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Objective. To introduce the Hospital Standardized Mortality Ratio (HSMR) as an alternative to assess the quality of hospital care in Mexico. Material and Methods. Datasets of public hospital discharges were used as source of information. The analyses were based in a logistic model to estimate the risk of hospital death adjusting by sex, age, length of stay and main diagnosis. The HSMR is estimated dividing the observed deaths by the addition of the risk for each discharge by hospital. Results. The ISSSTE had the lowest HSMR. At state level, the best figure was obtained by the hospitals of the ISSSTE in Veracruz, while the worst performance corresponds to hospitals of the SS in Nayarit. Conclusion. Our results suggest that this indicator can be used as a suitable alternative to evaluate the performance of hospitals in terms of mortality. [ABSTRACT FROM AUTHOR]

Objective. To estimate and compare direct costs per hemodialysis session in public and private units in Mexico City. Material and Methods. PAATI, a microcosting strategy, was used to determine total costs of four public and two private health hospitals in Mexico City. A "shadow study" approach was employed to collect the needed data. Charts containing the "PAATI" information for each session were developed in Microsoft Excel. Results. The average annual cost per patient undergoing hemodialysis in public units is $158 964.00 MX. The estimated cost for the care of all population estimated in need of renal replacement therapy (via hemodialysis) was estimated to be $10 921 788 072.00 MX. Conclusion. Human resources and infrastructure availability in México are very limited for nephrology, and in consequence for offering hemodialysis services. [ABSTRACT FROM AUTHOR]

Objective. To estimate the effect of "Seguro Popular" (SP) on the incidence of catastrophic health expenditure (CHE) and out-of-pocket (OOP) health expenditure in the medium term. Material and Methods. We used the 'Encuesta de Evaluación del SP' -SP Survey Evaluation- (2005-2008). We analyzed the SP effect on the rural cohort during two years of follow-up (2006 and 2008) and in the urban cohort during one year of follow-up (2008). Results. At the local level (regional clusters) we did not find an effect of the SP. At the household level we found a protective effect of SP on CHE and the OOP health payments in outpatient and hospitalization in rural areas; and a significant effect on the reduction of OOP health payments in outpatient services in urban zones. Conclusions. SP seems to be an effective program to protect poor household against out-of-pocket health expenditures in the medium term. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the reproducibility and validity of folate intake (FI) estimated from a food frequency questionnaire (FFQ), taking into account the retention factor (RF) associated with meal preparation processes. Material and Methods: A total of 497 healthy adult participants were interviewed with a FFQ. A second interview was performed one year later of a sample of 100 randomly selected individuals who had not modified their diet during the previous year . In addition, serum folate (SF) concentrations were measured by radioimmunoassay to evaluate the validity of FI. Results: Reproducibility of IF was 0.36 and 0.34 for folate without FR and with FR, respectively. SF concentration significantly correlated with FI (0.18 with RF; 0.21 without RF, p<0.05). Conclusions: Incorporating the folate RF in estimates of FI does not improve the reproducibility and validity of those estimates. [ABSTRACT FROM AUTHOR]