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Open Access

Effective access to health care in Mexico

  • Juan Pablo Gutierrez1,
  • Sebastian Garcia-Saiso2,
  • German Fajardo-Dolci3 and
  • Mauricio Hernandez-Avila4
BMC Health Services Research201414(Suppl 2):P42

Published: 7 July 2014


Public HealthHealth CareHealth ServiceHealth SystemHealth Survey


Effective access measures are intended to reflect progress toward universal health coverage. This study proposes an operative approach to measuring effective access: in addition to the lack of financial protection, the willingness to make out-of-pocket payments for health care signifies a lack of effective access to pre-paid services.

Materials and methods

Using data from a nationally representative health survey in Mexico, effective access at the individual level was determined by combining financial protection and effective utilization of pre-paid health services as required. The measure of effective access was estimated overall, by sex, by socioeconomic level, and by federal state for 2006 and 2012.


In 2012, 48.49% of the Mexican population had no effective access to health services. Though this represents an improvement since 2006, when 65.9% lacked effective access, it still constitutes a major challenge for the health system. Effective access in Mexico presents significant heterogeneity in terms of federal state and socioeconomic level.


Measuring effective access will contribute to better targeted strategies toward universal health coverage. The analysis presented here highlights a need to improve quality, availability, and opportuneness (location and time) of health services provision in Mexico.

Authors’ Affiliations

Center for Evaluation Research & Surveys, National Institute of Public Health, Cuernavaca, Mexico
Ministry of Health, Ciudad de Mexico, Mexico
The Mexican Institute of Social Security, Ciudad de Mexico, Mexico
Directorate-General, National Institute of Public Health, Cuernavaca, Mexico


© Gutierrez et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.