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Centralized health care more cost-effective, offers better access to preventive services
Date:9/14/2010

Families from rural Mexico who receive health care from centralized clinics run by the federal government pay up to 30 percent less in out-of-pocket expenses and utilize preventive services more often than those families who access decentralized clinics run by states, according to a study by researchers at the UCLA School of Public Health.

The findings are published in the September issue of the Journal of Social Science and Medicine and are currently available online.

The data were drawn from a comprehensive survey of 8,889 rural families from seven states in Mexico conducted in 2003 by Oportunidades, Mexico's principal anti-poverty program. The findings contradict the widely perceived notion that decentralized systems in which local knowledge and resources can be more effectively used to address local needs are superior to centralized organizations.

The study measured the effectiveness of centralized and decentralized providers using two measures: overall health expenditures by users (both centralized and decentralized providers offer free health care and drugs at rural clinics) and the utilization of preventive services (higher use reduces the cost of treating preventable conditions in the future).

Since centralized and decentralized organizations rarely operate within the same country during the same time period or cater to comparable populations, Mexico's health caredelivery system provides a unique opportunity to compare the two approaches side by side.

Starting the mid-1940s, the public safety net for Mexicans not covered by the Mexican Social Security Institute or other federal social security institutes was administered by the federal government. The government provided a limited bundle of cost-effective services, including primary and preventive care and basic hospitalization to the poorest rural areas of the country.

During the 1980s, the government undertook an ambitious de
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Contact: Sarah Anderson
sanderson@ph.ucla.edu
310-267-0440
University of California - Los Angeles
Source:Eurekalert

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