Migration, remittances, and health care utilization in Ecuador Migración, remesas de dinero y utilización de los servicios de salud en el Ecuador

• Main Authors: Daniel F. López-Cevallos, Chunhuei Chi
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2012
• Subjects: Migración; migración internacional; tendencias; accesibilidad a los servicios de salud; análisis multinivel; política de salud; Ecuador; Migration; emigration and immigration; trends; health services accessibility; multilevel analysis; national health policy; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doaj.org/article/7584ba53c08d4242b45ccb5c30d206a9

OBJECTIVE: To examine the relationship between migration and migrant remittances and health care utilization in Ecuador, and to identify any potential equalizing effects. METHODS: Using data from the 2004 National Demographic and Maternal & Child Health Survey (ENDEMAIN), a multilevel multivariate analysis was conducted to assess the relationship of two migrant predictors (households with an international migrant; use of migrant remittances) with use of preventive care, number of curative visits, hospitalization, and use of antiparasitic medicines. Relevant predisposing, enabling, and need factors were included following Andersen's Model of Health Care Utilization Behavior. Interaction terms were included to assess the potential equalizing effects of migration and remittances by ethnicity, area of residence, and economic status. RESULTS: Migrant predictors were strongly associated with use of antiparasitic medicines, and to a lesser extent, with curative visits, even after adjusting for various predisposing, enabling, and need factors. Interaction models showed that having an international migrant increased use of these services among low-income Ecuadorians (quintiles 1 and 2). No significant relationship was found between migrant predictors and use of preventive services. CONCLUSIONS: Migration and remittances seem to have an equalizing effect on access to antiparasitic medicines, and to a lesser extent, curative health care services. Health care reform efforts should take into account the scope of this effect when developing public policy. OBJETIVO: Examinar la relación entre la migración, las remesas de dinero y la utilización de los servicios de atención de la salud en el Ecuador y determinar los posibles efectos equilibradores. MÉTODOS: A partir de los datos de la Encuesta Demográfica y de Salud Materna e Infantil (ENDEMAIN) correspondientes al 2004, se efectuó un análisis multifactorial de varios niveles para evaluar la relación de dos factores predictivos de la migración (hogares con un migrante ...