School of Public Policy, University of Maryland, 2101 Van Munching Hall, College Park, MD, 20742, USA.
Centro de Investigación y Docencia Económicas (CIDE), Carretera Mexico Toluca 3655, Mexico, DF, Mexico.
Demography. 2018 Feb;55(1):361-386. doi: 10.1007/s13524-017-0645-4.
Aimed at covering the large fraction of workers in the informal sector without access to a social security program, the Mexican public health insurance program Seguro Popular began in 2002 and now reaches more than 50 million individuals. We estimate impacts of Seguro Popular for the population aged 50 and older on a set of indicators related to health care including utilization, diagnostic/preventive tests, and treatment conditional on being ill. Using the longitudinal Mexican Health and Aging Study over the period 2001-2012, we conduct before and after difference-in-difference matching impact estimators. Our results suggest large and important effects of the Program on utilization and diagnostic tests. We find overall smaller effects on the probability of being in treatment for individuals with chronic diseases, but these effects are concentrated in rural areas with relatively more health services versus rural areas with lower levels of health services. These results suggest that, to the extent that health services become more available in rural areas lacking services, effects of health insurance may increase.
旨在覆盖无法获得社会保障计划的大量非正式部门工人，墨西哥公共医疗保险计划“大众安全”于 2002 年启动，现已覆盖超过 5000 万人。我们估计“大众安全”计划对 50 岁及以上人群的一系列与医疗保健相关的指标的影响，包括利用、诊断/预防测试以及患病后的治疗。我们利用 2001-2012 年期间的墨西哥健康与老龄化纵向研究，进行了前后差异匹配影响估计。我们的结果表明该计划对利用率和诊断测试有较大且重要的影响。我们发现，对于患有慢性病的个体，该计划对接受治疗的概率的总体影响较小，但这些影响集中在卫生服务相对较多的农村地区与卫生服务水平较低的农村地区。这些结果表明，在缺乏服务的农村地区，卫生服务变得更加普及的情况下，医疗保险的效果可能会增加。
