Objective.

To study changes in health care utilization in the public and private sector in Mexico in 2012 and 2018.

Material and methods:

We used the 2012 and 2018-19 National Health and Nutrition Surveys and aggregated data on the supply of health services.

Results.

There was an accelerated increase in medical offices in pharmacies (MOP) that was related to a lower use of public health services, even among the population with social security. We found that individuals living in municipalities with a high density of MOP had a lower probability of using public services. The increase in the affiliation to the Seguro Popular (SP) was not followed by an increase in public health services and was not associated with a higher utilization of public health services.

Conclusions.

Affiliation or health insurance does not guarantee access to public services. Given the high increase in MOP, it is urgent to design and evaluate strategies to regulate their performance.