RESUMO
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.