Objetivo. Entender y cuantificar la relación entre los perfiles socioeconómico y de aseguramiento en salud y el uso de servicios médicos ambulatorios en el contexto de la universalización de la salud en México. Material y métodos. Utilizando la ENSANUT 2012, se estimaron modelos de regresión multinomial para analizar el uso de servicios ambulatorios y sus factores asociados. Resultados. La población con mayor pobreza, menor nivel educativo y residente de zonas de alta marginación tiene menor posibilidad de usar servicios de salud ambulatorios. En contraste, tener un seguro de salud y mayores ingresos favorecen el uso e influyen en la elección del proveedor. Conclusiones. Persisten barreras en el acceso a la salud asociadas con la condición de pobreza y de protección social. Sin embargo, existe espacio para disminuir el efecto de estas barreras, abordando las restricciones en la oferta de los servicios y en la calidad percibida de los mismos.
This article provides a comprehensive assessment of the effects of social protection interventions on material and subjective elements of well‐being. Drawing on a longitudinal survey located in two relatively deprived parts of Brazil, it assesses the effects of pensions and other cash transfers on the well‐being of older people and their households. This analysis is located within a dynamic economic and public policy context. The article finds that pension benefits significantly increase per capita income and that this is strongly associated with overall levels of satisfaction with household well‐being. Levels of reported subjective well‐being do not fall as respondents age, and the survey finds high levels of optimism about future well‐being. The positive effects of pension benefits were supported by upgraded health services and by more specific policies such as access to credit on favourable terms. Overall, the authors conclude that a combination of economic growth and effective public policies significantly boosted the well‐being of most households in their survey, and that Brazil can be taken as a model of good practice for other middle‐income countries.
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