimate of technical efficiency of Federal Entities through stochastic frontiers shows that most of these entities have health production inefficiencies both at outpatient and hospital levels, being the outpatient level the one with more inefficiency. Not necessarily entities that receive greater resources produce more health. The existence of multiple financing sources has limited the effect of the SPSS to reduce inequality in financing for population without social security among Federal Entities. More health resources are needed in order to face demographic and epidemiological transitions, but it is necessary to spend the available resources in a more efficient way. There are three main lines of action in terms of financing: structuring financing sources and improving the allocation mechanisms; and strengthening evaluation and monitoring resources exercise.