Composite Index of Health Indicators and Typology of the Mexican States Using and Extending the Performance Interval Approach

Jesus A. Trevino-Cantu
Statistika, 106(3): 353–371
https://doi.org/10.54694/stat.2025.59

Abstract

This study employs a performance-interval approach to assess health performance across Mexico's 32 states, addressing limitations of traditional single-value indices. Using OECD-selected indicators covering resources, health status, and risks, the methodology calculates a midpoint (MP) for average performance and an amplitude (A) for the balance of internal indicators. Extending this approach, the research develops a typology classifying states based on MP and A values to guide policy. Results reveal significant regional inequalities and institutional fragmentation; for instance, Mexico City exhibits high resource density yet high mortality rates due to its fragmented institutions. The analysis identifies four state groups, ranging from robust systems to those facing severe risks and uncertainty. By capturing internal disparities often obscured by single-value indices, the extended approach incorporates health system fragmentation into a composite index and a typology, as identified analytically in the current literature. The findings suggest that effective policy requires addressing resource scarcity and institutional coordination to reduce health disparities and improve outcomes across regions.

Keywords
Composite index; Performance interval; Health indicators; Health fragmentation; Mexico