Health system reform in Mexico 5: Assessing the effect of the 2001-06 Mexican health reform: an interim report card

Since 2001, Mexico has been designing, legislating, and implementing a major health-system reform. A key component was the creation of Seguro Popular, which is intended to expand insurance coverage over 7 years to uninsured people, nearly half the total population at the start of 2001. The reform included five actions: legislation of entitlement per family affiliated which, with full implementation, will increase public spending on health by 0.8-1.0% of gross domestic product; creation of explicit benefits packages; allocation of monies to decentralised state ministries of health in proportion to number of families affiliated; division of federal resources flowing to states into separate funds for personal and non-personal health services; and creation of a fund to protect families against catastrophic health expenditures. Using the WHO health-systems framework, we used a wide range of datasets to assess the effect of this reform on different dimensions of the health system. Key findings include: affiliation is preferentially reaching the poor and the marginalised communities; federal non-social security expenditure in real per-head terms increased by 38% from 2000 to 2005; equity of public-health expenditure across states improved; Seguro Popular affiliates used more inpatient and outpatient services than uninsured people; effective coverage of 11 interventions has improved between 2000 and 2005-06; inequalities in effective coverage across states and wealth deciles has decreased over this period; catastrophic expenditures for Seguro Popular affiliates are lower than for uninsured people even though use of services has increased. We present some lessons for Mexico based on this interim evaluation and explore implications for other countries considering health reforms.

Missing people and their property:the case for interim administration

Puts the case for reform of the law to allow for the administration of the estate of a missing person in the interim period between their disappearance and any later declaration of their presumed of death. Explains why reform is needed. Notes Parliamentary activities relating to the presumption of death and interim administration in the period 2008-12. Highlights Australian and Canadian legislation providing for such interim administration and the Irish Law Commission recommendations for a statutory scheme on administering a missing person's property.

Precast Concrete Panel Thickness for Epoxy-Coated Prestressing Strands, HR-353, Interim Report, 1994

A recommended minimum thickness for prestressed concrete (P/C) bridge deck panels containing 3/8-in. diameter, 270-ksi, low-relaxation, grit-impregnated, epoxy-coated prestressing strands is being evaluated by testing prototype panel specimens. As of January 1994, specimens from ten castings have been tested. The specimens in the first five castings were constructed to establish a preliminary minimum thickness for P/C panels. The specimens in the last five castings were constructed to 1) confirm the minimum panel thickness requirement, 2) measure the development length of epoxy-coated strands in specimens containing multiple strands, 3) measure the development length of uncoated strands in specimens containing multiple and single strands, 4) observe if concrete cracks form in thin panel specimens that have a raked top surface and are reinforced with welded wire fabric and either epoxy-coated or uncoated strands, 5) measure the transfer length for specimens containing a single uncoated strand, and 6) observe the seating characteristics of the grips used for uncoated strand and epoxy-coated strands. These tests have produced several initial findings. The preliminary recommended thickness for P/C panels containing grit-impregnated, epoxy-coated strands is 3 in. and the tentative development length for uncoated and coated multiple strands is approximately 45 in. and 24 in., respectively. Further tests will address confirmation of the recommended P/C panel thickness and establish the transfer and development lengths of single and multiple, uncoated and grit-impregnated epoxy-coated strands.

Precast Prestressed Concrete Panel Subdecks in Skewed Bridges, Interim Report, 1990

Precast prestressed concrete panels have been used in bridge deck construction in Iowa and many other states. To investigate the performance of these panels at abutment or pier diaphragm locations for bridges with various skew angles, a research program involving both analytical and experimental aspects, is being conducted. This interim report presents the status of the research with respect to four tasks. Task 1 which involves a literature review and two surveys is essentially complete. Task 2 which involved field investigations of three Iowa bridges containing precast panel subdecks has been completed. Based on the findings of these investigations, future inspections are recommended to evaluate potential panel deterioration due to possible corrosion of the prestressed strands. Task 3 is the experimental program which has been established to monitor the behavior of five configurations of full scale composite deck slabs. Three dimensional test and instrumentation frameworks have been constructed to load and monitor the slab specimens. The first slab configuration representing an interior panel condition is being tested and preliminary results are presented for one of these tests in this interim report. Task 4 involves the analytical investigation of the experimental specimens. Finite element methods are being applied to analytically predict the behavior of the test specimens. The first test configuration of the interior panel condition has been analyzed for the same loads used in the laboratory, and the results are presented herein. Very good correlation between the analytical and experimental results has occurred.

Interim report of the South Carolina State Health and Human Services Finance Commission

This report summarizes the Commission's activities through June 30, 1984.