Advertisement

Optimization of public resources through an ensemble-learning model to measure quality perception in the social protection system in health of Mexico

  • Roman Rodriguez-AguilarEmail author
  • Gustavo Rivera-Peña
Article
  • 4 Downloads

Abstract

In order to optimize the use of public resources, a model of ensemble learning was proposed to measure the perception of quality in the medical care granted to the people affiliated to the social protection in health system of Mexico. Which allows a more efficient allocation of resources based on the main areas of opportunity identified in the measurement of service quality. Identify the effect of the main factors that are directly related to the satisfaction level and perception of quality of health services. A satisfaction index was built using an ensemble model using principal component analysis, logistic model and bagging meta-estimator, to identify the effect of a group of factors in the perception of quality of health services and monitor the perceived quality of users in real time. The survey data collected for the “Social Protection System in Health-SPSS 2014” was used, considering a sample of 28,290 users. The proposed index shows, in general, the positive perception of quality of health services, the national average index was of 0.0756, 95% CI [− 9.714 to 2.027]. There are factors statistically significant (P < 0.05) that influence these results, among the most important that can be highlighted is the good perception of infrastructure OR 2.12; CI [95% 1.9–2.36]; the gratuity of the service provided OR 1.98; CI [95% 1.42–2.76]; and full medicines supply OR 1.81; CI [95% 1.91–2.36]. The key factors identified that determine the perception of quality allow to define focused strategies and lines of action to improve service quality as well as better allocation of resources.

Keywords

Care quality Statistical learning Bagging PCA Logistic models Mexico 

References

  1. 1.
    WHO (World Health Organization). (2010). Key components of a well-functioning health system. Ginebra. http://www.who.int/healthsystems/publications/hss_key/en/index.html.
  2. 2.
    Millman, M. (Ed.). (1993). Access to health care in America. Washington: The National Academies Press.Google Scholar
  3. 3.
    Secretaría de Salud. (2013). Programa Sectorial de Salud 2013–2018. México: SSA. http://portal.salud.gob.mx/contenidos/conoce_salud/prosesa/prosesa.html.
  4. 4.
    Valdespino, J. L., Olaiz, G., López-Barajas, M. P., Mendoza, L., Palma, O., Velázquez, O., et al. (2003). Encuesta Nacional de Salud 2000. Tomo I. Vivienda, población y utilización de servicios de salud. Cuernavaca, Morelos, México. Instituto Nacional de Salud Pública. México.Google Scholar
  5. 5.
    Frenk, J., González-Pier, E., Gómez-Dantés, O., Lezana, M. Á., & Knaul, F. M. (2007). Reforma integral para mejorar el desempeño del sistema de salud en México. Salud Pública México, 49, s23–s36.CrossRefGoogle Scholar
  6. 6.
    Gutierrez, J. P., Rivera-Dommarco, J., Shamah-Levy, T., Villalpando-Hernandez, S., Franco, A., Cuevas-Nasu, L., et al. (2013). Encuesta Nacional de Salud y Nutrición 2012. Resultados nacionales. 2a. ed. Cuernavaca, México: Instituto Nacional de Salud Pública (MX).Google Scholar
  7. 7.
    Sistema de Protección Social en Salud. (2014). Informe de Resultados 2014. México: SSA. http://www.seguro-popular.gob.mx/images/Contenidos/informes/Informe%20de%20Resultados%202014.pdf.
  8. 8.
    Lafond, A. K. (1995). Improving the quality of investment in health: Lessons on sustainability. Health Policy and Planning, 1995(10), 63–76.Google Scholar
  9. 9.
    Guldner, M., & Rifkin, S. (1993). Sustainability in the health sector, Part 1: Vietnam case study. London: Save the Children Fund.Google Scholar
  10. 10.
    Taylor, S. A., & Cronin, J. J., Jr. (1994). Modeling patient satisfaction and service quality. Journal of Health Care Marketing, 14(1), 34–44.Google Scholar
  11. 11.
    Alvarado, R., & Vera, A. (2001). Evaluación de la satisfacción de usuarios del Sistema Nacional de Servicios de Salud. Revista Chilena de Salud Pública, 5(2–3), 81–89.Google Scholar
  12. 12.
    Boscarino, J. A. (1992). The public’s perception of quality hospitals II: Implications for patient surveys. Hospital and Health Services Administration, 37(1), 13–35.Google Scholar
  13. 13.
    John, J. (1992). Patient satisfaction: The impact of past experience. Journal of Health Care Marketing, 12(3), 56–64.Google Scholar
  14. 14.
    Langseth, P., Langan, P., & Talierco, R. (1995). Service Delivery Survey (SDS): A management tool. Washington: The Economic Development Institute of the World Bank.Google Scholar
  15. 15.
    Gilbert, F. W., Lumpkin, J. R., & Dant, R. P. (1992). Adaptation and customer expectation of health care options. Journal of Health Care Marketing, 12(3), 46–55.Google Scholar
  16. 16.
    McAlexander, J. H., Kaldenberg, D. O., & Koenig, H. F. (1994). Service quality measurement. Journal of Health Care Marketing, 14(3), 34–40.Google Scholar
  17. 17.
    Donabedian, A. (1988). Quality assessment and assurance: Unity of purpose, diversity of means. Inquiry, 25, 173–192.Google Scholar
  18. 18.
    Parasuraman, A., Berry, L., & Zeithaml, V. (1991). Refinement and reassessment of the SERVQUAL scale. Journal of Retailing, 67(2), 420–450.Google Scholar
  19. 19.
    O’Connor, S. J., Shewchuk, R. M., & Carney, L. W. (1994). The great gap. Journal of Health Care Marketing, 14(2), 32–39.Google Scholar
  20. 20.
    Petersen, M. B. H. (1988). Measuring patient satisfaction: Collecting useful data. Journal of Nursing Quality Assurance, 2(3), 25–35.Google Scholar
  21. 21.
    Babakus, E., & Mangold, W. G. (1992). Adapting the SERVQUAL scale to hospital services: An empirical investigation. Health Services Research, 26(6), 767–786.Google Scholar
  22. 22.
    Weitzman, B. C. (2015). High-quality health care. In A. R. Kovner (Ed.), Health care delivery in the United States (5th ed.). Berlin: Springer.Google Scholar
  23. 23.
    Wirtz, V. J., Santa-Ana-Tellez, Y., Servan-Mori, E., & Avila-Burgos, L. (2012). Heterogeneous effects of health insurance on out-of-pocket expenditure on medicines in Mexico. Value in Health, 15(5), 593–603.CrossRefGoogle Scholar
  24. 24.
    Serrano-del-Rosal, R., & Loriente-Arín, N. (2008). La anatomía de la satisfacción del paciente. Salud Pública Méx, 50(2), 162–172.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Faculty of EngineeringUniversidad Anahuac NorteNaucalpan de JuárezMexico
  2. 2.Faculty of Business and EconomicsUniversidad Anahuac NorteNaucalpan de JuárezMexico

Personalised recommendations