UE-Mexico Dialogues – Network Structure

In the first workshop of the Seminar on Deepening Health Systems, held on network structure, the characteristics of health systems in Europe and Mexico were detailed. In European countries, health systems are based on primary or first level care, which is supported by the general or family physician. Said physician acts as gatekeeper to the health system, i.e., solves the most common health issues.

Some developments found in Mexico are that health units are now a gate entrance to each institution, each first level health unit serves a defined number of patients, inter-agency agreements in some states exist, and there is a presence of social networks in the IMSS, through IMSS-Oportunidades, the Ministry of Health, and ISSSTE.

Finally, it was established that to formally base all health systems in the primary care network and in the first-contact physician as a gateway to specialized care, is needed. Additionally, issues such as to create a common model of primary care, a database of specialists in general medicine, and introduce a capitation component in the remuneration of first-contact physicians (i.e. to pay an extra amount for each patient seen) must be addressed. Primary care has to be reinforced through legal normatives (as done in Spain) and economic incentives (as done in the United Kingdom).