Health Policy Related to Overcrowding in Mexico
1Medical Program, University of Monterrey (;UDEM), Mexico
The demand for unscheduled health care services that enter the emergency departments has increased significantly in the last 3 to 4 decades, related to the definition of emergency medicine in Mexico and the design of hospital care and management models that contemplate these services with more qualified personnel and infrastructure in continuous development and improvement.
Prior to the 1980s, the demand for emergency services was not very high, however, with the explosive development of emergency services in Mexico together with the significant growth of patients with cardiovascular and metabolic risk factors mixed with high daily stress from a developing country has led to an increase in demand from 35 million emergency consultations in the year 2000 to more than 54 million in 2014.
In addition to the aforementioned problems, the increase in emergency surgery events, the delay in surgical programming due to multiple factors, emerging or seasonal public health problems, and the lack of education about emergency services have led to a high increase of the demand for these services.
In 2015, the Mexican Institute for Social Security initiated an improvement program to streamline care times in the emergency departments, dividing the program into three important pillars: First, the TRIAGE service, second, the department's own care processes of emergency and third the hospital beds management program.
The first pillar of this process was to establish a professional TRIAGE system, with special training of doctors that strengthen their diagnostic skills in front of the emergency departments to perform an effective classification, allowing to filter the real urgencies based on the Manchester TRIAGE scale.
The second pillar is the improvement of processes within the emergency department, for this, the recommendations of the General Health Council of Mexico, which is an accrediting entity of quality of health services, were followed, with the support of its recommendations that were implemented to improve the management systems, department administration, decrease in medical errors, decrease in infections associated with medical care, which had a real impact on service times.
The last pillar of support is the hospital bed management system, this program consists of permanent visits by the directors or managers of the health units, which identify free beds, probable patient discharges, infrastructure failures, etc. This keeps discharge management times and bed occupancy rates high to streamline the flow of patients in emergency areas.
Currently Mexico faces new challenges towards the years after 2020, with continuous budget adjustments of the government that determine lack of human and material resources, decrease in the efficiency of services and increase in re-entry rates due to ineffective treatments.