2014, Number 1
<< Back Next >>
salud publica mex 2014; 56 (1)
Analysis of outpatient healthcare utilization in the context of the universal healthcare coverage reform in Mexico
Bautista-Arredondo S, Serván-Mori E, Colchero MA, Ramírez-Rodríguez B, Sosa-Rubí SG
Language: Spanish
References: 25
Page: 18-31
PDF size: 355.86 Kb.
ABSTRACT
Objective. Understand and quantify the relationship between socio-economic and health insurance profiles and the use of outpatient medical services in the context of universal health care in Mexico.
Materials and methods. Using ENSANUT 2012 multinomial regression models were estimated to analyze the use of outpatient services and associated factors.
Results. Population with greater poverty levels, lower educational level and living in highly marginalized areas have lower odds to use outpatient health services. In contrast, health insurance and higher income increase the odds to use health services and influence the choice of provider.
Conclusions. Barriers to access to health care related to poverty and social protection persist. However, there is space to lower the effect of these barriers by addressing constraints linked to the supply and the perceived quality of healthcare services.
REFERENCES
The Lancet Mexico: Celebrating universal health coverage. Lancet 2012; 380(9842): 622. doi: 10.1016/S0140-6736(12)61342-7.
Knaul FM, González-Pier E, Gómez-Dantés O, García-Junco D, Arreola-Ornelas H, Barraza-Lloréns M, et al. The quest for universal health coverage: Achieving social protection for all in Mexico. Lancet 2012;380(9849):1259-1279. doi: 10.1016/S0140-6736(12)61068-X.
Knaul FM, Frenk J. Health insurance in Mexico: Achieving universal coverage through structural reform. Health Aff 2005;24(6):1467-1476.
Secretaría de Salud. Sistema de Protección Social en Salud: Elementos conceptuales, financieros y operativos (2ª ed.). González Pier E, Barraza Lloréns M, Gutiérrez-Delgado C, Vargas-Palacios A. (coord.) México: FCE, Secretaría de Salud, Fundación Mexicana para la Salud, Instituto Nacional de Salud Pública, 2006.
Comisión Nacional de Protección Social en Salud. Dirección General de Financiamiento. [Consultado: noviembre 10, 2012]. Disponible en: http://sistemas.cnpss.gob.mx:7000/reportespef/fraccion_ii_20121/reportes.html
Grupo de trabajo de la Fundación Mexicana para la Salud Universalidad en los servicios de salud en México. Salud Publica Mex 2013;55:EE1-EE64.
Gutierrez JP, Rivera-Dommarco J, Shamah-Levy T, Villalpando-Hernández S, Franco A, Cuevas-Nasu L, et al. Encuesta Nacional de Salud y Nutrición 2012. Resultados Nacionales. Cuernavaca, México: Instituto Nacional de Salud Pública (MX), 2012.
Brown C, Pagán J, Rodríguez-Oreggia E. The decision-making process of health-care utilization in Mexico. Health Policy 2005;72:81-91.
Danese-De los Santos L, Valencia-Mendoza A, Sosa-Rubí S. Analysis of changes in health-care service access and choice of provider in Mexico: The utilization of curative health services 2000-2006. BMC Public Health 2011, 11:771. doi:10.1186/1471-2458-11-771
Valencia-Mendoza A, Bertozzi SM. A predictive model for the utilization of curative ambulatory health services in Mexico. Salud Publica Mex 2008;50:397-407.
López-Ceballos D, Chunhuei C. Health-care utilization in Ecuador: a multilevel analysis of socio-economic determinants and inequality issues. Health Policy Plan 2009:1-10.
Valdivia M. Public health infrastructure and equity in the utilization of outpatient health-care services in Peru. Health Policy Plan 2002;17:12-19.
Andersen RM. Revisiting the behavioral model and access to medical care: Does it matter? J Health Soc Behav 1995;36:1-10.
Cameron AC, Trivedi PK, Milne F, Piggott J. A microeconometric model of the demand for health care and health insurance in Australia. Rev Econ Stud;55(1):85-106.
Deb P, Trivedi PK. The structure of demand for health care: Latent class versus two-part models. J Health Econ 2002;21(4):601-625.
Ichoku HE, Murray L. Demand for healthcare services in Nigeria: A multivariate nested logit model. Afr Dev Rev 2003;15(2-3):396-424.
Sahn DE, Younger SD, Genicot G. The demand for health care services in rural Tanzania. Ox Bull Econ Stat 2003;65(2):241-260.
Winkelmann R. Reforming health care: Evidence from quantile regressions for counts. J Health Econ 2006;25(1):131-145.
Comisión Nacional para el Desarrollo de los Pueblos Indígenas (CDI). Los hogares y la población indígena. [Consultado: octubre 1, 2012]. Disponible en: http://www.cdi.gob.mx/index.php?id=211&option=com_content&task=view
Consejo Nacional de Población (CONAPO). Índice de marginación por localidad. [Consultado: noviembre 11 2012]. Disponible en http://www.conapo.gob.mx/es/CONAPO/Indice_de_Marginacion_por_Localidad_2010
Hosmer DW, Lemeshow S. Applied logistic regression, (2a ed). New York, NY: Wiley, 2000.
Cameron AC, Trivedi PK. Microeconometrics using Stata A. College Station, Texas: Stata Press, 2010.
Wirtz VJ, Serván-Mori E, Heredia-Pi I, Dreser A, Ávila-Burgos L. Factores asociados con la utilización y el gasto en medicamentos en México. Salud Publica Mex 2013;55 supl 2:S112-S122.
Pérez-Cuevas R, Doubova SV, Wirtz VJ, Dreser A, Serván-Mori E, Hernández-Ávila M. Consultorios médicos en farmacias privadas: efectos inesperados en el uso de servicios de salud y el acceso de medicamentos. Cuernavaca: INSP, 2012.
Ávila-Burgos L, Serván-Mori E, Wirtz VJ, Bautista-Arredondo S, Sosa-Rubí SG, Salinas-Rodríguez A. Seguro Popular y gasto en salud en hogares mexicanos: consolidar el efecto protector. Cuernavaca, México: INSP, 2012.