Health Care Utilization by Mexican Migrants Returning to Mexico Due to Health Needs

Abstract

BACKGROUND: A total of 12.7 million Mexicans reside as migrants in the United States, of whom only 45% have health insurance in this country while access to health insurance by migrants in Mexico is fraught with difficulties. Health insurance has been shown to impact the use of health care in both countries. This paper quantifies hospitalizations by migrants who return from the US seeking medical care in public private hospitals in the US Mexico border area in communities of origin. The proportion of bed utilization the proportion of hospitalizations in Mexico out of the total expected by migrants in the US were estimated. METHODS: The universe included 48 Ministry of Health 47 private hospitals serving municipalities of high or very high migration in Mexico, where 17% of remittance receiving households are located, as well as 15 public 159 private hospitals in 10 Mexican cities along the border with the US. Hospitals were sampled through various methods to include 27% of beds. Patients staff were interviewed data triangulated to quantify migrants that returned to Mexico seeking medical care. Official hospital discharge statistics secondary data from migration databases published statistics were analyzed to identify bed occupancy, general migrant hospitalization rates the size of the migrant population that maintains close relationships with households in communities of origin. RESULTS: Up to 1609 migrants were admitted to public hospitals (76.6%) 492 to private hospitals (23.4%) serving municipalities of high very high migration intensity in 2008. Up to 0.90% of public hospital capacity was used. In the border area up to 908 2416 migrants were admitted to public (27.3%) private (72.7%) hospitals, respectively. Up to 1.18% of public hospital capacity was used. Between 2.4% 20.4% of the expected hospitalization needs of migrants with dependent households are satisfied through these services. The most common diagnostic categories mentioned across hospitals were traumatisms, complications of diabetes elective surgery, in that order. Private hospitals mention elective surgeries as the main diagnostic category followed by complications of diabetes. CONCLUSIONS: Hospitals in communities of origin in Mexico are devoting few resources to respond to hospitalization needs of migrants in the US. Currently no hospital programs exist to stimulate migrant dem or to cater to their specific needs. Registering migratory history in clinical administrative records can be readily implemented. Developing bi national referral networks insuring migrants in the US within current Mexican federal programs could greatly increase migrant access to hospitals.