{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T18:03:41Z","timestamp":1759514621362,"version":"3.37.3"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Comisi\u00f3n Nacional de Protecci\u00f3n Social en Salud","award":["RPCISP\/1502"],"award-info":[{"award-number":["RPCISP\/1502"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The \u2018Seguro M\u00e9dico Siglo XXI\u2019 (SMSXXI), a universal coverage medical insurance programme for children under 5\u2009years of age, started in 2006 to help avoid catastrophic health expenditures in poor families without social security in Mexico. The study used information from the National Health Information System for the 2006\u201314 period. An ecological approach was followed with a panel of the 2457 municipalities of Mexico as the units of analysis. The outcome variables were the municipality-level neonatal mortality and infant mortality rates in population without access to social security. The programme variable was the coverage of the SMSXXI programme at the municipality level, expressed as a proportion. Demographic and economic variables defined at the municipality level were included as covariates. Impact was estimated by fitting a fixed-effects negative binomial regression model. Results reveal that the SMSXXI significantly reduced both infant and neonatSal mortality in the target population, although in a non-linear fashion, with minimum mortality levels found around the 70% coverage range. The effect is mostly given by the transition from the first quintile to the fourth quintile of coverage (&amp;lt;13% vs 70.5\u201393.7% coverage), and it is attenuated significantly at coverage levels very close to or at 100%. The observed risk reduction amounted to an estimated total of 11 358 infant deaths being avoided due to the SMSXXI during the 2006\u201314 period, of which 48% were neonatal. In conclusion, we found a significant impact of the SMSXXI programme on both infant mortality and neonatal mortality. An attenuation of the effect of the insurance on mortality rates at levels close to 100% coverage may reflect the saturation of health units in detriment of the quality of care.<\/jats:p>","DOI":"10.1093\/heapol\/czaa013","type":"journal-article","created":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T20:10:44Z","timestamp":1581624644000},"page":"609-615","source":"Crossref","is-referenced-by-count":2,"title":["Impact of the \u2018Seguro M\u00e9dico Siglo XXI\u2019 medical insurance programme on neonatal and infant mortality in Mexico, 2006\u201314: an ecological approach to estimation"],"prefix":"10.1093","volume":"35","author":[{"given":"Jos\u00e9","family":"Urquieta-Salom\u00f3n","sequence":"first","affiliation":[{"name":"Directorate of Indicators and Analysis of Governmental Information, National Institute of Statistics and Geography, Av. Patriotismo 711A, Benito Ju\u00e1rez, 03730, Ciudad de M\u00e9xico, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8775-8399","authenticated-orcid":false,"given":"H\u00e9ctor","family":"Lamadrid-Figueroa","sequence":"first","affiliation":[{"name":"Department of Perinatal Health, National Institute of Public Health (INSP), Av. Universidad 655, 62440, Cuernavaca, MOR, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo","family":"Angeles","sequence":"first","affiliation":[{"name":"Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandra","family":"Montoya","sequence":"first","affiliation":[{"name":"Department of Perinatal Health, National Institute of Public Health (INSP), Av. Universidad 655, 62440, Cuernavaca, MOR, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalba","family":"Rojas-Mart\u00ednez","sequence":"first","affiliation":[{"name":"Department of Perinatal Health, National Institute of Public Health (INSP), Av. Universidad 655, 62440, Cuernavaca, MOR, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Mart\u00ednez-Nolasco","sequence":"first","affiliation":[{"name":"Department of Perinatal Health, National Institute of Public Health (INSP), Av. Universidad 655, 62440, Cuernavaca, MOR, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Torres-Pereda","sequence":"first","affiliation":[{"name":"Department of Perinatal Health, National Institute of Public Health (INSP), Av. Universidad 655, 62440, Cuernavaca, MOR, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"O\u2019Shea","sequence":"first","affiliation":[{"name":"Secretar\u00eda de Salud del Estado de M\u00e9xico, Av. Independencia 5 Ote. 1009, Reforma y FFCC Nacionales, 50070 Toluca de Lerdo, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor M","family":"Villagr\u00e1n","sequence":"first","affiliation":[{"name":"Comisi\u00f3n Nacional de Protecci\u00f3n Social en Salud, Secretar\u00eda de Salud, Calle Gustavo E. Campa 54, Guadalupe Inn, \u00c1lvaro Obreg\u00f3n, 01020 Ciudad de M\u00e9xico, CDMX, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Halley","sequence":"first","affiliation":[{"name":"Comisi\u00f3n Nacional de Protecci\u00f3n Social en Salud, Secretar\u00eda de Salud, Calle Gustavo E. Campa 54, Guadalupe Inn, \u00c1lvaro Obreg\u00f3n, 01020 Ciudad de M\u00e9xico, CDMX, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ver\u00f3nica","family":"Delgado-S\u00e1nchez","sequence":"first","affiliation":[{"name":"Comisi\u00f3n Nacional de Protecci\u00f3n Social en Salud, Secretar\u00eda de Salud, Calle Gustavo E. Campa 54, Guadalupe Inn, \u00c1lvaro Obreg\u00f3n, 01020 Ciudad de M\u00e9xico, CDMX, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Lazcano-Ponce","sequence":"first","affiliation":[{"name":"Department of Perinatal Health, National Institute of Public Health (INSP), Av. 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