Utilization and purchase of medical care services in Mexico by residents in the United States of America, 1998-1999

ArticleinRevista Panamericana de Salud Pública 19(5):300-5 · June 2006with4 Reads
DOI: 10.1590/S1020-49892006000500002 · Source: PubMed
Abstract
We assessed self-reported frequency of purchase of medications and medical care services in Mexico by southern New Mexico (United States, [U.S.]) residents in relation to their medical insurance coverage. We analyzed data obtained in 1998 and 1999 from a health interview survey of residents in a six-county region of southern New Mexico, using prevalence and logistic regression methods for complex survey data. About 22% of southern New Mexico residents had purchased medications and 11% had sought medical care in Mexico at least once during the year preceding the survey. When we adjusted for the effects of other variables, persons able to pay for services out of pocket and those who were uninsured were more likely than persons who were fully covered to purchase medications or medical care in Mexico. Large numbers of people residing near the border in New Mexico traveled south to Mexico to purchase medications and medical care. Lack of medical insurance was associated with higher frequencies of these purchases. There seems to be a need to establish relationships between U.S. private and public care plans and Mexican medical care providers to identify appropriate mechanisms for U.S. residents to purchase medical care in Mexico.

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    • "The Texas Behavioral Risk Factor Survey revealed that in 2007, 38% of Texas Border residents had purchased medicines in Mexico during the previous year [31]. Escobedo and Cardenas [32] and Rivera et al. [33], using representative community survey data from two communities bordering Mexico, documented that 22% of residents in New Mexico's border counties and 33% of El Paso residents had purchased medicines in Mexico during the year prior to the survey. Researchers have reported that these rates are higher among the poor and uninsured [30, 34]. "
    [Show abstract] [Hide abstract] ABSTRACT: To study antibiotic dispensing to US and Mexican residents, at Mexican pharmacies at the US-Mexico border, and the pharmacy clerks' capability to promote appropriate use. The site selected was Ciudad Juarez, Chihuahua (pop. 1.2 million) separated from El Paso, Texas (pop. 800,000) by the Rio Grande River. A convenience sample of 32 pharmacies located near the international bridges, major shopping centers, and interior neighborhoods was selected. Pharmacy clients were interviewed (n=230) and 152 interactions between clients and pharmacy clerks were observed. Information was obtained about education and pharmaceutical training of 113 clerks working in 25 pharmacies. A senior pharmacy clerk in each of the 25 pharmacies was interviewed and asked for their recommendations to clients presenting two clinical scenarios and seven diagnoses. Professionally trained pharmacists only spend a few hours a week in some pharmacies. Clerks' education levels are very low; some have only completed primary education. There is no required pharmaceutical training and their knowledge about pharmaceuticals comes mostly from representatives of the pharmaceutical industry. Clerks' knowledge of antibiotics, the most frequently sold class of medicines (65% without prescription), is very limited. Clients trust pharmacy clerks and tend to follow their advice. The findings raise concerns about dispensing of antibiotics at Mexican border pharmacies and antibiotic overuse due to lack of control. Because inappropriate antibiotic use contributes to increased resistance, pharmacy clerks should receive independent training to dispense antibiotics and promote their appropriate use.
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    • "However, to what extent this finding holds in the case of cross-border utilization of health services is unclear. While previous studies have documented the importance of lack of U.S. health insurance in cross-border utilization of health services91011121314151617, little is known about the role of acculturation in this process. The issue of acculturation has particular relevance in explaining patterns of health care utilization in the U.S.- Mexico border area where the vast majority of the local population on the U.S. side of the border are of Mexican origin. "
    [Show abstract] [Hide abstract] ABSTRACT: Health services from Mexico constitute an important source of care for U.S. residents living along the U.S.-Mexico border. Data from The Cross-Border Utilization of Health Care Survey (n=966) were used to estimate logit models that related acculturation, as measured by generational status, to the use of medication, physician, dental, and inpatient services from Mexico by Mexican Americans in the Texas border region. Relative to first-generation Mexican immigrants, later-generation Mexican Americans were progressively less likely to go to Mexico for health services. This finding holds with or without adjusting for the effects of selected demographic and socioeconomic variables. Addressing unmet needs in medical care in the southwestern U.S. border area should go beyond a simple expansion of health insurance coverage ─ it is also important to deliver health services that are sensitive to generational differences within the population in terms of linguistic and cultural barriers to health care access.
    Full-text · Article · Aug 2012
    • "Indeed, the costs and benefits of transnational health seeking behaviors are not well understood among Hispanic populations [15]. Overwhelmingly, studies of transnational health service utilization have focused on the influence of health insurance status and cost and not other facilitating and risk factors161718 . Understanding how these behaviors may be linked to diet, health prevention, as well as the detection and treatment of illness and disease, will provide much needed insight into understanding the relationship between border-mobility and health along the US-Mexico border. "
    [Show abstract] [Hide abstract] ABSTRACT: Examination of border-specific characteristics such as trans-border mobility and transborder health service illuminates the heterogeneity of border Hispanics and may provide greater insight toward understanding differential health behaviors and status among these populations. In this study, we create a descriptive profile of the concept of trans-border mobility by exploring the relationship between mobility status and a series of demographic, economic and socio-cultural characteristics among mobile and non-mobile Hispanics living in the El Paso-Juarez border region. Using a two-stage stratified random sampling design, bilingual interviewers collected survey data from border residents (n = 1,002). Findings show that significant economic, cultural, and behavioral differences exist between mobile and non-mobile respondents. While non-mobile respondents were found to have higher social economic status than their mobile counterparts, mobility across the border was found to offer less acculturated and poorer Hispanics access to alternative sources of health care and other services.
    Full-text · Article · Feb 2011
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