Lyndon B. Johnson School of Public Affairs, University of Texas at Austin, Austin, TX, United States.
School of Social Work, University of Texas at Arlington, Arlington, TX, United States.
Front Public Health. 2022 Oct 21;10:1025159. doi: 10.3389/fpubh.2022.1025159. eCollection 2022.
To compare total out-of-pocket expenses for physician visits and medications among older adults living with diabetes in Mexico from urban, semi-urban, and rural areas.
The sample included 2,398 Mexicans aged 65 years and older with self-reported diabetes from the 2018 Mexican Health and Aging Study. Out-of-pocket expenses for physician visits and medications were regressed on locality, controlling for several factors.
The profile of those with higher out-of-pocket medication expenditures included rural localities, higher education, unmarried, depressive symptoms, participation in Seguro Popular, and lacking insurance. In the multivariate analysis, rural older adults with diabetes paid a higher amount in medication expenditures compared with other localities.
Differences in locality are closely tied to the effective implementation of Seguro Popular. Although this program has improved access to care, participants have higher out-of-pocket expenditures for medications than those on employer-based plans across all localities. Among all groups, the uninsured bare the highest burden of expenditures, highlighting a continued need to address health inequities for the most underserved populations.
比较居住在墨西哥的老年糖尿病患者在城市、半城市和农村地区看医生和买药的总自付费用。
该样本包括来自 2018 年墨西哥健康与老龄化研究的 2398 名年龄在 65 岁及以上、自我报告患有糖尿病的墨西哥人。对医生就诊和药物的自付费用进行回归分析，控制了几个因素。
药物支出自付额较高的人群特征包括农村地区、较高的教育程度、未婚、抑郁症状、参加 Seguro Popular 以及没有保险。在多变量分析中，与其他地区相比，农村地区的老年糖尿病患者在药物支出方面支付的金额更高。
地区差异与 Seguro Popular 的有效实施密切相关。尽管该计划改善了获得医疗服务的机会，但与所有地区的雇主为基础的计划相比，参与者在药物方面的自付支出更高。在所有群体中，没有保险的人承担着最高的支出负担，这突显了继续需要解决服务不足人群的健康不平等问题。
