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Does demand for diabetic and hypertensive services amongst obese adults in Mexico depend on supply side infrastructure?

Sara Bleich, Ph.D. Program in Health Policy, Harvard University, 104 Mount Auburn Street, 3rd Floor, Cambridge, MA 02138, 617.495.5602, bleich@fas.harvard.edu, Christopher Murray, MD, PhD, Harvard Initiative for Global Health, 104 Mount Auburn Street, 3rd Floor, Cambridge, MA 02139, David Cutler, PhD, Social Sciences, Harvard University, University Hall 031, Cambridge, MA 02138, and Alyce Adams, PhD, Department of Ambulatory Care and Prevention, Harvard University, 133 Brookline Avenue, 6th Floor, Boston, MA 02215.

Introduction Demand for diabetes and hypertension services is expected to rise rapidly in the coming years given that Mexico has a high rate of obesity and recently created Popular Health Insurance (PHI), a program to extend health insurance to the 57% of the population without coverage. This paper examines the extent to which the service supply (i.e. number of physicians, number of nurses, number of beds etc.) predicts utilization of diabetic and hypertensive health care services amongst obese Mexican adults, who qualify for PHI.

Data and Methods To identify the prevalence and distribution of diabetes and hypertension, the Mexican National Health Survey (2000) with a sample of 47,674 adults was used. Supply-side data was obtained from the Mexican National Registry of Health Infrastructure (2000). Each data set is representative at the national and state level. Multivariate analysis was used to estimate the independent effect of supply-side services on health service utilization.

Results While there is little variation in the prevalence of diabetes and hypertension amongst obese adults across the Mexican states, service availability varies significantly. Within each geographical subgroup, crude rates of hospital beds, doctors, operating rooms, and nurses rise with income. After adjusting for geography, income, and gender the availability of supply side services is associated with utilization of services.

Conclusions Supply side infrastructure is a significant predictor of hypertensive and diabetic service use among the adult obese population in Mexico. However, utilization of services cannot be explained by the service supply alone; geography and income are also important predictors.

Learning Objectives:

Keywords: Obesity, Access to Care

Presenting author's disclosure statement:

Not Answered

Perspectives on Chronic Disease and Aging

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA