Users' perception of quality as a driver of private healthcare use in Mexico: Insights from the People's Voice Survey.

<h4>Objective</h4>The Mexican government has pursued multiple initiatives to improve healthcare coverage and financial protection. Yet, out-of-pocket health spending and use of private sector providers in Mexico remains high. In this paper, we sought to describe the characteristics of pu...

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Main Authors: Svetlana V Doubova, Hannah H Leslie, Ricardo Pérez-Cuevas, Margaret E Kruk, Catherine Arsenault
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0306179
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author Svetlana V Doubova
Hannah H Leslie
Ricardo Pérez-Cuevas
Margaret E Kruk
Catherine Arsenault
author_facet Svetlana V Doubova
Hannah H Leslie
Ricardo Pérez-Cuevas
Margaret E Kruk
Catherine Arsenault
author_sort Svetlana V Doubova
collection DOAJ
description <h4>Objective</h4>The Mexican government has pursued multiple initiatives to improve healthcare coverage and financial protection. Yet, out-of-pocket health spending and use of private sector providers in Mexico remains high. In this paper, we sought to describe the characteristics of public and private healthcare users, describe recent visit quality across provider types, and to assess whether perceiving the public healthcare sector as poor quality is associated with private health sector use.<h4>Methods and findings</h4>We analyzed the cross-sectional People's Voice Survey conducted from December 2022 to January 2023. We used Chi-square tests to compare contextual, individual, and need-for-care factors and ratings of most recent visits between users of public (social security and other public providers) and private sector providers (stand-alone private providers and providers adjacent to pharmacies). We used a multivariable Poisson regression model to assess associations between low ratings of public healthcare sources and the use of private care. Among the 811 respondents with a healthcare visit in the past year, 31.2% used private sources. Private healthcare users were more educated and had higher incomes than public healthcare users. Quality of most recent visit was rated more highly in private providers (70.2% rating the visit as excellent or very good for stand-alone private providers and 54.3% for pharmacy-adjacent doctors) compared to social security (41.6%) and other public providers (46.6%). Those who perceived public health institutions as low quality had a higher probability of seeking private healthcare.<h4>Conclusion</h4>Users rated public care visits poorly relative to private care; at the population level, perceptions of poor quality care may drive private care use and hence out-of-pocket costs. Improving public healthcare quality is necessary to ensure universal health coverage.
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spelling doaj-art-948e3a2e99954d11a5a552e2efec39692025-08-20T02:22:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01196e030617910.1371/journal.pone.0306179Users' perception of quality as a driver of private healthcare use in Mexico: Insights from the People's Voice Survey.Svetlana V DoubovaHannah H LeslieRicardo Pérez-CuevasMargaret E KrukCatherine Arsenault<h4>Objective</h4>The Mexican government has pursued multiple initiatives to improve healthcare coverage and financial protection. Yet, out-of-pocket health spending and use of private sector providers in Mexico remains high. In this paper, we sought to describe the characteristics of public and private healthcare users, describe recent visit quality across provider types, and to assess whether perceiving the public healthcare sector as poor quality is associated with private health sector use.<h4>Methods and findings</h4>We analyzed the cross-sectional People's Voice Survey conducted from December 2022 to January 2023. We used Chi-square tests to compare contextual, individual, and need-for-care factors and ratings of most recent visits between users of public (social security and other public providers) and private sector providers (stand-alone private providers and providers adjacent to pharmacies). We used a multivariable Poisson regression model to assess associations between low ratings of public healthcare sources and the use of private care. Among the 811 respondents with a healthcare visit in the past year, 31.2% used private sources. Private healthcare users were more educated and had higher incomes than public healthcare users. Quality of most recent visit was rated more highly in private providers (70.2% rating the visit as excellent or very good for stand-alone private providers and 54.3% for pharmacy-adjacent doctors) compared to social security (41.6%) and other public providers (46.6%). Those who perceived public health institutions as low quality had a higher probability of seeking private healthcare.<h4>Conclusion</h4>Users rated public care visits poorly relative to private care; at the population level, perceptions of poor quality care may drive private care use and hence out-of-pocket costs. Improving public healthcare quality is necessary to ensure universal health coverage.https://doi.org/10.1371/journal.pone.0306179
spellingShingle Svetlana V Doubova
Hannah H Leslie
Ricardo Pérez-Cuevas
Margaret E Kruk
Catherine Arsenault
Users' perception of quality as a driver of private healthcare use in Mexico: Insights from the People's Voice Survey.
PLoS ONE
title Users' perception of quality as a driver of private healthcare use in Mexico: Insights from the People's Voice Survey.
title_full Users' perception of quality as a driver of private healthcare use in Mexico: Insights from the People's Voice Survey.
title_fullStr Users' perception of quality as a driver of private healthcare use in Mexico: Insights from the People's Voice Survey.
title_full_unstemmed Users' perception of quality as a driver of private healthcare use in Mexico: Insights from the People's Voice Survey.
title_short Users' perception of quality as a driver of private healthcare use in Mexico: Insights from the People's Voice Survey.
title_sort users perception of quality as a driver of private healthcare use in mexico insights from the people s voice survey
url https://doi.org/10.1371/journal.pone.0306179
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