Does the new public management contribute to improving the performance of obstetric care in Mexico public hospitals?

Resumen

In pursuit of higher performance in the Public Administration, the Mexican government implemented the New Public Management (NPM) model in 2008, with the aim of correcting deficiencies in its public services - including those of the Ministry of Health (MoH) -.  In ten years of work under the new model, no information has been provided on the effects of NPM on the performance indicators, such as effectiveness and efficiency, of government institutions. The present study had the objective to analyze the impact of the NPM on the effectiveness and efficiency of MoH care facilities. Effectiveness was evaluated as the proportion of hospital discharges (HD) indicating a recovery diagnosis, and efficiency as the average length of hospital stays, modeled with survival analysis and local kernel regression methods. Data analyzed pertained to a time series of 16.5 million obstetric HD (64% of total discharges) produced from 2000 to 2015. The results revealed high levels of effectiveness (98% of HD with recovery diagnosis) and efficiency (an average hospital stay of 1.74 days), before and after NPM. The consistently high performance throughout the period analyzed, indicate that MoH hospitals had attained optimal effectiveness and efficiency levels prior to the NPM implementation. The indistinctive impact of the public management reform may suggest that NPM was applied as a blanket solution without considering institutional specificities.