The Impact of Social Health Insurance on Diabetes and Hypertension Process Indicators among Older Adults in Mexico

Abstract

Social health insurance for the poor improved some but not all health care process indicators among diabetic and hypertensive older people in Mexico.

The impact of user charges on health outcomes in low-income and middle-income countries: a systematic review

“…Three studies evaluated the impact of reducing user charge on chronic condition–related outcomes (with two studies in Mexico and one in Ghana)39 42 43 (online supplementary table 5). Outcomes in these three studies included blood glucose control (HbA1c), adherence to medication, diet and exercise for hypertension and diabetes, and anaemia.…”

Preventive healthcare-seeking behavior among poor older adults in Mexico: the impact of Seguro Popular, 2000-2012

“…The instrumental variable used in the present study (the interaction between the logarithm of population density at the municipality level in year 2000 and a dummy for whether Ensanut was conducted in 2005-6) takes into account the fact that the intensity of the roll-out process and the penetration of SP over the study period were not equally distributed across different areas. As explained in other studies, 6 SP was introduced in 2002 and gradually adopted by all the states by 2005. At first, it was targeted to smaller areas in order to achieve universal coverage more quickly; 18,19 however, after 2006, SP spread to more urbanized areas.…”

“…3,4 In contrast, recent studies have found that SP had little to no impact on diabetes and hypertension treatment and care among Mexican elders, and even produced an increase in ambulatory care sensitive hospitalizations (ACSH). 5,6 Effective preventive care for older adults can reduce health care costs and reduce multimorbidity and mortality. 7 SP provides a package of services that is limited in scope and availability since patients need to be treated via the SP network of health facilities.…”

“…A similar IV has been used in prior studies. 6,21 A similar variable with this interaction for 2011-12 was also explored as a potential IV. To account for temporal and spatial heterogeneity across municipalities, both municipality and year fixed effects were included.…”

Is Being Insured Sufficient to Ensure Effective Access to Health Care among Poor People in Mexico in the Long Term?

“…) using cross‐sectional information for several years, combined with other techniques such as instrumental variables or propensity score matching, seems very promising. Applying this approach, Rivera‐Hernandez et al () suggested that older Mexican adults covered by SP have better pharmacologic treatment for diabetes than their noninsured counterparts. However, they found no impact of SP on either pharmacologic treatment for hypertension or nonpharmacologic treatment for either diabetes or hypertension.…”