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 car e 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 fo r many years. Studying how the movement of patients has been taking pl ace, and how it has affected health care providers' practices, is the first step towards the understanding and organization of health care s ervices for the border region. This paper reports on the results of a health care provider survey conducted betweeen 1987 and 1989 in Arizon a and Sonora border towns. The paper includes information on the chara cteristics of border health care providers (98 residing on the U.S. si de of the border and 249 on the Mexican side) and the demographics and diagnosis of patients who engage in border crossing behavior. The opi nions of health care providers about why patients from the neighbourin g country come to their offices; the existing communication system bet ween providers in both nations; and some of the problems that result f rom attending patients residing in the neighboring nation are also rep orted. Results from the survey demonstrate that although the border co nstitutes a region in itself, health services at the border are not st ructured to recognize this regional orientation. Improved communicatio n between health care providers on both sides of the border, the estab lishment 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 satisfaction of health care providers and consumers.