Personal and social determinants of health services utilization by Mexican older people

Background. Increased healthcare needs among older individuals around the world demands a better understanding of factors influencing healthcare service utilization patterns. Objective. To examine personal and social correlates to health services utilization among Mexican older persons. Design and methods. This was a cross-sectional study conducted between 2004 and 2006 with 2030 Mexican adults 60 years and older and based on a health services utilization framework. A two-stage cluster sampling with probability proportionate to size was used. Participants were randomly selected and recruited in four metropolitan areas in Northeastern Mexico. Chi-square and Pearson's chi-squared tests and logistic regression were used for data analyses. Results. Significantly more women than men had lost a spouse and were illiterate. Also, females reported significantly poorer health, higher nutritional risk and lower ability to perform activities of daily and instrumental living than males. Predictors of healthcare utilization were: Having a caregiver during an illness; perceiving to have a health problem; being able to afford food, and having children. Conclusions. Predisposing, enabling and need factors are strong predictors of health services utilization among Mexican older persons. In addition, gender differences exist among this population in relation to health status, but not to health services demands.