2024, Number 1
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salud publica mex 2024; 66 (1)
Adolescent use of outpatient health services in Mexico: their health needs and associated factors
Ávila-Burgos L, Montañez-Hernández JC, Cerecer-Ortiz N, Hubert C, Heredia-Pi I, Suárez-López L, Villalobos A
Language: English
References: 33
Page: 25-36
PDF size: 363.20 Kb.
ABSTRACT
Objective. To estimate adolescent use of outpatient
services, identifying their health needs and associated socioeconomic
factors.
Materials and methods. Using
data from Ensanut 2018-2019, adolescents (ages 10-19) with
health needs and those receiving care from health personnel
(users) were identified. Needs were analyzed by sex and
socioeconomic status (SES). Logistics models were used to
assess the factors associated with the use of health care and
choice of provider.
Results. 6% of adolescents reported
health needs, of whom 64% used outpatient services. Respiratory
and gastrointestinal infections were the principal
health needs prompting use of services overall. However, by
SES, motivations centered on pregnancy for the poor and
accidental injuries for the wealthy. One in three adolescents
with health needs, particularly the poorest, received no care.
Living with a partner and having health insurance were the
main predictors of use. Greater schooling among household
heads and higher SES correlated with the use of private
services.
Conclusions. Despite being aware of their health
needs, adolescents are the group that uses health services
the least in Mexico. Promoting preventative and timely treatment
for this population would encourage youths to seek
care more often.
REFERENCES
World Health Organization. Coming of age: adolescent health [Internet].Geneva: WHO, 2019 [cited March 2023]. Available from: https://www.who.int/news-room/spotlight/coming-of-age-adolescent-health
Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al.Our future: a Lancet commission on adolescent health and wellbeing.Lancet. 2016;11;387(10036):2423-78. https://doi.org/10.1016/S0140-6736(16)00579-1
Marmot M. Social determinants of health inequalities. Lancet.2005;365(9464):1099-104. https://doi.org/10.1016/S0140-6736(05)71146-6
Carrilero N, Dalmau-Bueno A, García-Altés A. Socioeconomicinequalities in 29 childhood diseases: evidence from a 1,500,000 childrenpopulation retrospective study. BMC Public Health. 2021;21(1). https://doi.org/10.1186/s12889-021-11230-9
Shakya HB, Domingue B, Nagata JM, Cislaghi B, Weber A, DarmstadtGL. Adolescent gender norms and adult health outcomes in the USA: aprospective cohort study. Lancet Child Adolesc Health. 2019;3(8):529-38.https://doi.org/10.1016/S2352-4642(19)30160-9
Instituto Nacional de Estadística y Geografía. Población total porentidad federativa y grupo quinquenal de edad según sexo, serie de añoscensales de 1990 a 2020. Mexico: Inegi [cited March 2023]. Available from:https://www.inegi.org.mx/app/tabulados/interactivos/?pxq=Poblacion_Poblacion_01_e60cd8cf-927f-4b94-823e-972457a12d4b
Shamah-Levy T, Vielma-Orozco E, Heredia-Hernández O, Romero-Martínez M, Mojica-Cuevas J, Cuevas-Nasu L, et al. Encuesta Nacional deSalud y Nutrición 2018-19: Resultados Nacionales. Cuernavaca: InstitutoNacional de Salud Pública, 2020 [cited March 2023]. Available from:https://ensanut.insp.mx/encuestas/ensanut2018/doctos/informes/ensanut_2018_informe_final.pdf
Gobierno de México. Anuario de Morbilidad 1984-2022. Morbilidad porgrupo de edad. Mexico: Gobierno de México, 2021 [cited March 2023].Available from: https://epidemiologia.salud.gob.mx/anuario/html/morbilidad_grupo.html
Villalobos A, Hubert C, Hernández-Serrato MI, de la Vara-Salazar E,Suárez-López L, Romero-Martínez M, et al. Adolescent motherhood in under
100 000 inhabitants communities in the first decades of the millennium.Salud Publica Mex. 2019;61(6):742-52. https://doi.org/10.21149/1055310. Hidalgo-Solórzano E, Pérez-Núñez R, Mojarro FR, Vera-López JD, HíjarM. Non-fatal unintentional injuries in Mexican population: prevalence andassociated factors. Ensanut 2018-19. Salud Publica Mex. 2020;62(6):829-39.https://doi.org/10.21149/11563
Centro Nacional de Equidad de Género y Salud Reproductiva. Modelode Atención Integral a la Salud Sexual y Reproductiva para Adolescentes(MAISSRA). Mexico: Centro Nacional de Equidad de Género y Salud Reproductiva,2017 [cited March 2023]. Available from: https://www.gob.mx/salud/cnegsr/documentos/modelo-de-atencion-integral-a-la-salud-sexualy-reproductiva-para-adolescentes-maissra-135795
Knaul FM, Frenk J. Health insurance in Mexico: achieving universal coveragethrough structural reform. Health Aff (Millwood). 2005;24(6):1467-76. https://doi.org/10.1377/hlthaff.24.6.1467
Grupo Interinstitucional para la Prevención del Embarazo enAdolescentes. Estrategia Nacional para la Prevención del Embarazo enAdolescentes. Mexico: Gobierno de México, 2018 [cited March 2023].Available from: https://www.gob.mx/conapo/documentos/documentooficial-de-la-estrategia
Bautista-Arredondo S, Serván-Mori E, Colchero MA, Ramírez-RodríguezB, Sosa-Rubí SG. Analysis of outpatient healthcare utilization in thecontext of the universal healthcare coverage reform in Mexico. SaludPublica Mex. 2014;56(1):18-31 [cited March 2023]. Available from: https://www.saludpublica.mx/index.php/spm/article/view/7319/9594
Colchero MA, Gómez R, Bautista-Arredondo S. Characterization ofthe “primary health care cascade” in public services in Mexico in localitieswith less than 100 000 inhabitants. Salud Publica Mex. 2019;61(6):734-41.https://doi.org/10.21149/10570
Villalobos A, de Castro F, Rojas R, Allen B. Contraception in Mexicanadolescents in upper secondary schools: use and unmet needs. SaludPublica Mex. 2017;59(5):566-76. https://doi.org/10.21149/8481
Adongo W, Asaarik MJ. Health seeking behaviors and utilization ofhealthcare services among rural dwellers in under-resourced communitiesin Ghana. Int J Caring Sci. 2018;11(2):840-50 [cited March 2023]. Availablefrom: https://www.internationaljournalofcaringsciences.org/docs/25_adongo_original_10_2.pdf
Bradshaw J. A taxonomy of social need. In: Mclachlan G, ed. Problemsand progress in medical care: essays on current research, volume 7thseries. London: Oxford University Press, 1972.
Rodriguez-Santana I, Mason A, Gutacker N, Kasteridis P, Santos R, RiceN. Need, demand, supply in health care: working definitions, and theirimplications for defining access. Health Econ Policy Law. 2023;18(1):1-13.https://doi.org/10.1017/S1744133121000293
Levesque JF, Harris MF, Russell G. Patient-centred access to health care:conceptualising access at the interface of health systems and populations.Int J Equity Health. 2013;12. https://doi.org/10.1186/1475-9276-12-18
World Health Organization. Handbook for conducting an adolescenthealth services barriers assessment (AHSBA) with focus on disadvantagedadolescents. Geneva: WHO, 2019 [cited March 2023]. Available from:https://www.who.int/publications/i/item/9789241515078
Romero-Martínez M, Shamah-Levy T, Vielma-Orozco E, Heredia-Hernández O, Mojica-Cuevas J, Cuevas-Nasu L, et al. National Health andNutrition Survey 2018-19: methodology and perspectives. Salud PublicaMex. 2019;61(6):917-23. https://doi.org/10.21149/11095
Ávila-Burgos L, Montañez-Hernández JC, Cerecer-Ortiz N, Hubert C,Heredia-Pi I, Suárez-López L, Villalobos A. Adolescent use of outpatienthealth services in Mexico: their health needs and associated factors.Appendix. Health needs prompting the search for care by category:adolescents using outpatient services, Ensanut 2018-19. Fisgshare, 2023.https://doi.org/10.6084/m9.figshare.24201486.v1
Stierman EK, Kalbarczyk A, Oo HNL, Koller TS, Peters DH. Assessingbarriers to effective coverage of health services for adolescents inlow- and middle-income countries: a scoping review. J Adolesc Health.2021;69(4):541-8. https://doi.org/10.1016/j.jadohealth.2020.12.135
Instituto Nacional para la Evaluación de la Educación. PanoramaEducativo de México. Indicadores del Sistema Educativo Nacional2018. Educación básica y media superior. Mexico: INEE, 2019 [citedMarch 2023]. Available from: https://www.inee.edu.mx/wp-content/uploads/2019/08/P1B117.pdf
Lister NB, Baur LA, Felix JF, Marcus C, Reinehr T, Summerbell C,Wabitsch M. Child and adolescent obesity. Nat Rev Dis Primers. 2023;9(1).https://doi.org/10.1038/s41572-023-00435-4
Boerma T, Hosseinpoor AR, Verdes E, Chatterji S. A global assessmentof the gender gap in self-reported health with survey data from 59countries. BMC Public Health. 2016;16. https://doi.org/10.1186/s12889-016-3352-y
World Health Organization. Mental Health Atlas 2020. Geneva:WHO, 2021 [cited March 2023]. Available from: https://www.who.int/publications/i/item/9789240036703
Gutiérrez JP, Rivera-Dommarco J, Shamah-Levy T, Villalpando-Hernández S, Franco A, Cuevas-Nasu L, et al. Encuesta Nacional de Saludy Nutrición 2012. Resultados Nacionales. Cuernavaca: Instituto Nacionalde Salud Pública, 2012 [cited March 2023]. Available from: https://ensanut.insp.mx/encuestas/ensanut2012/doctos/informes/ENSANUT2012ResultadosNacionales.pdf
30.Tylee A, Haller DM, Graham T, Churchill R, Sanci LA. Youth-friendlyprimary-care services: how are we doing and what more needs to bedone? Lancet. 2007;369(9572):1565-73. https://doi.org/10.1016/S0140-6736(07)60371-7
Perez-Amador J, Giorguli S. Child marriage and early transitions toadulthood in Mexico. In: Verma S, Petersen A, eds. Developmental scienceand sustainable development goals for children and youth. Social IndicatorsResearch Series, vol 74. Springer, Cham, 2018:239-56. https://doi.org/10.1007/978-3-319-96592-5_13
Pérez-Cuevas R, Doubova SV, Wirtz VJ, Servan-Mori E, Dreser A,Hernández-Ávila M. Effects of the expansion of doctors’ offices adjacent toprivate pharmacies in Mexico: secondary data analysis of a national survey.BMJ Open. 2014;4(5):1-11. https://doi.org/10.1136/bmjopen-2013-004669
Diario Oficial de la Federación. Acuerdo por el que se emite elModelo de Atención a la Salud para el Bienestar (MAS-Bienestar). MexicoCity: Secretaría de Gobernación, 25 octubre de 2022 [cited March 2023].Available from: https://www.dof.gob.mx/nota_detalle.php?codigo=5669707&fecha=25/10/2022#gsc.tab=0