The cascade of access to the public health system in older Mexican adults and associated factors.

Background: Information about access to the public health system for elders is lacking in Mexico.

Objective: Develop a cascade of access to the public health system in Mexican older adults and identify factors that could promote or hinder it.

Material and methods: A cross-sectional analysis using data from the 2018, 2021, and 2022 National Health and Nutrition Survey rounds. A cascade of access to the public health system was constructed. Multivariate regression models were performed to identify related factors.

Results: 43.33%, 40.85%, and 43.79% of older adults had access to the public health system in 2018, 2021, and 2022, respectively. In 2018, frailty increased 2.419 times the probability of having access. While, being married or in union, being literate, and living in an urban residency increased access in 2021 and 2022.

Conclusions: There are persistently low levels of public healthcare access among older Mexican adults. Frailty elders had more probability of having access in 2018. Seguro Popular might have promoted access by overcoming organizational obstacles from the public system and surpassing sociodemographic barriers. After its elimination, sociodemographic variables became more relevant in promoting or reducing access.