Miller Grant, Pinto Diana, Vera-Hernández Marcos
Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 94305-6019, USA, and National Bureau of Economic Research.
Inter-American Development Bank, 1300 New York Avenue, N.W., Washington, DC 20577, USA.
Am Econ J Appl Econ. 2013 Oct;5(4):61-91. doi: 10.1257/app.5.4.61.
Unexpected medical care spending imposes considerable financial risk on developing country households. Based on managed care models of health insurance in wealthy countries, Colombia's Régimen Subsidiado is a publicly financed insurance program targeted to the poor, aiming both to provide risk protection and to promote allocative efficiency in the use of medical care. Using a "fuzzy" regression discontinuity design, we find that the program has shielded the poor from some financial risk while increasing the use of traditionally under-utilized preventive services - with measurable health gains.
意外的医疗支出给发展中国家的家庭带来了相当大的经济风险。基于富裕国家医疗保险的管理式医疗模式,哥伦比亚的补贴制度是一项针对贫困人口的公共资助保险计划,旨在提供风险保护并提高医疗保健使用的配置效率。通过使用“模糊”回归断点设计,我们发现该计划在增加传统上未充分利用的预防性服务使用量的同时,保护了贫困人口免受一些经济风险——带来了可衡量的健康收益。