Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico.
Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico.
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DOI：
10.1007/s10198-009-0180-3
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发表时间：
2010-10
影响因子：
4.4
通讯作者：
Sesma-Vazquez, Sergio
中科院分区：
文献类型：
--
作者：
Galarraga, Omar;Sosa-Rubi, Sandra G.;Salinas-Rodriguez, Aaron;Sesma-Vazquez, Sergio
关键词：
墨西哥的Seguro Popular(SP)的目标是改善对未参保人口的财政保护，使其免受过度医疗支出的影响。本文从两个不同的来源估计了SP对灾难性卫生支出(CHE)和自付卫生支出(OOP)的影响。首先，我们使用了SP影响评价调查(2005-2006)，并将工具变量(IV)的结果与实验基准进行了比较。然后，我们使用与国家健康和营养调查(ENSANUT 2006)相同的IV方法。我们假设外生性，估计幼稚模型，并将它们与利用特定SP实现机制进行识别的IV模型进行比较。估计的IV模型包括两阶段最小二乘(2SLS)、双变量PROBIT和两阶段残差包含(2SRI)模型。工具变量估计导致了与“黄金标准”的可比估计。工具变量估计数表明，国家一级的灾难性支出减少了54%。SP受益者的门诊和药品支出也较低。不仅在有限的实验数据集上发现了选择校正的保护效果，而且在国家层面上也发现了这种选择校正的保护效果。
The goal of Seguro Popular (SP) in Mexico was to improve the financial protection of the uninsured population against excessive health expenditures. This paper estimates the impact of SP on catastrophic health expenditures (CHE), as well as out-of-pocket (OOP) health expenditures, from two different sources. First, we use the SP Impact Evaluation Survey (2005–2006), and compare the instrumental variables (IV) results with the experimental benchmark. Then, we use the same IV methods with the National Health and Nutrition Survey (ENSANUT 2006). We estimate naïve models, assuming exogeneity, and contrast them with IV models that take advantage of the specific SP implementation mechanisms for identification. The IV models estimated included two-stage least squares (2SLS), bivariate probit, and two-stage residual inclusion (2SRI) models. Instrumental variables estimates resulted in comparable estimates against the “gold standard.” Instrumental variables estimates indicate a reduction of 54% in catastrophic expenditures at the national level. SP beneficiaries also had lower expenditures on outpatient and medicine expenditures. The selection-corrected protective effect is found not only in the limited experimental dataset, but also at the national level.
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影响因子：
168.9
作者：
Knaul, Felicia Marie;Arreola-Ornelas, Hector;Sesma, Sergio
通讯作者：
Sesma, Sergio
影响因子：
3.7
作者：
Angrist, JD;Imbens, GW;Rubin, DB
通讯作者：
Rubin, DB
影响因子：
6.1
作者：
HECKMAN, JJ
通讯作者：
HECKMAN, JJ
DOI：
10.2471/blt.06.033720
发表时间：
2007-08-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Limwattananon, Supon;Tangcharoensathien, Viroj;Prakongsai, Phusit
通讯作者：
Prakongsai, Phusit
影响因子：
1.9
作者：
Little, Roderick J.;Long, Qi;Lin, Xihong
通讯作者：
Lin, Xihong