Dataset Information

Out of Sight and Uninsured: Access to Healthcare Among US-Born Minors in Mexico.

ABSTRACT: To examine health insurance coverage among the 550,000 U.S.-born minors living in Mexico. Representative data from Mexico's 2018 National Survey of Demographic Dynamics was used to describe health coverage among persons aged 0-17 living in Mexico (N = 78,370). Multinomial logistic regression models were estimated to identify the association between birthplace (Mexico versus the United States) and health insurance coverage in Mexico. 39% of U.S-born minors living in Mexico in 2018 lacked health insurance compared to just 13% of Mexican-born minors. Logistic regression found that, net of potential confounders, being born in the United States was associated with 87% lower odds of being insured among minors in Mexico. U.S.-born minors disproportionately rely on private insurance programs and are particularly likely to be uninsured in the first year back from the United States. Special attention is needed to ensure access to care among U.S.-born minors in Mexico.

SUBMITTER: Wassink JT

PROVIDER: S-EPMC7195250 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Out of Sight and Uninsured: Access to Healthcare Among US-Born Minors in Mexico.

Wassink Joshua T JT

Journal of immigrant and minority health 20200601 3

To examine health insurance coverage among the 550,000 U.S.-born minors living in Mexico. Representative data from Mexico's 2018 National Survey of Demographic Dynamics was used to describe health coverage among persons aged 0-17 living in Mexico (N = 78,370). Multinomial logistic regression models were estimated to identify the association between birthplace (Mexico versus the United States) and health insurance coverage in Mexico. 39% of U.S-born minors living in Mexico in 2018 lacked health i ...[more]

PMID: 32232609

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Project description:Background: Dependence is a significant health-related condition for older adults (OA) and implies that self-care is transferred to other people, the community or institutions. Recent studies have analyzed the relationship between out-of-pocket (OOP) healthcare expenditures and dependence. Nonetheless, these studies were not specifically designed to estimate the economic impact of dependence. Our aim was to estimate the total adjusted annual OOP healthcare expenditures in dependent older adults compared to independent ones. Additionally, we explore the potential combined effect of basic activities of daily living (ADL) and instrumental activities of daily living (IADL) dependence on OOP healthcare expenditures. Methods: Data comes from the cross-sectional study "Economic impact of physical dependence in older adults and the burden of informal care" conducted in 2018 with a sample of 735 community-dwelling older Mexican adults ages 60 and older. We used direct (medical and non-medical) and indirect costs to estimate the OOP healthcare expenditures associated with dependence. We applied the Katz scale to assess dependence in ADL and the Lawton scale to assess dependence in IADL. Two-Part regression models were used to analyze the relationship between dependence and OOP health expenditures. Results: Presence of ADL dependence represented a higher level of expenditure, 107% compared to non-dependent OA (β = 1.07, CI95%: 0.43-1.71), and 97% for IADL dependence (β = 0.97, CI95%: 0.49-1.45). The combined effect of ADL and IADL dependence (132%) was greater (β = 1.32, CI95%: 0.74-1.90) than the effect of ADL or IADL dependence alone. In monetary terms, OA with ADL dependence had a total annualized mean OOP healthcare expenditure of $31,865 (Mexican pesos), OA with IADL $26,912, and combined ADL and IADL $39,520. Conclusions: ADL and IADL dependence are associated with the total annualized OOP healthcare expenditures. This association is even higher when both conditions are present together. These findings highlight the economic implications of the dependence for individuals, their families, and the health system. Given that current evidence on effective interventions to prevent dependence in OA is insufficient, future studies should be conducted to estimate their costs and determine what interventions work, as well as their effectiveness and cost-effectiveness in different sub-groups of the population, and how these might be appropriately implemented.

Dataset Information

Out of Sight and Uninsured: Access to Healthcare Among US-Born Minors in Mexico.

Publications

Out of Sight and Uninsured: Access to Healthcare Among US-Born Minors in Mexico.

Similar Datasets

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