Underlying Systemic Motifs That Prevent Diabetes Patients From Seeking and Utilizing Health Services in a Country With a High Prevalence of Diabetes
Author(s)
Israel Rico Alba, Ph.D.1, Jorge Guzman Caniupan, MHE2, Emmanuel Robles, Engr.2, Alberto Retana Guzman, M.B.A.1.
1Strategic Market Access, Novo Nordisk, Mexico City, Mexico, 2AHS Health Consulting, Mexico City, Mexico.
1Strategic Market Access, Novo Nordisk, Mexico City, Mexico, 2AHS Health Consulting, Mexico City, Mexico.
OBJECTIVES: To identify the motifs for not-seek and not-use of the health services by diabetes patients in a country with a high prevalence of the disease.
METHODS: A qualitative-quantitative study about the frequency and reasons for non-seeking care (n-SC) and non-utilization of health services (n-UHS) for a health need in the Mexican population was realized. To this, a care-cascade was developed. Data was obtained from the National Health and Nutrition Survey of 2018 for populations with <100,000 inhabitants. The n-SC, n-UHS patterns, and the reported motifs of the general population (GP) vs diabetes mellitus (DMp) patients were compared. A subanalysis of three diabetic needs was conducted: DMp who attended a follow-up visit(DM-fu), DMp with multimorbidity (DMm), and DMp who attended for other needs(DM-on).
RESULTS: In 2018, nearly 6 million people sought care for a health need in Mexico. Of them, 5.3% were DMp(n=585,503). Overall, 0.7% of GP and 0.6% of DMp n-SC. Of all patients who sought care, 1.4% of GP were not-attended; this percentage was 3.6 times higher in DMp (6.4%; n=20,535). The subanalysis showed that while all DMm sought and received care, DM-on were less likely to seek care and faced more barriers (1.5% and 13.2%, respectively). In the DM-fu all sought care, but 2.4% were not attended. In GP, 46.6% of the motifs for n-SC were: was innecessary, haven´t money or time, nowhere to go, and long-waiting-times. In contrast, 37.3% of DMp reported lack of confidence. In GP, 48.9% of the n-UHS reasons were: the provider didn´t consider it necessary, they not-attend and lack-of-confidence. In DM-fu 65.2% reported this same motif and in 34.7% the service was closed, while all DM-on stated that the provider didn´t consider it necessary.
CONCLUSIONS: Diabetes patients showed different care-seeking patterns than the general population, facing additional and systemic barriers that were out of their control.
METHODS: A qualitative-quantitative study about the frequency and reasons for non-seeking care (n-SC) and non-utilization of health services (n-UHS) for a health need in the Mexican population was realized. To this, a care-cascade was developed. Data was obtained from the National Health and Nutrition Survey of 2018 for populations with <100,000 inhabitants. The n-SC, n-UHS patterns, and the reported motifs of the general population (GP) vs diabetes mellitus (DMp) patients were compared. A subanalysis of three diabetic needs was conducted: DMp who attended a follow-up visit(DM-fu), DMp with multimorbidity (DMm), and DMp who attended for other needs(DM-on).
RESULTS: In 2018, nearly 6 million people sought care for a health need in Mexico. Of them, 5.3% were DMp(n=585,503). Overall, 0.7% of GP and 0.6% of DMp n-SC. Of all patients who sought care, 1.4% of GP were not-attended; this percentage was 3.6 times higher in DMp (6.4%; n=20,535). The subanalysis showed that while all DMm sought and received care, DM-on were less likely to seek care and faced more barriers (1.5% and 13.2%, respectively). In the DM-fu all sought care, but 2.4% were not attended. In GP, 46.6% of the motifs for n-SC were: was innecessary, haven´t money or time, nowhere to go, and long-waiting-times. In contrast, 37.3% of DMp reported lack of confidence. In GP, 48.9% of the n-UHS reasons were: the provider didn´t consider it necessary, they not-attend and lack-of-confidence. In DM-fu 65.2% reported this same motif and in 34.7% the service was closed, while all DM-on stated that the provider didn´t consider it necessary.
CONCLUSIONS: Diabetes patients showed different care-seeking patterns than the general population, facing additional and systemic barriers that were out of their control.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH268
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Public Health
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas