title: Access to medicines for acute illness in middle income countries in Central America.
abstract: OBJECTIVE
  To analyze the main predictors of access to medicines for persons who experienced acute health conditions.
  
  
  METHODS
  This was a cross-sectional analytic study, based on data from household surveys. We examined the predictors of: (1) seeking care for acute illness in the formal health care system and (2) obtaining all medicines sought for the acute condition.
  
  
  RESULTS
  The significant predictors of seeking health care for acute illnesses were urban geographic location, head of household with secondary school education or above, age under 15, severity of illness perceived by the respondent, and having health insurance. The most important predictor of obtaining full access to medicines was seeking care in the formal health care system. People who sought care in the formal system were three times more likely to receive all the medicines sought (OR 3.0, 95%CI 2.3;4.0). For those who sought care in the formal health system, the strongest predictors of full access to medicines were seeking care in the private sector, having secondary school education or above, and positive perceptions of quality of health care and medicines in public sector health facilities. For patients who did not seek care in the formal health system, full access to medicines was more likely in Honduras or Nicaragua than in Guatemala. Urban geographic location, higher economic status, and male gender were also significant predictors.
  
  
  CONCLUSIONS
  A substantial part of the population in these three countries sought and obtained medicines outside of the formal health care system, which may compromise quality of care and pose a risk to patients. Determinants of full access to medicines inside and outside the formal health care system differ, and thus may require different strategies to improve access to medicines.
authors.forename: Isabel Cristina Martins
authors.initials: IC
authors.lastname: Emmerick
authors.forename: Vera Lucia
authors.initials: VL
authors.lastname: Luiza
authors.forename: Luiz Antonio Bastos
authors.initials: LA
authors.lastname: Camacho
authors.forename: Dennis
authors.initials: D
authors.lastname: Ross-Degnan
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006166:Guatemala / Q000453:epidemiology / Q000208:ethnology; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006721:Honduras / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009527:Nicaragua / Q000453:epidemiology / Q000208:ethnology; D004364:Pharmaceutical Preparations / Q000600:supply & distribution*; D012737:Sex Factors; D012959:Socioeconomic Factors
chemical_list: D004364:Pharmaceutical Preparations