Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006

By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization).Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status.Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the remaining income-related healthcare utilization differences, the differences in quality between public and private health services, and the general perception that MoH facilities offer inferior services.Numerous analyses around the world have found that healthcare utilization correlates with income, with lower income populations less likely to have or seek out formal healthcare. The discrepancies by socioeconomic status are particularly widespread in developing countries, including Mexico [1-5]. When ill, poorer Mexicans often do not seek formal healthcare, because they cannot afford the cost of formal healthcare [6].Income-related differences in the use of health services in Mexico are largely because of the historical lack of access to adequate financial support for healthcare