Valencia-Mendoza A, Bertozzi SM

Language: English
References: 22
Page: 397-407
PDF size: 210.76 Kb.

ABSTRACT

Objectives. To estimate the degree to which individual and household variables jointly predict utilization of curative ambulatory services in Mexico for four types of health providers. Material and Methods. Patient choice of provider (selfcare, Ministry of Health, social security, or private provider) when they become ill is modeled using a nested multinomial logit model that uses household and individual variables as predictors. The data are from the Mexican National Health Survey conducted in 2000. Results. Being a social security beneficiary is one of the most important predictors of utilization. A strong positive relationship between socio-economic status (SES) and demand for services was also found, with the strongest relationship being for private providers, followed by social security. Utilization of Ministry of Health (MoH) services was negatively associated with household SES. Conclusions. Expansion of health insurance coverage should significantly reduce health inequalities due to reduced care-seeking by non-beneficiaries.

REFERENCES

1. Anil BD. Nutrition and Labor Productivity in Agriculture: Estimates for Rural South India. Rev Ec and Stat 1988;70(3):406-413.

2. Behrman JR, Anil BD. Health and Nutrition. In: Hollis BC, Srinivasan, ed.Handbook of Development Economics Vol.1. Amsterdam: North-Holland,1988:631-711.

3. Strauss J. Does Better Nutrition Raise Farm Productivity? Journal of Political Economy 1986;94:297-320.

4. Valdespino JL, Olaiz G, López-Barajas MP, Mendoza L, Palma O, Velázquez O, et al. Encuesta Nacional de Salud 2000, Tomo I: Vivienda, población y utilización de servicios de salud. Cuernavaca, México: Instituto Nacional de Salud Pública, 2003.

5. Barraza-Lloréns M, Bertozzi S, González-Pier E, Gutiérrez JP. Addressing inequity in health and health care in Mexico. Health Aff 2002;21(3):47-56.

6. Gómez de León J, Bloom E, Bitran R, Dow W, Straffon B, Orozco M.La demanda de servicios de salud en México: Un análisis econométrico. México: Conapo, 1995.

7. Zamudio A. La demanda por servicios médicos en México. México DF:Centro de Investigación y Docencia Económicas, AC. Documento de Trabajo Número 94, 1997.

8. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 1995;36:1-10.

9. Gertler P, van-der-Gaag J. The Willingness to pay for medical care: evidence from two developing countries. Baltimore: Johns Hopkins Press,1990.

10. Moshiro C, Heuch I, Nordrehaug-Astrom A, Stel P, Hemed Y,Kuale G. Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey. BMC Public Health 2005;5:11.

11. Instituto Nacional de Estadística, Geografía e Informática. Encuesta Nacional de Ingreso y Gasto de los Hogares, 2000. Mexico: Instituto Nacional de Estadística, Geografía e Informática, 2001.

12. Masako I. The demand for medical care: evidence from urban areas in Bolivia. Washington, D.C: The World Bank. Living Standards Measurement Study Working Paper Number 123, 1996.

13. Sahh DE, Younger SD, Genicot G. The demand for health care services in rural Tanzania. Oxf Bull Econ Stat 2003;65(2):241-260.

14. Aking JS, Guilkey DK, Denton EH. Quality of services and demand for health care in Nigeria: A multinomial probit estimation. Soc Sci Med 1995;40(11):1527-1537.

15. Wong EL, Popkin MB, Guilkey DK, Akin JS. Accessibility, quality of care and prenatal care use in the Philippines. Soc Sci Med 1987;24(11):927-944.

16. Greene, W. Análisis Econométrico. 3ª edición. Madrid: Prentice Hall, 1999.

17. Consejo Nacional de Población. Índice de marginación, 2000. Mexico:Consejo Nacional de Población, 2001.

18. Häkkinen U. Change in determinants of use of physician services in Finland between 1987 and 1996. Soc Sci Med 2002;55(9):1523-1537.

19. Mamadou M. Quality of care and the demand for health services in Bamako, Mali: the specific roles of structural, process, and outcome components. Soc Sci Med 2003;56(6):1183-1196.

20. Meer J, Rosen HS. Insurance and the utilization of medical services.Soc Sci Med 2004;58(9):1623-1632.

21. OCDE. Estudios de la OCDE sobre los sistemas de salud: México.Mexico City: OCDE/SSA, 2005.

22. van Doorslaer E, Masseria C, OECD Health Equity Research Group Members. Income-Related Inequality in the Use of Medical Care in 21 OECD Countries. In: OECD (ed). Towards High-Performing Health Systems. Paris: OECD Health Policy Studies, 2004.