A predictive model for the utilization of curative ambulatory health services in Mexico.
OBJECTIVE
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.


METHODS
Patient choice of provider (self-care, 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.
Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, México. avalencia@correo.insp.mx
Atanacio
A
Valencia-Mendoza
Stefano M
SM
Bertozzi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D002755:Choice Behavior; D005191:Family Characteristics; D005260:Female; D006282:Health Personnel / Q000145:classification / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008800:Mexico; D008875:Middle Aged; D008962:Models, Theoretical; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011203:Poverty; D012943:Social Security; D012946:Social Welfare; D012959:Socioeconomic Factors; D055815:Young Adult