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  • Title: [Composite indicators for primary health care. The case of Mexico].
    Author: Valencia GJ, José MV, Serrano OV.
    Journal: Salud Publica Mex; 1990; 32(5):552-65. PubMed ID: 2089630.
    Abstract:
    In 1978 the World Health Organization proposed as a goal the following slogan: "Health for everyone in the 2000 year". Though, to obtain the covering first assistance indicators is crucial for the evaluation work and for the analysis of the health strategies. In 1981 the World Health Organization proposed 13 indicators, based on them, this work builds up three new indicators. These indicators allow to have a simple and reliable description of the covering that each one of the federal entities of the Mexican Republic keep. The 1985 WHO indicator, PROM, and our mixed indicator, Institutional Medical Assistance Request, are highly correlated. The Mixed indicators of Health Covering allow the making of global covering evaluations. Also allows the studding of all the covering relations and correlations reached with other indicators or variables. This work describes and illustrates the use of 3 new indicators of primary health care coverage based on the 13 indicators proposed by the World Health Organization in 1981. The new compound indicators permit a simple and reliable description of the health coverage of each of Mexico's states and federal entities. The data correspond to the year 1985 and the compound indicators are those that depend lineally on 1 or more of the simple indicators proposed by Kumate and Barnard in their 1988 study of the 13 WHO indicators in Mexico. Principal components analysis was used to transform the original indicators that are correlated among themselves into a group of new indicators that are not correlated. 3 of the compound indicators that together explained 82.2% of the variation in the original 13 simple indicators were retained. The 1st compound indicator included prenatal care, attention at delivery, postpartum care of the infant, growth monitoring, medical consultations, and hospitalizations. It was termed the indicator of demand for institutional medical attention and explained 59.4% of the variation. The 2nd compound indicator, termed access to facilities for diagnosis and treatment of endemic diseases, included the 2 WHO indicators diagnosis and treatment of endemic diseases and facilities (a measure of the population with reasonable access to health facilities). This indicator explained 13.04% of the variation in the original indicators. The 3rd compound indicator included vaccinations with BCG and DPT, and medical care in terminal illness, potable water, and health facilities. It was termed the indicator of comparison between prevention by immunization and access to health and hygienic resources and explained 9.82% of the original variation. The indicator termed demand for institutional medical attention was very highly correlated with a compound indicator proposed by the WHO in 1985 that consisted of the arithmetic average of its 13 simple indicators. The high correlation demonstrates that primary health care coverage is adequately represented by either the WHO 1985 indicators or the indicator of demand for institutional medical attention. The simple indicators most important in describing health coverage are those included in the demand for institutional medical attention. The 3 compound indicators can be used to represent the different characteristics of the states graphically in 2 or 3 dimensions for purposes of comparison. They can also be used for overall comparisons of coverage between states.
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