ABSTRACT
In the context of the 80th anniversary of the Instituto Mexicano del Seguro Social (IMSS), there are several health problems and challenges to be faced in relation to user population, which currently represents 42% of Mexico's population. Among these issues, once five waves of COVID-19 infections have passed and mortality rates have decreased, mental and behavioral disorders stand out as a re-emerging and priority problem. In response to this, in 2022 the Mental Health Comprehensive Program (MHCP, 2021-2024) materialized, which represents, for the first time, the opportunity to provide health services that address mental disorders and addictions of user's population IMSS, under the Primary Health Care model. That is, prioritizing health promotion, risk factors prevention, screening, timely diagnosis, and not just hospitalization and drug supply. Among the MHCP strategies, which motivated the writing of this document, we highlight the availability of reliable data, through the census of mental and behavioral disorders, related to important characteristics in terms of population, state, hospital, prevalence of disorders, in order to act accordingly through the infrastructure and human resources available at the IMSS, with emphasis on the first level of care. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
In diabetes, obtaining optimal control is key to reducing chronic complications. Unfortunately, not all patients achieve the recommended goals. Therefore, the challenges to develop and evaluate comprehensive care models are enormous. In October 2008, the Diabetic Patient Care Program (DiabetIMSS) was designed and implemented in family medicine. Its principal component is the multidisciplinary team (doctor, nurse, psychologist, dietitian, dentist, and social worker) that offers coordinated health care;monthly medical consultation and individual, family and group education on self-care and prevention of complications for 12 months. Due to the COVID-19 pandemic, the percentage of attendance at the DiabetIMSS modules decreased significantly. This is how the Medical Director considered it necessary to strengthen them, and the Diabetes Care Centers (CADIMSS) arose. In addition to providing medical care with a comprehensive and multidisciplinary approach, the CADIMSS encourages the co-responsibility of the patient and his family. It consists of monthly medical consultation and nursing staff provides monthly educational sessions for 6 months. Pending tasks remain and there are still areas of opportunity to modernize and reorganize services that contribute to improving the health of the population with diabetes. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
Background: The third wave of COVID-19 in Mexico produced a high demand for hospital care, which is why it was created a multidisciplinary group to optimize decision-making: the Interinstitutional Command for the Health Sector (COISS, according to its initials in Spanish). So far, there is no scientific evidence of the COISS processes or their effect on the behavior of epidemiological indicators and the hospital care needs of the population in the context of COVID-19 in the entities involved. Objectives: To analyze the trend on epidemic risk indicators throughout the COISS group's management in the third wave of COVID-19 in Mexico. Material and methods: Mixed study: 1) non-systematic review of information from technical documents issued by COISS, 2) secondary analysis of open-access institutional databases through the description of healthcare needs of cases notified with COVID-19 symptoms, and an ecological analysis by each Mexican state on the behavior of hospital occupancy, RT-PCR positivity, and COVID-19 mortality in two-time points. Results: The COISS activity in identifying states with epidemic risk generated actions aimed at a reduction in hospital occupancy of beds, positivity by RT-PCR, and mortality from COVID-19. Conclusions : The decisions of the COISS group reduced the indicators of epidemic risk. Continuing the work of the COISS group is an urgent need. Conclusions: The decisions of the COISS group reduced the indicators of epidemic risk. Continuing the work of the COISS group is an urgent need. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
The COVID-19 pandemic established a new challenge for health services in Mexico, which is why these services faced the challenge of responding to the affected people, by providing them services with opportunity, efficiency, effectiveness and safety. The Instituto Mexicano del Seguro Social (IMSS, Mexican Institute for Social Security) gave medical attention to the larger number of affected people: towards the end of September, 2022, 3,335,552 patients were registered, who represented 47% of the total (7,089,209) of confirmed COVID-19 cases since the beginning of the pandemic in 2020. Of all the cases treated, 295,065 (8.8%) required hospitalization. In addition of new scientific evidence and the implementation of best practices in medical care and directive management (with the general objective of improvement of the processes in hospital attention, even without an effective treatment at the time), we presented an evaluation, supervision method with a comprehensive (involving the three levels of health services) and analytic (structure, process, result and directive management components) approach. The achievement of specific goals and lines of action was established in a technical guideline with health policies for the COVID-19 medical care. These guidelines were instrumented with a standardized evaluation tool, a result dashboard and a risk assessment calculator, improving the quality of medical care and directive management by the multidisciplinary health team. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
Two years after the onset of the COVID-19 pandemic, the Mexican Institute for Social Security (IMSS, according to its initials in Spanish) rethought new projects focused on the new needs of the population and social security organizations and institutions. The Institute, as a cornerstone in the search for the wellbeing of Mexicans, aligned with the National Development Plan and the Strategic Health for Wellbeing Program, sought to direct its transformation towards a preventive, resilient, comprehensive, innovative, sustainable, modern and accessible IMSS. For this reason, the Medical Services Director designed the PRIISMA Project, as the one that over the next three years could make possible to innovate and improve its medical care processes, starting with the recovery of medical services and identifying those groups of beneficiaries who experience the most vulnerable circumstances. The PRIISMA project consisted of five sub-projects: 1. Vulnerable groups;2. Efficient and effective care;3. Prevent IMSS plus;4 IMSS University and 5. Recovery of medical services. The strategies of each project seek to improve medical care for all IMSS beneficiaries and users with a human rights perspective and by priority groups;the goal is reducing the gaps in access to health care, leaving no one behind and leaving no one out;and to surpass the goals for medical services provided before the pandemic. This document provides an overview of strategies and progress of the PRIISMA sub-projects achieved during 2022. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
The Mexican Social Security Institute, the most prominent social security institution in Mexico, plays a significant role in Mexican health care. Throughout almost eight decades of existence, it has faced significant challenges, whose experiences have contributed to the generation of health policies in the country. Recently, the health emergency caused by COVID-19 evidenced a strong impact of the epidemiological transition associated with the high prevalence of chronic-degenerative diseases, which meant an increased risk of complications and death when facing emerging diseases. The institute is transformed through changes in its policies and forms of health care for the population to provide innovative responses and fulfill the commitment to provide social security to our country. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
Nowadays, mental health has acquired greater relevance and attention as a consequence mainly of the COVID-19 pandemic, to which is attributed a negative impact on the development of life, work and social coexistence of people, along with the magnitude derived from non-communicable diseases. This is why the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute for Social Security) developed the Mental Health Comprehensive Program 2021-2024, whose main purpose was to establish strategies and lines of action for the prevention, early detection and timely management regarding mental health and addictions. Based on this, different actions have been carried out, for example, the identification of the material and human resources available at IMSS to meet the mental health issue;the training of healthcare professionals at the three levels of care;the integration of a census that has reported a prevalence of anxiety and depressive episodes in the users of 39.9 and 3%, respectively, as well as the evaluation of instruments for screening mental disorders. Therefore, this document describes what has been done in the IMSS in relation to the user's mental health in the context of the COVID-19 pandemic.