Utilization of health services along the Arizona-Sonora border: the providers' perspective

Under the proposed North American Free Trade Agreement between Mexico, Canada, and the United States, issues of health policy and health care delivery will have to be addressed. People at the U.S.-Mexico border have been using health care providers on either side of the border for many years. Studying how the movement of patients has been taking place, and how it has affected health care providers' practices, is the first step towards the understanding and organization of health care services for the border region. This paper reports on the results of a health care provider survey conducted between 1987 and 1989 in Arizona and Sonora border towns. The paper includes information on the characteristics of border health care providers (98 residing on the U.S. side of the border and 249 on the Mexican side) and the demographics and diagnosis of patients who engage in border crossing behavior. The opinions of health care providers about why patients from the neighboring country come to their offices; the existing communication system between providers in both nations; and some of the problems that result from attending patients residing in the neighboring nation are also reported. Results from the survey demonstrate that although the border constitutes a region in itself, health services at the border are not structured to recognize this regional orientation. Improved communication between health care providers on both sides of the border, the establishment of health care protocols with quality assurance programs, and suitable health care financing mechanisms are some of the issues that require immediate attention if the health care delivery system at the border is to function more efficiently and to the satisfaction of health care providers and consumers.