Health care utilization among older Mexicans: Health and socioeconomic inequalities

Maryland Population Research Center, University of Maryland, College Park, MD 20742, USA.
Salud publica de Mexico (Impact Factor: 0.94). 02/2007; 49 Suppl 4(Suppl 4):S505-14. DOI: 10.1590/S0036-36342007001000010
Source: PubMed

ABSTRACT To examine the determinants of the utilization of health care services among the population of older adults in Mexico. Three types of health care services are analyzed: preventive care, visits to the doctor, and hospitalizations.
Data was used from the 2001 Mexican Health and Aging Study (MHAS/ENASEM) and estimates were made using multivariate probit regression methods.
Socioeconomic factors, health conditions reported by the individuals, and the availability of health insurance are significant determinants of the differential use of services by older adults.
Specific health conditions are important determinants of use of the various types of health care services. For all three types, however, the availability of health insurance is an enabling factor of health care use. Older age is associated with greater propensity to use health care services but its effect is small when controlling for health conditions.

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    • "Urban areas have more extensive and developed formal labour markets with access to social security services and a greater variety of private health services. In contrast, the majority of the labour market in rural areas is informal, resulting in a less extensive presence of social insurance services and more participation of the MoH health services [40]. "
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    ABSTRACT: A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization). Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the remaining income-related healthcare utilization differences, the differences in quality between public and private health services, and the general perception that MoH facilities offer inferior services.
    BMC Public Health 10/2011; 11:771. DOI:10.1186/1471-2458-11-771 · 2.26 Impact Factor
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    • "In terms of geographical areas, 7 out of every 100 rural women, 17 out of every 100 peri-urban women and 19 out of every 100 urban women possessed health insurance coverage, which reinforced the aforementioned findings that income plays a critical role in health insurance coverage and health status. These results are not in agreement with findings from a study by Wong and Diaz[27], who found that almost three-quarters of the urban population (73%) have coverage compared to 38% of those in rural areas; women showed a slightly higher and similar coverage (56%) than men (52%). Bennett et al.[28] postulated that rural residents were more likely to be uninsured than urban residents (17.8% versus 15.3%), and that rural respondents were more likely than urban counterparts to report having deferred health care because of cost (15.1% versus 13.1%). "
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    ABSTRACT: A comprehensive review of the literature revealed that less information is available in literature on health status of women, and health status of women in 3 geographical zones in Jamaica. This study examined data on the health status of women in Jamaica in order to provide some scientific explanation of those factors that account for their health status; and differences based on area of residence. The sub-sample for the current study was 8,541 women ages of 15 and 100 years extracted from a national survey of 25,018 respondents. Stratified random sampling technique was used to draw the sample. Data were stored, retrieved and analyzed using SPSS 16.0. Descriptive statistics were used to provide background information on the subsample, and logistic regressions were utilized to model health statuses. Rural women had the lowest health status (OR = 0.819, 95% CI = 0.679-0.989) among all women (peri-urban OR = 1.054, 95% CI = 0.842-1.320; urban OR = 1.00) and that they were the least likely to have health insurance coverage. Health insurance was the critical predictor of good health status of women in Jamaica, and this was equally the same across the 3 geographic areas; and that married women were 1.3 times more likely (OR 1.3, 95 CI = 1.036-1.501) to report good health compared to those who were never married. This study provides an understanding of women's health status in Jamaica as well as the disparity which correlates based on the different geographical regions.
    North American Journal of Medical Sciences 10/2009; 1(5):256-71. DOI:10.4297/najms.2009.5256
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    • "Recent publications show that access to health insurance in Mexico increases the use of conventional health care services, more specifically of doctor visits, hospitalization, and preventive exams (Wong and Díaz, 2007; Pagán, Puig and Soldo, 2007) and reduces the use of alternative and traditional medicine (Van Gameren, 2010). Hence, for Mexicans living in Mexico, a substitution away from non-proven methods toward conventional medical services is found. "
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    ABSTRACT: We analyze the effect of health insurance coverage on the utilization of services to heal an illness or injury, ranging from visits to conventional health care providers in general and psychiatrists and dentists in particular, to the use of folk healers and prayers. The data are from the Hispanic Healthcare Survey conducted in 2007 among Latin Americans living in the USA. We account for potential endogeneity of insurance, acknowledging that confounding factors may affect both insurance purchase and services use; however, endogeneity does not appear to be problematic. Findings confirm that Latin Americans with insurance coverage are more likely to visit conventional health care providers, an effect that is also found for psychiatrists and dentists. We find a reduction of the probability to visit a folk healer, suggestion substitution of alternative for regular methods. An increase of the probability that others prayed for one's recovery is found, suggesting complementarity.
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