Table 2.
Poisson regression models of Recovery policy on health service use and outcomes April 2020 – November 2021, Mexican Institute of Social Security (N = 700 delegation months)*
| Level effect of the Recovery policy | Slope effect of the Recovery policy per month | |
|---|---|---|
|
Indicator
|
IRR (95% CI)
|
IRR (95% CI)
|
|
Child health care
|
|
|
| Consultations for sick children |
1.20 (1.12-1.29) |
0.89 (0.87-0.92) |
| Childhood vaccinations |
1.65 (1.48-1.84) |
0.96 (0.95-0.98) |
|
Reproductive and maternal health care
| ||
| Contraceptive use visits |
1.01 (0.95-1.08) |
0.94 (0.93-0.96) |
| Antenatal care visits |
1.05 (1.03-1.08) |
0.99 (0.98-1.00) |
| Deliveries (includes caesarean sections) |
1.15 (1.11-1.19) |
1.04 (1.03-1.05) |
| Caesarean section deliveries numbers |
1.01 (0.99-1.03) |
0.99 (0.98-0.99) |
|
Cancer screenings
| ||
| Cervical cancer screening |
0.98 (0.94-1.02) |
0.95 (0.93-0.98) |
| Breast cancer screening |
1.06 (0.97-1.16) |
0.96 (0.92-1.00) |
|
Noncommunicable disease care
| ||
| Diabetes visits |
0.99 (0.97-1.00) |
1.03 (1.01-1.04) |
| Hypertension visits |
0.99 (0.98-1.01) |
0.99 (0.98-1.00) |
| Patients with controlled diabetes |
1.05 (1.02-1.08) |
1.03 (1.02-1.04) |
| Patients with controlled hypertension | 1.09 (1.07-1.11) | 1.01 (1.01-1.02) |
CI – confidence interval, IRR – incidence rate ratio
*Poisson models include data from April 2020 to November 2021 (COVID-19 period). Models are adjusted for months since the start of the COVID-19 pandemic, average number of beds occupied by COVID-19 patients per month (log transformed), and seasonality. Population exposure is defined as the 2021 IMSS population per delegation, limited as follows: women aged 15-49 y for contraceptive visits, antenatal care visits, deliveries, total deliveries for cesarean deliveries, children under 5 y for sick child visits, children under 10 y for vaccinations, women aged 25-64 y for cervical cancer screening, women aged 50-69 y for breast cancer screening, adults over 20 for diabetes and hypertension consultations, and consultations for diabetes or consultations for hypertension for control of each disease. For analysis of the quality indicators, the start of the COVID-19 period (starting April 2020) and policy period (starting April 2021) were lagged for one month (May 2020 and May 2021 respectively).