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The effect of the exit of an insurer, due to government liquidation, on access to health care: evidence from Colombia.

作者信息

Chamorro Cindy, Fernández Manuel, Espinosa Oscar

机构信息

Faculty of Economics, Universidad de los Andes, Calle 19A N°. 1-37, Bogotá, D.C., Colombia.

Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Carrera 30 N°. 45-03, Bogotá, D.C., Colombia.

出版信息

Int J Health Econ Manag. 2025 Mar;25(1):51-65. doi: 10.1007/s10754-024-09381-4. Epub 2024 Jul 13.

DOI:10.1007/s10754-024-09381-4
PMID:39002041
Abstract

Our study evaluates the liquidation effect of a health insurer from a subsidized scheme, with the largest number of members in Colombia, on restrictions to future access to user care. Based on the information regarding complaints and judicial claims about healthcare, the effect of this government decision is estimated using a dynamic econometric model of differences in differences. Our results suggest that the liquidation of the Health-Promoting Entity (EPS, its acronym in Spanish) CAPRECOM has a negative effect, specifically, it led to an increase of 0.32 and 0.21 in complaints rates per 1,000 members in the receiving EPSs during the first and second quarters after the intervention, respectively. However, this effect does not persist over time and becomes diluted in the following quarters. There is no evidence of a relationship between the magnitude of the effect and the EPSs performance ranking. Additionally, we do not find significant effects on judicial claims. Our results are important concerning the design and implementation of public policies for EPSs liquidation. We demonstrate the necessity of implementing actions to incorporate guidelines and strategic plans during the transition period. Such actions would enable safeguarding the right to health for the affected population in a liquidation insurer case.

摘要

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本文引用的文献

1
Health care systems in low- and middle-income countries.低收入和中等收入国家的医疗保健系统。
N Engl J Med. 2014 Feb 6;370(6):552-7. doi: 10.1056/NEJMra1110897.
2
The effect of change of health insurance on access to care.医疗保险变更对医疗服务可及性的影响。
Inquiry. 1998;35(4):389-97.
3
Termination from Medi-Cal--does it affect health?医疗补助终止——这会影响健康吗?
N Engl J Med. 1984 Aug 16;311(7):480-4. doi: 10.1056/nejm198408163110735.