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Recent literature indicates that people with Disorders of Intellectual Development (DID) experience health disparities in the pathologies that they present, and a worst access to health care. However, current evidence-based knowledge is still sparse outside the Anglo-Saxon countries. The POMONA-I and POMONA-II European projects aimed to collect information on the health status of people with DID in Europe. The POMONA-ESP project in Spain is meant to collect health information in a wide and representative sample of persons with DID. Also, there are studies that claim for the need of specialized services for people with DID at the public health system. There are also studies about the current state of the education and training about DID for students within the health sector. In this paper we review the latest evidences about the health of the persons with DID and we present the main research activities and care initiatives about this issue.

This paper discusses some of the proposals regarding the improvement of the efficiency in the delivery of health care services. Several countries have implemented different strategies based on the experience of the Health Maintenance Organizations, which have used the market to stimulate competition between providers and insurance companies. One of the proposals includes the creation of agencies that would compete in quality and in price. Another one implies the creation of a National Health Service capable of hiring public or private services from local agencies. The ideal strategy would enable a consumer to choose between insurance companies and public and private providers, and would hopefully create cost conditions reasonably correlated with the efficiency and quality of the rendered services.

The purpose of this paper is to present the basic principles needed to implement a national strategy for quality assurance in medical care in Mexico. The first part is devoted to a review of the basic concepts of quality of care with the aim of analyzing the evolution of the discussion of the concept of "quality assurance". This review constitutes the reference frame of the description of the historical evolution of quality assurance in different parts of the world. Finally, the experiences regarding quality assurance in Mexico are discussed and several basic proposals for the design of a national quality assurance strategy are presented.