Post-COVID19 strategies to support the health care interactions of U.S. Mexican immigrants and return migrants with the Mexican health system.

Background: Mexican migrants in the United States (U.S.) are twice more likely to underutilize health care and to experience low quality of care compared to the U.S.-born population. Current and former Mexican migrants in the U.S have used health services in Mexico due to lower cost, perceived quality, cultural familiarity, and the geographic proximity of the two countries. Objective: This study aims to characterize the different health care interactions of current and former U.S. Mexican migrants with public and private health care organizations of the Mexican health system and to identify strategies to improve health care interactions post-COVID19. Methods: We use a typology of cross-border patient mobility to analyze the facilitators and barriers to improve the health care interactions of current and former U.S. Mexican migrants with the Mexican health system. Our policy analysis framework examines how an outcome can be achieved by various configurations or combinations of independent variables. The main outcome variable is the improvement of health care interactions of U.S. Mexican migrants and return migrants with different government agencies and public and private health care providers in the Mexican health system. The main explanatory variables are availability, affordability, familiarity, perceived quality of health care and type of health coverage. Findings: As the Mexican health system emerges from the COVID19 pandemic, new strategies to integrate current and former U.S. Mexican migrants to the Mexican health system could be considered such as the expansion of telehealth services, a regulatory framework for health services used by transnational patients, making enrollment procedures more flexible for return migrants and guiding return migrants as they reintegrate to the Mexican health system. Conclusions: The health care interactions of U.S. Mexican migrants with the Mexican health system are likely to increase in the upcoming decades due to population ageing. Regulatory improvements and programs that address the unique needs of U.S. Mexican migrants and return migrants could substantially improve their health care interactions with the Mexican health system.