Lina Sofía Palacio-Mejía

Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico

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Publications (13)16.73 Total impact

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    ABSTRACT: The findings of a case study assessing the design and implementation of an electronic health record (EHR) in the public health system of Colima, Mexico, its perceived benefits and limitations, and recommendations for improving the implementation process are presented. In-depth interviews and focus group discussions were used to examine the experience of the actors and stakeholders participating in the design and implementation of EHRs. Results indicate that the main driving force behind the use of EHRs was to improve reporting to the two of the main government health and social development programs. Significant challenges to the success of the EHR include resistance by physicians to use the ICD-10 to code diagnoses, insufficient attention to recurrent resources needed to maintain the system, and pressure from federal programs to establish parallel information systems. Operating funds and more importantly political commitment are required to ensure sustainability of the EHRs in Colimaima.
    Journal of the American Medical Informatics Association 09/2012; · 3.57 Impact Factor
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    ABSTRACT: To evaluate and analyze health information systems (his) in the Mesoamerican Region. The conceptual framework and tools of the Health Metrics Network (nhm) was used. It measures six components of the his assessment: resources, indicators, data sources, information management, products and use. In this study we found that the average score of the HIS in the Mesoamerican region was 57%, being the maximum value for Mexico (75%) and the minimum for El Salvador (41%). The item that had lowest scores was that referring to the Management and Administration, where the average assessment was 37%, placing it as present but not adequate. The component with the highest score was Information Products with more than 69%, adequate. In any case, no items were very adequate. The performance of his is heterogeneous between countries. It is necessary to strengthen and standardize the criteria of the his in the region, so that these are integrated and used in the decision making process based on real information.
    Salud publica de Mexico 01/2011; 53 Suppl 3:S368-74. · 0.94 Impact Factor
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    ABSTRACT: To document the status of operational and managerial processes of the Fund for Protection against Catastrophic Expenses (FPGC), as well as to describe its evolution, and to explore the relationship between covered diseases and the Mexican health profile. This is a joint management study, which included a qualitative and a quantitative phase. We conducted semi-structured interviews with key informants. We also analyzed the records of CNPSS, the hospital discharge and mortality data bases. Fifty two percent of the states take twice as long to report and validate the cases. From 2004-2009 the FPGC increased its coverage from 6 to 49 interventions, that means a spending increase of 2 306.4% in nominal terms and 1 659.3% in real terms. The HIV/AIDS was the intervention prioritized with 39.3% and Mexico City had the highest proportion of expenditure (25.1%). A few diseases included in the health profile are covered by the FPGC. The review of the inclusion criteria of diseases is urgent, so as to cover diseases of epidemiological importance.
    Salud publica de Mexico 01/2011; 53 Suppl 4:407-15. · 0.94 Impact Factor
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    ABSTRACT: OBJECTIVE: To evaluate and analyze health information systems (his) in the Mesoamerican Region. MATERIAL AND METHODS: The conceptual framework and tools of the Health Metrics Network (nhm) was used. It measures six components of the his assessment: resources, indicators, data sources, information management, products and use. RESULTS: In this study we found that the average score of the HIS in the Mesoamerican region was 57%, being the maximum value for Mexico (75%) and the minimum for El Salvador (41%). The item that had lowest scores was that referring to the Management and Administration, where the average assessment was 37%, placing it as present but not adequate. The component with the highest score was Information Products with more than 69%, adequate. In any case, no items were very adequate. CONCLUSION: The performance of his is heterogeneous between countries. It is necessary to strengthen and standardize the criteria of the his in the region, so that these are integrated and used in the decision making process based on real information.
    Salud publica de Mexico 12/2010; 53:s368-s374. · 0.94 Impact Factor
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    ABSTRACT: Objetivo. Desarrollar un modelo automatizado de regionalización operativa para la planeación de las redes de servicios de salud propuestas en el Modelo Integrador de Atención a la Salud (MIDAS). Material y métodos. Con información disponible para México en 2005 y 2007 se realizó un modelo geoespacial para estimar el área potencial de influencia alrededor de cada unidad de atención médica, con base en el menor tiempo de viaje. Los resultados se compararon con un Estudio de Regionalización Operativa (ERO) para Oaxaca llevado a cabo en 2005. Resultados. Comparado con el modelo geoespacial, el ERO asignó 48% de las localidades a centros de salud más lejanos y 23% de los centros de salud a hospitales más lejanos. Conclusiones. El modelo calculado en este estudio generó una regionalización más eficiente que el ERO de Oaxaca, minimizando el tiempo de viaje para el acceso a los servicios de salud. Este modelo ha sido adoptado por la Dirección General de Planeación y Desarrollo en Salud para la instrumentación del Plan Maestro Sectorial de Recursos para la Atención de la Salud.
    Salud publica de Mexico 10/2010; 52(5):432-446. · 0.94 Impact Factor
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    ABSTRACT: To develop an automated model for the operational regionalization needed in the planning of the health service networks proposed by the new Mexican health care model (Modelo Integrador de Servicios de Salud MIDAS). Using available data for México during 2005 and 2007, a geospatial model was developed to estimate potential catchment areas around health facilities based on access travel time. The results were compared with an operational regionalization (ERO) study manually carried out in Oaxaca with 2005 data. The ERO assigned 48% of villages to health care centers further away than those assigned by the geospatial model, and 23% of these health centers referred patients to more distant hospitals. The model calculated by this study generated a more efficient regionalization than the ERO model, minimizing travel time to access health services. This model has been adopted by the General Department of Health Planning and Development of the Mexican Ministry of Health for the implementation of the Health Sector Infrastructure Master Plan.
    Salud publica de Mexico 10/2010; 52(5):432-46. · 0.94 Impact Factor
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    ABSTRACT: OBJECTIVE: Explore the regional differences in breast (BC) and cervical cancer (CC) mortality in Mexico. MATERIAL AND METHODS: We estimated mortality trends for BC and CC using probabilistic models adjusted by state marginalization level and urban and rural residence. RESULTS: BC mortality shows a rising trend, from a rate of 5.6 deaths per 100000 women in 1979 to 10.1 in 2006. The CC mortality rate reached a peak in 1989 and after this decreased significantly to 9.9 in 2006. The highest BC mortality rates are found in Mexico City (13.2) and the northern part of the country (11.8). As for CC, the highest mortality rates are found in the south (11.9 per 100000 women the). DISCUSSION: The number of BC cases are increased gradually at the national level during the last three decades and high rates of CC mortality persist in marginalized areas.
    Salud publica de Mexico 01/2009; 51. · 0.94 Impact Factor
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    ABSTRACT: Explore the regional differences in breast (BC) and cervical cancer (CC) mortality in Mexico. We estimated mortality trends for BC and CC using probabilistic models adjusted by state marginalization level and urban and rural residence. BC mortality shows a rising trend, from a rate of 5.6 deaths per 100000 women in 1979 to 10.1 in 2006. The CC mortality rate reached a peak in 1989 and after this decreased significantly to 9.9 in 2006. The highest BC mortality rates are found in Mexico City (13.2) and the northern part of the country (11.8). As for CC, the highest mortality rates are found in the south (11.9 per 100000 women the). The number of BC cases are increased gradually at the national level during the last three decades and high rates of CC mortality persist in marginalized areas.
    Salud publica de Mexico 01/2009; 51 Suppl 2:s208-19. · 0.94 Impact Factor
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    ABSTRACT: The reduction in cervical cancer mortality in developed countries has been attributed to well-organized, population-based prevention and control programs that incorporate screening with the Papanicolaou (Pap) smear. In Mexico, there has been a decrease in cervical cancer mortality, but it is unclear what factors have prompted this reduction. Using data from national indicators, we determined the correlation between cervical cancer mortality rates and Pap coverage, birthrate, and gross national product, using a linear regression model. We determined relative risk of dying of cervical cancer according to place of residence (rural/urban, region) using a Poisson model. We also estimated Pap smear coverage using national survey data and evaluated the validity and reproducibility of Pap smear diagnosis. An increase in Pap coverage (beta= -0.069) and a decrease in birthrate (beta=0.054) correlate with decreasing cervical cancer mortality in Mexico. Self-reported Pap smear rates in the last 12 months vary from 27.4% to 48.1%. Women who live in the central (relative risk, 1.04) and especially the southern (relative risk, 1.47) parts of Mexico have a greater relative risk of dying of cervical cancer than those who live in the north. There is a high incidence of false negatives in cervical cytology laboratories in Mexico; the percentage of false negatives varies from 3.33% to 53.13%. The decrease in cervical cancer mortality observed in Mexico is proportional to increasing Pap coverage and decreasing birthrate. Accreditation of cervical cytology laboratories is needed to improve diagnostic precision.
    Cancer Epidemiology Biomarkers &amp Prevention 11/2008; 17(10):2808-17. · 4.56 Impact Factor
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    ABSTRACT: To examine cervical cancer mortality rates in Mexican urban and rural communities, and their association with poverty-related factors, during 1990-2000. We analyzed data from national databases to obtain mortality trends and regional variations using a Poisson regression model based on location (urban-rural). During 1990-2000 a total of 48,761 cervical cancer (CC) deaths were reported in Mexico (1990 = 4,280 deaths/year; 2000 = 4,620 deaths/year). On average, 12 women died every 24 hours, with 0.76% yearly annual growth in CC deaths. Women living in rural areas had 3.07 higher CC mortality risks compared to women with urban residence. Comparison of state CC mortality rates (reference = Mexico City) found higher risk in states with lower socio-economic development (Chiapas, relative risk [RR] = 10.99; Nayarit, RR = 10.5). Predominantly rural states had higher CC mortality rates compared to Mexico City (lowest rural population). CC mortality is associated with poverty-related factors, including lack of formal education, unemployment, low socio-economic level, rural residence and insufficient access to healthcare. This indicates the need for eradication of regional differences in cancer detection. This paper is available too at: http://www.insp.mx/salud/index.html.
    Salud publica de Mexico 02/2003; 45 Suppl 3:S315-25. · 0.94 Impact Factor
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    ABSTRACT: Abstract OBJECTIVE: Previous studies have indicated varying rates of HIV infection among labor migrants to the United States of America. Most of these studies have been conducted with convenience samples of farmworkers, thus presenting limited external validity. This study sought to estimate the prevalence of HIV infection and risk factors among Mexican migrants traveling through the border region of Tijuana, Baja California, Mexico, and San Diego, California, United States. This region handles 37% of the migrant flow between Mexico and the United States and represents the natural port of entry for Mexican migrants to California. METHODS: From April to December 2002 a probability survey was conducted at key migrant crossing points in Tijuana. Mexican migrants, including ones with a history of illegal migration to the United States, completed an interview on HIV risk factors (n = 1 429) and an oral HIV antibody test (n = 1,041). RESULTS: Despite reporting risk factors for HIV infection, none of the migrants tested positive for HIV. CONCLUSIONS: Our findings contrast with previous estimates of HIV among labor migrants in the United States that were based on nonprobability samples. Our findings also underline the need for early HIV prevention interventions targeting this population of Mexican migrants. Source: PubMed
    Salud Publica de Mexico. 01/2003; 3(45):315-325.
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    ABSTRACT: Objetivo. Analizar las tasas de mortalidad por cáncer cervicouterino en las poblaciones urbanas y rurales de las regiones y entidades federativas de México, y su relación con factores relacionados con la pobreza, durante el periodo de 1990 a 2000. Material y métodos. Se analizaron las bases de datos de población del Instituto Nacional de Estadística, Geografía e Informática, las estimaciones de población del Consejo Nacional de Población para el periodo de 1990 a 2000 y las Estadísticas Vitales de Mortalidad registradas por la Secretaría de Salud y el Instituto Nacional de Estadística, Geografía e Informática. Estos datos fueron analizados para obtener tendencias de mortalidad, y se obtuvieron variaciones regionales para el mismo periodo usando un modelo de regresión de Poisson, de acuerdo con la localidad (urbanorural). Resultados. Para el periodo de 1990 a 2000 se reportaron oficialmente un total de 48 761 defunciones por cáncer cérvicouterino en México, iniciado en 1990 con 4 280 muertes en el año y terminado con 4 620 en el 2000, lo que representa en promedio 12 mujeres fallecidas cada 24 horas, con un crecimiento promedio anual de los casos absolutos de mortalidad por cáncer cervicouterino de 0.76%. Las mujeres que viven en el área rural tienen 3.07 veces mayor riesgo de mortalidad por este cáncer, en comparación con las mujeres residentes en el área urbana. Comparando las tasas de mortalidad por cáncer cervicouterino de las entidades federativas respecto al Distrito Federal se encontró un mayor riesgo en estados con menor desarrollo económico y social, como Chiapas, con un RR de 10.99 y Nayarit, con un RR de 10.5. Se observó que los riesgos de mortalidad en las entidades con mayor predominio rural aumentan considerablemente respecto al Distrito Federal, el cual posee el menor porcentaje de población rural en el país. Conclusiones. Los resultados muestran que la mortalidad por cáncer cervicouterino se encuentra relacionada con los factores presentes en la pobreza como son la falta de escolaridad, el desempleo, el bajo nivel socioeconómico, la residencia en áreas rurales y la falta de acceso efectivo a los servicios de salud. En México, este cáncer es un problema de género y equidad, por lo que debe impulsarse la eliminación de disparidades regionales en la detección de cáncer. Este artículo también está disponible en: http:// www.insp.mx/salud/index.html
    Salud publica de Mexico 12/2002; · 0.94 Impact Factor
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    ABSTRACT: Mortality due to cervical cancer (CC) has decreased in developed countries given extensive screening and effective coverage. In developing countries mortality rates due to CC remain high. Since the mid-nineties there has been a decrease in mortality due to CC in Mexico, which can be attributed to the increase in coverage of the Papanicolaou (PAP) (beta -.195, IC95% -.274, -.117) and the decrease in the birth rate (beta -.407, IC95% -.632, -.182). The use of the PAP in conjunction with an HPV test within the early CC detection program would have a synergistic effect; HPV testing should be combined with the Pap test. Primary prevention of CC is possible with the HPV vaccine. This vaccine will be an additional tool for reducing CC-related morbidity and mortality, but will not replace screening and treatment. To adopt a prevention policy that includes an HPV vaccine we will need to: determine the burden of HPV-related disease; have sufficient epidemiological evidence and data about technical aspects of the vaccine; take into account the psyschosocial and ethical aspects of the vaccine and guarantee good organization of vaccine implementation.
    Gaceta medica de Mexico 142 Suppl 2:43-9. · 0.13 Impact Factor

Publication Stats

57 Citations
16.73 Total Impact Points

Institutions

  • 2009
    • Instituto Nacional de Salud Pública
      • The Center for Population Health Research
      Cuernavaca, Morelos, Mexico
  • 2002–2003
    • El Colegio de la Frontera Norte
      Tia Juana, Baja California, Mexico