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Article first published online: 8 AUG 2012
Copyright © 2012 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 60, Issue 2, pages 196–203, February 2013
How to Cite
Pérez-Cuevas, R., Doubova, S. V., Zapata-Tarres, M., Flores-Hernández, S., Frazier, L., Rodríguez-Galindo, C., Cortes-Gallo, G., Chertorivski-Woldenberg, S. and Muñoz-Hernández, O. (2013), Scaling up cancer care for children without medical insurance in developing countries: The case of Mexico. Pediatr. Blood Cancer, 60: 196–203. doi: 10.1002/pbc.24265
Conflict of interest: Nothing to declare.
Authors' contributions: Ricardo Pérez-Cuevas conceptualized and designed the study, coordinated the fieldwork, wrote the paper, and did the manuscript final version approval. Svetlana Doubova did the literature review, reviewed the database, did statistical analysis and interpretation of the data, and contributed in drafting the paper. Marta Zapata-Tarres contributed in the design of the study, developed the data collection instruments, did the field staff training, and revised critically the paper. Sergio Flores-Hernández did the statistical analysis and interpretation of the results. Lindsay Frazier reviewed the results of the study and revised critically the paper for important intellectual content. Carlos Rodriguez-Galindo reviewed the results of the study and revised the paper critically for important intellectual content. Gabriel Cortes-Gallo participated in the conception of the study, reviewed the results, and did the manuscript final approval. Salomon Chertorivski-Woldenberg participated in the conception of the study and did the manuscript final approval. Onofre Muñoz-Hernández participated in the conception and design of the study, and did the manuscript final approval.
- Issue published online: 14 DEC 2012
- Article first published online: 8 AUG 2012
- Manuscript Accepted: 2 JUL 2012
- Manuscript Received: 10 MAY 2012
- Unknown funding agency
- The System for Social Protection for Health
- childhood cancer;
- developing countries;
- survival experience
In 2006, the Mexican government launched the Fund for Protection Against Catastrophic Expenditures (FPGC) to support financially healthcare of high cost illnesses. This study aimed at answering the question whether FPGC improved coverage for cancer care and to measure survival of FPGC affiliated children with cancer.
A retrospective cohort study (2006–2009) was conducted in 47 public hospitals. Information of children and adolescents with cancer was analyzed. The coverage was estimated in accordance with expected number of incident cases and those registered at FPGC. The survival was analyzed by using Kaplan–Meier survival curves and Cox proportional hazards regression modeling.
The study included 3,821 patients. From 2006 to 2009, coverage of new cancer cases increased from 3.3% to 55.3%. Principal diagnoses were acute lymphoblastic leukemia (ALL, 46.4%), central nervous system (CNS) tumors (8.2%), and acute myeloid leukemia (AML, 7.4%). The survival rates at 36 months were ALL (50%), AML (30.5%), Hodgkin lymphoma (74.5%), Non-Hodgkin lymphoma (40.1%), CNS tumors (32.8%), renal tumors (58.4%), bone tumors (33.4%), retinoblastoma (59.2%), and other solid tumors (52.6%). The 3-year overall survival rates varied among the regions; children between the east and south-southeast had the higher risks (hazard ratio 3.0; 95% CI: 2.3–3.9) and 2.4; 95% CI: 2.0–2.8) of death from disease when compared with those from the central region.
FPGC has increased coverage of cancer cases. Survival rates were different throughout the country. It is necessary to evaluate the effectiveness of this policy to increase access and identify opportunities to reduce the differences in survival. Pediatr Blood Cancer 2013;60:196–203. © 2012 Wiley Periodicals, Inc.