Organización del abasto de medicamentos en los servicios estatales de salud. Potenciales consecuencias de la mezcla público-privada.

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Bibliographic Details
Title:	Organización del abasto de medicamentos en los servicios estatales de salud. Potenciales consecuencias de la mezcla público-privada.
Authors:	López-Moreno, Sergio¹ slopez@correo.xoc.uam.mx, Martínez-Ojeda, Rosa Haydeé², López-Arellano, Oliva¹, Jarillo-Soto, Edgar¹, Castro-Albarrán, Juan Manuel³
Source:	Salud Pública de México. nov/dic2011 supplement 4, Vol. 53, pS445-S457. 13p.
Subjects:	MEDICAL care research, DRUG prescribing, QUANTITATIVE research, QUALITATIVE research, SCIENTIFIC observation, SUPPLY chain management
Geographic Terms:	MEXICO
Abstract (English):	Objective. To assess the consequences of private outsourcing on the overall supply and filling of prescriptions in state health services. Material and Methods. The research was conducted using quantitative and qualitative techniques in 13 states. The information was collected through interviews and direct observation. The interviews were carried on staff of state health services related to the drug supply chain and users of health services. The quantitative approach examined the percentage of stocked full recipes in a sample of users. Results. States that have opted for the fully outsourced model, and properly monitored this choice, have increased the supply of drugs to their users and guaranteed the supply in the care units in charge. Other states with the outsourced model have multiple problems: direct purchase of drugs not included in the basic drugs catalogue, failure of suppliers and shortage of supplies in the laboratories that provide the company. The main disadvantages identified in all models were: the subordination of the medical criteria to administrative criteria, insufficient planning based on local care needs, heterogeneous procedures, insufficient knowledge of regulations and lack of normativity. Conclusion. The results indicate that the incorporation of private providers in the drug supply chain may not be the solution to bring down the shortage faced by health services, especially at the hospital level. The shift to outsourcing models has developed without incorporating evaluation mechanisms and the consequences that this transition can have on state health systems must be investigated more deeply. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Objetivo. Evaluar las consecuencias de la subrogación privada sobre el proceso general de abasto y el surtimiento completo de recetas en los servicios estatales de salud. Material y métodos. La investigación se realizó utilizando técnicas cuantitativas y cualitativas en 13 entidades federativas. La información se recolectó mediante entrevistas y observación directa. Las entrevistas se aplicaron a personal de los servicios estatales de salud relacionados con la cadena de abasto de medicamentos y a usuarios de los servicios de atención. La aproximación cuantitativa examinó, en una muestra por conveniencia de usuarios, el porcentaje de recetas completas surtidas. Resultados. Las entidades que han optado por el modelo tercerizado en su totalidad y lo controlan adecuadamente han incrementado el suministro de medicamentos entre sus usuarios y garantizado el abasto en las unidades de atención a su cargo. Otras entidades con modelo tercerizado tienen múltiples problemas: compra directa de medicamentos no incluidos en el cuadro básico, incumplimiento de proveedores y escasez de insumos en los laboratorios que proveen a la empresa. Como principales inconvenientes de todos los modelos se identificaron la subordinación de los criterios médicos a los criterios administrativos; la insuficiente planeación basada en las necesidades locales de atención; la heterogeneidad de los procedimientos; el conocimiento insuficiente de la normatividad y la falta de regulación. Conclusión. Los resultados indican que la incorporación de proveedores privados en la cadena de abasto de medicamentos podría no ser la solución para abatir el desabasto que padecen los servicios de salud, especialmente a escala hospitalaria. El cambio hacia modelos subrogados (tercerizados) se ha desarrollado sin incorporar mecanismos de evaluación, y las consecuencias que esta transición puede acarrear sobre los sistemas estatales de salud deben ser investigadas con mayor profundidad. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Objective. To assess the consequences of private outsourcing on the overall supply and filling of prescriptions in state health services. Material and Methods. The research was conducted using quantitative and qualitative techniques in 13 states. The information was collected through interviews and direct observation. The interviews were carried on staff of state health services related to the drug supply chain and users of health services. The quantitative approach examined the percentage of stocked full recipes in a sample of users. Results. States that have opted for the fully outsourced model, and properly monitored this choice, have increased the supply of drugs to their users and guaranteed the supply in the care units in charge. Other states with the outsourced model have multiple problems: direct purchase of drugs not included in the basic drugs catalogue, failure of suppliers and shortage of supplies in the laboratories that provide the company. The main disadvantages identified in all models were: the subordination of the medical criteria to administrative criteria, insufficient planning based on local care needs, heterogeneous procedures, insufficient knowledge of regulations and lack of normativity. Conclusion. The results indicate that the incorporation of private providers in the drug supply chain may not be the solution to bring down the shortage faced by health services, especially at the hospital level. The shift to outsourcing models has developed without incorporating evaluation mechanisms and the consequences that this transition can have on state health systems must be investigated more deeply. [ABSTRACT FROM AUTHOR]
ISSN:	00363634