[墨西哥与药品使用及支出相关的因素]
[Factor associated with medicines utilization and expenditure in Mexico].
作者信息
Wirtz Veronika J, Serván-Mori Edson, Heredia-Pi Ileana, Dreser Anahí, Ávila-Burgos Leticia
机构信息
Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
Centro de Investigación en Evaluación y Encuestas, Dirección de Economía de la Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
出版信息
Salud Publica Mex. 2013;55 Suppl 2:S112-22.
OBJECTIVE
To analyze medicine utilization and expenditure and associated factors in Mexico, as well as to discuss their implications for pharmaceutical policy.
MATERIALS AND METHODS
Analysis of a sample of 193,228 individuals from the Mexican National Health and Nutrition Survey 2012. Probability and amount of expenditure were estimated using logit, probit and quantile regression models, evaluating three dimensions of access to medicines: (1) likelihood of utilization of medicines in the event of a health problem, (2) probability of incurring expenses and (3) amount spent on medicines.
RESULTS
Individuals affiliated to IMSS were more likely to use medicines (OR=1.2, p<0.05). Being affiliated to the IMSS, ISSSTE or SP reduced the likelihood of spending compared to those without health insurance (about RM 0.7, p<0.01). Median expenditures varied between 195.3 and 274.2 pesos.
CONCLUSIONS
Factors associated with the use and expenditure on medicines indicate that inequities in the access to medicines persist.
目的
分析墨西哥的药物使用及支出情况及其相关因素，并探讨其对药品政策的影响。
材料与方法
对2012年墨西哥全国健康与营养调查中的193228名个体样本进行分析。使用逻辑回归、概率单位回归和分位数回归模型估计支出概率和金额，评估药品可及性的三个维度：（1）出现健康问题时使用药品的可能性，（2）产生费用的概率，以及（3）药品支出金额。
结果
墨西哥社会保障局（IMSS）参保人员更有可能使用药品（比值比=1.2，p<0.05）。与没有医疗保险的人相比，隶属于IMSS、墨西哥州立工人社会保障和服务协会（ISSSTE）或社会安全和服务局（SP）的人支出可能性降低（约70比索，p<0.01）。支出中位数在195.3至274.2比索之间。
结论
与药品使用和支出相关的因素表明，药品可及性方面的不平等现象依然存在。
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