TY - JOUR
T1 - The impact of subsidized health insurance for the poor
T2 - Evaluating the colombian experience using propensity score matching
AU - Trujillo, Antonio J.
AU - Portillo, Jorge E.
AU - Vernon, John A.
N1 - Funding Information:
An earlier version of this paper benefited from comments by Gabriel Picone and Myron Fottler, as well as by participants in the International Health Economics Association (IHEA) meeting in 2003. We also would like to thank Juan Miguel Gallegos, Nelcy Pare-des and Ursula Gideon for assistance in securing the household and community data. The authors take sole responsibility for any remaining errors. Antonio J. Trujillo would like to thank The University of Central Florida for the financial support provided for this work.
PY - 2005/9
Y1 - 2005/9
N2 - This paper evaluates the impact of Colombia's subsidized health insurance program (SUBS) on medical care utilization. Colombia's SUBS program is a demand-side subsidy intended for low-income families, where the screening of beneficiaries takes place in decentralized locations across the country. Due to the self-selection problems associated with non-experimental data, we implement Propensity Score Matching (PSM) methods to measure the impact of this subsidy on medical care utilization. By combining unique household survey data with community and regional data, we are able to compute propensity scores in a way that is consistent with both the local government's decision to offer the subsidy, and with the individual's decision to accept the subsidy. Although the application of PSM using these rich datasets helps to achieve a balance between the treatment and control groups along observable dimensions, we also present instrumental variable estimates to control for the potential endogeneity of program participation. Using both methods, we find that Colombia's subsidized insurance program greatly increased medical care utilization among the country's poor and uninsured. This evidence supports the case for other Latin American countries implementing similar subsidy programs for health insurance for the poor.
AB - This paper evaluates the impact of Colombia's subsidized health insurance program (SUBS) on medical care utilization. Colombia's SUBS program is a demand-side subsidy intended for low-income families, where the screening of beneficiaries takes place in decentralized locations across the country. Due to the self-selection problems associated with non-experimental data, we implement Propensity Score Matching (PSM) methods to measure the impact of this subsidy on medical care utilization. By combining unique household survey data with community and regional data, we are able to compute propensity scores in a way that is consistent with both the local government's decision to offer the subsidy, and with the individual's decision to accept the subsidy. Although the application of PSM using these rich datasets helps to achieve a balance between the treatment and control groups along observable dimensions, we also present instrumental variable estimates to control for the potential endogeneity of program participation. Using both methods, we find that Colombia's subsidized insurance program greatly increased medical care utilization among the country's poor and uninsured. This evidence supports the case for other Latin American countries implementing similar subsidy programs for health insurance for the poor.
KW - Colombia
KW - Health insurance program evaluation
KW - Medical care use
KW - Propensity score
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U2 - 10.1007/s10754-005-1792-5
DO - 10.1007/s10754-005-1792-5
M3 - Article
C2 - 16082516
AN - SCOPUS:23844553770
SN - 1389-6563
VL - 5
SP - 211
EP - 239
JO - International journal of health care finance and economics
JF - International journal of health care finance and economics
IS - 3
ER -