Abstract
BackgroundWe analyze the effects of the Mexican universal health insurance program, Seguro Popular, on key variables associated with the provision of healthcare services. Given that the program was introduced gradually over a period that lasted more than a decade, the dynamics of the roll-out of the program and its reaction to the expansion of healthcare services it caused should be accounted for when evaluating the program.MethodsWe present a new semiparametric procedure to analyze time-varying continuous interventions. This is accomplished by bringing together the literatures on continuous and on dynamic treatments. Our approach allows the researcher to estimate mean and quantile dose-response functions by applying local regression methods to appropriately weighted samples that control for time-dependent confounding.ResultsUsing administrative data, we show compelling evidence that Seguro Popular has incremented the human and physical resources available for healthcare services over the period 2001–2013. Moreover, we show that these effects have been heterogeneously distributed.ConclusionsThe program has proven most helpful in less vulnerable territories, leaving behind those in greater need.
Highlights
Introduction to affordable healthcare servicesAt the start of the mil-Traditionally, health insurance in Mexico has been part lennium, the newly-installed government proposed and of the social security system that provides healthcare ser- enacted a health insurance program for those in inforvices, retirement pensions, and several other benefits, for mal employment, with the intention to achieve universal everyone with a formal employer that paid the contri- health coverage [1, 2]
We intend to estimate the effect of the health insurance program, (SP), on key variables associated with the provision of healthcare services in Mexico
In our analysis we focus on the 233 Sanitary jurisdiction (SJ) as recipients of Seguro Popular (SP) coverage, defined as the number of persons affiliated to the program relative to the size of the target population in every SJ, that is, the number of individuals who do not have access to the health insurance provided by law through the social security system to formal workers7
Summary
We present a new semiparametric procedure to analyze time-varying continuous interventions. This is accomplished by bringing together the literatures on continuous and on dynamic treatments. Our approach allows the researcher to estimate mean and quantile dose-response functions by applying local regression methods to appropriately weighted samples that control for time-dependent confounding
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