title: [Out-of-pocket expenditure by elderly adults enrolled in a public health insurance programme in Mexico].
abstract: OBJECTIVE
  To identify the association between various sociodemographic variables and out-of-pocket expenditure on health by elderly people enrolled in Seguro Popular (SP).
  
  
  METHODS
  Analytical cross-sectional study. An in-person survey was administered to users of three outpatient clinics in the state of Veracruz: a health centre (first level), regional hospital (second level) and highly specialised hospital. The out-of-pocket expenditure on health was analysed using a generalised linear model.
  
  
  RESULTS
  The sample consisted of 1,049 beneficiaries of SP over age 60 with a response rate of 97.7%. The monthly out-of-pocket expenditure on health was $64.80 (95% confidence interval [95% CI]: 59.90-69.80). The highest expense category was drugs that are included in the SP ($28.80; 95% CI: 25.80-31.70) and drugs that are not covered by the SP ($8.00; 95% CI: 6.70-9.20).
  
  
  CONCLUSIONS
  People over age 60 enrolled in SP pay out of their pocket to meet their health needs, despite having public health insurance. This represents an inequity in access, especially for the most vulnerable such as the rural population.
authors.affiliation: Doctorado en Ciencias de la Salud, Instituto de Ciencias de la Salud, Universidad Veracruzana, Xalapa, Veracruz, México. Electronic address: ppavon@uv.mx.
authors.forename: Patricia
authors.initials: P
authors.lastname: Pavón-León
authors.affiliation: Dirección de Investigación, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
authors.forename: Hortensia
authors.initials: H
authors.lastname: Reyes-Morales
authors.affiliation: Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Veracruz, México.
authors.forename: Armando J
authors.initials: AJ
authors.lastname: Martínez
authors.affiliation: Instituto de Investigaciones Histórico-Sociales, Universidad Veracruzana, Xalapa, Veracruz, México.
authors.forename: Silvia María
authors.initials: SM
authors.lastname: Méndez-Maín
authors.affiliation: Doctorado en Ciencias de la Salud, Instituto de Ciencias de la Salud, Universidad Veracruzana, Xalapa, Veracruz, México.
authors.forename: María Del Carmen
authors.initials: MDC
authors.lastname: Gogeascoechea-Trejo
authors.affiliation: Instituto de Ciencias de la Salud, Universidad Veracruzana, Xalapa, Veracruz, México.
authors.forename: María Sobeida L
authors.initials: MSL
authors.lastname: Blázquez-Morales
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011634:Public Health; D012959:Socioeconomic Factors
keywords: Ancianos; Elderly; Gasto en salud; Health expenditure; Health services; Servicios de salud