Since 1999, Mexico’s path to implementing international hospital certification or accreditation standards and adopting policies of measureable results for quality, patient safety and clinical outcomes at private hospitals have been legislated, effective January 2009 with current revisions enacted in 2012.
Due to changes in global health, countries exploring the manner in which to elevate their standards of care and the growing opportunities to attract medical tourism, in 1999, Mexico’s General Health Council (Consejo de Salubridad General) began preparing a certification program for domestic hospitals.
Mexico’s General Health Council (Consejo de Salubridad General)
The General Health Council (GHC) in Mexico is a decentralized organization reporting directly to the president. GHC’s road to creating a national certification program for hospitals has evolved over time. As a member of the Pan American Health Organization (PAHO), a working group was formed in 1999 in an attempt to create national hospital certification standards with international standards as the benchmark for their respective countries. However, because the certification process was not compulsory and merely voluntary, many hospitals, public and private, chose not to certify their hospitals.
However, in 2007, GHC established criteria for medical institutions and organizations and, in 2008, created the National Certification System for Medical Care Organizations (Sistema Nacional de Certificación de Establecimientos de Atención Medica (SiNaCEAM).
Hospital certification requires healthcare organizations comply with the necessary standards to provide quality medical care, patient safety and continuous improvement. Certification requirements had a two-prong approach:
1) Meet international standards focused on the patient, medical care management and goals for patient safety;
2) Create national standards focused on the patient, medical care management and information systems.
Benefits of JCI accreditation may provide an American patient with peace of mind providing the means to evaluate whether a physician or hospital is credible and provides the level of care to which they are accustomed.
Hospital Certification (Accreditation)
Many states and the U.S. government require hospitals to be accredited by the Joint Commission (formerly known as Joint Commission of Accreditation of Health Care Organizations or JCAHO), the largest accreditation organization in the country, in order to contract with insurance companies or receive payment by Medicare.
In addition, as the primary hospital accreditation organization, accreditation is a condition of licensure for hospitals providing patients and physicians confidence in the quality of care offered at those facilities.
As of 2009, Mexico is the only country to have signed a formal agreement with JCAHO adopting U.S. hospital standards for national hospital certification, the Mexican equivalency to JCAHO accreditation. All private hospitals in Mexico are required to obtain national certification. In addition, once certification is obtained, those hospitals operate with procedures and audit practices comparable to JCAHO standards.
Furthermore, the Mexican Hospital Association signed an agreement with GHC prohibiting Mexican health insurers to pay hospitals for insurance claims unless they are certified; thereby, compelling Mexican hospitals to obtain and maintain their national hospital certification.
It is of primary importance for an individual considering medical travel to ensure that the hospital where the procedure will be performed is nationally certified. In 2011, only 6 percent of private hospitals in Mexico were certified.
According to GHC, as of February 2013, 85 percent of private hospitals and 14.7 percent of public hospitals were certified. The majority of hospitals were in large urban centers: Mexico City, the states of Mexico, Puebla, Jalisco and Nuevo Leon.
International Accreditation
As of April 2014, seven private hospitals in Mexico are internationally accredited through Joint Commission International (JCI), JCAHO’s international arm. JCI established international standards comparable to JCAHO taking into account cultural issues of hospitals abroad. Although international accreditation is often used for marketing purposes to demonstrate that a higher level of quality is provided, the reality is that JCI accreditation has no legal standing in Mexico.
Licensure and national certification are what insurance companies traditionally examine for their contracting criteria in Mexico. However, in order to mitigate risk, foreign health insurers should require that hospitals have national certification.
Benefits of JCI accreditation may provide an American patient with peace of mind providing the means to evaluate whether a physician or hospital is credible and provides the level of care to which they are accustomed.
Case in Point
Mexican hospitals are undergoing a cultural evolution due to GHC hospital certification requirements. Mexico City’s Sports Clinic is privately owned and provides ambulatory surgical services at three locations. To meet new certification goals, its largest hospital was remodeled with a complete overhaul of the operating rooms, preoperative/post-operative areas, patient suites and the rehabilitation floor.
With a focus on quality of care and patient safety, Diana Rangel, quality director at Sports Clinic, indicated that compliance with and the implementation of new standards required training and the hiring of additional staff who were highly qualified to meet patient needs.
and trauma surgeon and Sports Clinic CEO and chief medical officer, ensured that all processes within its hospitals focus on quality and patient safety. In addition, Dr. Zarur and his team implemented a “Performance Improvement, Quality and Patient Safety Plan” with quality and safety measures as a means to monitor performance within Sports Clinic facilities as permanent policy.
When Sports Clinic’s largest facility at the World Trade Center received CHG national certification, the hospital also met CHG’s International Patient Safety Goals, which require compliance with quality improvement and patient safety protocols. Moreover, Sports Clinic requires medical staff have board certification in specialties (orthopedics, plastic surgery, general surgery), thereby providing another level of comfort for patients at its facilities.
Dr. Zarur believes national hospital certification creates “continuous improvement in the quality of medical care delivered, essential patient safety, and that participating healthcare institutions obtain a competitive advantage by maintaining and/or improving their position in the healthcare market.”
His team believes its institutional image is strengthened demonstrating that standards and current regulations are in compliance, which is determined by an independent body, the CHG.
American Medical Travel to Mexico
According to Forbes magazine, Mexico is “convenient and affordable” and a natural choice for medical tourism due to its proximity to the United States. Mexico is the leading destination for medical travel by Americans, according to the Center for Medical Tourism Research. In addition, Americans now comprise two-thirds of the one million documented foreigners in Mexico with more than 70,000 Americans working as of 2012.
Many of these aging American baby boomers have purchased homes and may require medical attention. Dallasbased D Magazine’s “Why International Medical Tourism is growing?” cited two important factors determining whether an American patient would consider medical travel: affordability of procedures and confidentiality/privacy.
An Informed Consumer
A potential patient, domestic or international, who is researching Mexican healthcare institutions, should ensure the hospital is nationally certified. As savvy American consumers explore options for an elective medical procedure utilizing Internet search engines and social media websites, they should ensure that both the physician is board certified in a specialty and the hospital is nationally certified.
Certification will provide the consumer with information based on measurable results in quality, patient safety and clinical outcomes, which is of primary importance to any consumer exploring a medical procedure in Mexico or elsewhere.
About the Author
Rosanna Gomez Moreno is a Texas licensed attorney and partner at McMains & Moreno Global Consultants, L.L.C., a consulting and project development company that advises companies, developers and governments focused on Latin American markets.
She participates in global healthcare and medical tourism conferences around the world.
She has a B.A. from the University of Texas at San Antonio, an M.A. in International Relations from St. Mary’s University and a J.D. from South Texas College of Law in Houston. rmoreno@mcmainsmoreno.com
