The Covid-19 cascade of care in Mexico: symptoms, positivity, and health care seeking decisions amid the pandemic

Objective. The study describes health care services utilization contextualized by the needs of the Mexican population during the Covid-19 pandemic. Materials and methods. We used data from the National Health and Nutrition Survey, Covid-19. Among the population with symptoms compatible with Covid-19, we describe the proportion who sought care, received care, were tested, were diagnosed positive, and survived, and whether they received care in public or private services. We estimated factors associated with the probability of seeking and receiving care. Results. Out of 7.1% of the population with symptoms compatible with Covid-19, 64.4% received care, and 15.4% tested positive; 74.5% received care in the private sector, even among the population with social security. Those with social security, in contact with a suspected or confirmed Covid-19 case, and with at least one comorbidity had a higher probability of seeking and receiving care. Conclusions. The most relevant finding of our study is the large proportion of the population with Covid-19 symptoms who sought and received care in private facilities an essential aspect for decision-makers to consider as the current health reform moves forward in Mexico.