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dc.contributor.authorDoubova, Svetlana Ven_US
dc.contributor.authorPérez-Cuevas, Ricardoen_US
dc.contributor.authorCanning, Daviden_US
dc.contributor.authorReich, Michael Ren_US
dc.date.accessioned2015-08-03T13:59:58Z
dc.date.issued2015en_US
dc.identifier.citationDoubova, Svetlana V, Ricardo Pérez-Cuevas, David Canning, and Michael R Reich. 2015. “Access to healthcare and financial risk protection for older adults in Mexico: secondary data analysis of a national survey.” BMJ Open 5 (7): e007877. doi:10.1136/bmjopen-2015-007877. http://dx.doi.org/10.1136/bmjopen-2015-007877.en
dc.identifier.issn2044-6055en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:17820714
dc.description.abstractObjectives: While the benefits of Seguro Popular health insurance in Mexico relative to no insurance have been widely documented, little has been reported on its effects relative to the pre-existing Social Security health insurance. We analyse the effects of Social Security and Seguro Popular health insurances in Mexico on access to healthcare of older adults, and on financial risk protection to their households, compared with older adults without health insurance. Setting: Secondary data analysis was performed using the 2012 Mexican Survey of Health and Nutrition (ENSANUT). Participants: The study population comprised 18 847 older adults and 13 180 households that have an elderly member. Outcome measures The dependent variables were access to healthcare given the reported need, the financial burden imposed by health expenditures measured through catastrophic health-related expenditures, and using savings for health-related expenditures. Separate propensity score matching analyses were conducted for each comparison. The analysis for access was performed at the individual level, and the analysis for financial burden at the household level. In each case, matching on a wide set of relevant characteristics was achieved. Results: Seguro Popular showed a protective effect against lack of access to healthcare for older adults compared with those with no insurance. The average treatment effect on the treated (ATET) was ascertained through using the nearest-neighbour matching (−8.1%, t-stat −2.305) analysis. However, Seguro Popular did not show a protective effect against catastrophic expenditures in a household where an older adult lived. Social Security showed increased access to healthcare (ATET −11.3%, t-stat −3.138), and protective effect against catastrophic expenditures for households with an elderly member (ATET −1.9%, t-stat −2.178). Conclusions: Seguro Popular increased access to healthcare for Mexican older adults. Social Security showed a significant protective effect against lack of access and catastrophic expenditures compared with those without health insurance.en
dc.language.isoen_USen
dc.publisherBMJ Publishing Groupen
dc.relation.isversionofdoi:10.1136/bmjopen-2015-007877en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513520/pdf/en
dash.licenseLAAen_US
dc.subjectaccess to healthcareen
dc.subjectfinancial risk protectionen
dc.subjecthealth insuranceen
dc.subjectolder adultsen
dc.titleAccess to healthcare and financial risk protection for older adults in Mexico: secondary data analysis of a national surveyen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalBMJ Openen
dash.depositing.authorCanning, Daviden_US
dc.date.available2015-08-03T13:59:58Z
dc.identifier.doi10.1136/bmjopen-2015-007877*
dash.contributor.affiliatedReich, Michael
dash.contributor.affiliatedCanning, David


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