Integrated preventive care coverage effectiveness in high-risk worksites in Mexico

Abstract

Worksites have been considered a propitious environment for promoting health. In 2005, an integrated preventive care (IPC) system was implemented in Mexico consisting of health promotion and disease prevention interrelated activities, delivered on a single visit and on location. This project contributes relevant information on IPC coverage and its degree of effectiveness on providing health promotion services to workers at high-risk worksites. There were included 68 worksites particularly affected by high fatal and nonfatal injury rates; the target population comprised 45,724 workers. Coverage referred to the completion of IPC actions within the last year, and effectiveness was defined as the extent to which an observed IPC coverage came close to an ideal IPC coverage. Means and 95% confidence intervals (CI) were calculated for given estimates. Overall IPC mean coverage effectiveness was 61.2% (95% CI 60.8-61.6), a value below satisfactory range limits. Results broken down by sex and age showed higher mean coverage effectiveness for adult working men than adult working women (p < 0.0001). Promotion of reproductive health was the IPC process with the lowest mean coverage effectiveness (51.8%; 95% CI 50.8-52.7), followed by the disease detection process (59.0%; 95% CI 58.4-59.6) and the disease prevention and control process (61.0%; 95% CI 60.5-61.5). Maintaining the health of the workforce poses a significant challenge for health services. Therefore, analysis of coverage effectiveness represents a useful tool for evaluating and reorganizing preventive medicine care at worksites.