Hernández-Torres Jinneth, Avila-Burgos Leticia, Valencia-Mendoza Atanacio, Poblano-Verástegui Ofelia
Hospital Rafael Uribe Uribe, Bogotá, Colombia.
Rev Salud Publica (Bogota). 2008 Jan-Feb;10(1):18-32. doi: 10.1590/s0124-00642008000100003.
Estimating Seguro Popular de Salud's (SPS) initial outcome regarding households' catastrophic health spending (CHS). The relationship of other important factors to the CE was also estimated.
A cross-sectional study, based on evaluating Seguro Popular's survey, was carried out in the Mexican states of Colima and Campeche during 2002; it was carried out during the first semester of 2005. SPS and other co-variables' relationship with CHS was estimated by using the probit model. Such relationship was then estimated again using the bi-probit model, but taking endogeneity between CHS and SPS affiliation into consideration. Some simulations led to a detailed analysis of the influence of the use by type of service on the CHS.
The probability of SPS-affiliated households incurring CHS was about 8% less than un-affiliated households (controlled for other co-variables and corrected for endogeneity). The probability of incurring CHS was always less for affiliated people, independently of the income bracket which they belonged to and the kind of services used.
The results suggested that SPS is financially protecting households; nevertheless, the goal of a 75 % reduction in CHS has still to be achieved.
评估大众健康保险（SPS）在家庭灾难性医疗支出（CHS）方面的初步成效。同时还估计了其他重要因素与灾难性医疗支出的关系。
2002年在墨西哥的科利马州和坎佩切州开展了一项横断面研究，该研究基于对大众健康保险调查的评估；于2005年上半年进行。通过使用概率单位模型估计了SPS及其他协变量与CHS的关系。然后再次使用双变量概率单位模型估计这种关系，但考虑到CHS与SPS参保之间的内生性。一些模拟对按服务类型使用情况对CHS的影响进行了详细分析。
参保SPS的家庭发生CHS的概率比未参保家庭低约8%（在控制其他协变量并校正内生性的情况下）。无论所属收入阶层和使用的服务类型如何，参保人群发生CHS的概率始终较低。
结果表明，SPS在经济上对家庭起到了保护作用；然而，将CHS降低75%的目标仍有待实现。
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