[Health services utilization in Mexico: the perspective of individuals with diabetes]. / Utilización de los servicios de salud en México: perspectivas de los individuos con diabetes.

AIMS: This paper reports findings of a qualitative study whose focus is health services use among individuals with chronic illness. DESIGN: Qualitative research with an ethnographic orientation. SETTING: A low income neighborhood of Guadalajara, Mexico. SUBJECTS: Twenty subjects selected through a theoretical sample. Measurements and main results. Open-ended interviews. The data were content-analyzed. Most diabetic sufferers live with two or more chronic illnesses. Medical services use is combined with that of other healing systems. Participants also combine different types of health care services. Four health care use categories were found: frequent, occasional, periodical, and abandonment. Those who use health services frequently have oscillating or deteriorating illness trajectories, are supported by family members and are primarily women and elderly/retired men. Those who abandon health services have stable trajectories, they are their families primary providers, and cannot stop work to receive medical care; but some others have deteriorating illness trajectories and their symptoms do not ameliorate with consultations. CONCLUSIONS: Different factors explain patterns of health services utilization. Such patterns of use have serious implications in the health care reorganization.

[Sources of support of individuals with diabetes in a deprived area of Guadalajara, Mexico]. / Las fuentes de apoyo de los individuos con diabetes en una zona marginal de Guadalajara, México.

This article examines the relationship between sociodemographic factors and sources of support in non-insulin dependent diabetes mellitus patients living in a socially deprived area of Guadalajara, Mexico. A total of 121 diabetic subjects and the same number of caretakers, spouses and children, participated in the study. Findings show that some variables of diabetic individuals are associated with caretakers' age, sex and kinship. Moreover, sex distribution of children and family composition were also associated with sources of support. No association was found between disease characteristics and those of caretakers. The impact of these results on health services programs is discussed.

[Patterns of medical prescriptions for individuals with diabetes mellitus type 2 at the primary care level]. / Patrones de prescripción médica a individuos con diabetes mellitus tipo II en el primer nivel de atención.

A cross-sectional study was conducted to investigate the prescription patterns of general practitioners for non-insulin dependent diabetes mellitus patients in Guadalajara, Mexico. Two hundred and forty medical prescriptions were evaluated. These were indicated by 16 primary care physicians. Results showed that physicians prescribed pharmacologic agents in 93 per cent of the cases, dietary control in 73 per cent, and physical exercise in 48 per cent. A combination therapy of these three measures was employed in 40 per cent of the patients, but the combination regimen of diet and exercise was given only to 3 per cent of the patients. Data showed significant differences in prescribing patterns according to gender of physicians; male physicians prescribed the three measures by more than 10 per cent; On the contrary, female physicians prescribed the drug as the only therapy 27 per cent of the time. The proportion of prescribing diet and exercise measures increased with more years of professional experience. These observations support the findings that prescription patterns by primary care physicians do not meet the criteria currently recommended by international committees for diabetes therapy. We discuss some implications for the metabolic control of the disease and the quality of medical care.