Supply prescription filling and out-of-pocket expenditures on medicines in public hospitals in Mexico in 2009

Objective. To analyze the availability of drugs in public hospitals, the prescription-filling patterns for in-patients when they are discharged and their out-of-pocket expenditure during their hospitalization. Material and Methods. Using the National Satisfaction and Responsiveness Survey (ENSATA) 2009, which includes a representative sample of public hospitals in Mexico in 2009, the availability of 83 essential medicines in the hospital pharmacies at the day of visit, the proportion of prescriptions completely filled for patients when they are discharged and their out-of-pocket expenditure during their hospitalization were analyzed. Results. A total of 26 271 patients in 160 public hospitals were interviewed. The mean availability of drugs was 82% for all hospitals, with the lowest availability for the Ministry of Health (SESA) hospitals (77%, with a range of 30 to 96%). Patients discharged at social security hospitals received in 97% of cases a complete prescription filling, while in SESA hospitals the average was only 56.2%, with a large variance among states (13 to 94%). The median inpatient spending was 150 pesos in national currency (1% spent over 10 000 pesos). Conclusions. The lack of medicines in public hospitals may increase in-patient morbidity and mortality and has an economic impact on household spending, particularly in those with scarce resources.