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Health insurance coverage and the use of preventive services by Mexican adults

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  • José A. Pagán
  • Andrea Puig

    (Health Care Systems Department, The Wharton School, University of Pennsylvania, Philadelphia, PA, USA)

  • Beth J. Soldo

    (Population Aging Research Center and Department of Sociology, University of Pennsylvania, Philadelphia, PA, USA)

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    Abstract

    The lack of health insurance coverage could be a potentially important deterrent to the use of preventive health care by older adults with high rates of chronic co-morbidities. We use survey data from 12 100 Mexican adults ages 50 and older who participated in the 2001 Mexican Health and Aging Study (MHAS) to analyze the relation between health insurance coverage and the use of preventive health-care services in Mexico. Uninsured adults were less likely to use preventive screenings for hypertension, high cholesterol, diabetes and (breast, cervical and prostate) cancer than insured adults. After adjusting for other factors affecting preventive care utilization in a logistic regression model, we found that these results still hold for high cholesterol and diabetes screening. Similar results hold for the population not working during the survey week and for adults earning below 200% of the poverty line. Our results suggest that insured adults are in a relatively better position to detect some chronic diseases - and have them treated promptly - than uninsured adults because they have better access to cost-effective preventive screenings. Recent public policy initiatives to increase health insurance coverage rates in Mexico could lead to substantially higher preventive health-care utilization rates and improvements in population health. Copyright © 2007 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.1226
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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 16 (2007)
    Issue (Month): 12 ()
    Pages: 1359-1369

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    Handle: RePEc:wly:hlthec:v:16:y:2007:i:12:p:1359-1369

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. H. Shelton Brown & José A. Pagán & Elena Bastida, 2005. "The impact of diabetes on employment: genetic IVs in a bivariate probit," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 537-544.
    2. �ngel Marcos Vera-Hernández, 1999. "Duplicate coverage and demand for health care. The case of Catalonia," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 579-598.
    3. Wu, Stephen, 2003. "Sickness and preventive medical behavior," Journal of Health Economics, Elsevier, vol. 22(4), pages 675-689, July.
    4. Holly, Alberto & Gardiol, Lucien & Domenighetti, Gianfranco & Brigitte Bisig, 1998. "An econometric model of health care utilization and health insurance in Switzerland," European Economic Review, Elsevier, vol. 42(3-5), pages 513-522, May.
    5. Gerdtham, Ulf-G., 1996. "Equity in Health Care Utilisation: Further Tests Based on Hurdle models and Swedish Micro Data," Working Paper Series in Economics and Finance 116, Stockholm School of Economics.
    6. World Bank, 2006. "Decentralized Service Delivery for the Poor," World Bank Other Operational Studies 8173, The World Bank.
    7. Joyce, Ted, 2004. "Un-assured instruments: a comment on "insurance and the utilization of medical services"," Social Science & Medicine, Elsevier, vol. 58(9), pages 1633-1634, May.
    8. Sergi Jiménez-Mart�n & José M. Labeaga & Maite Mart�nez-Granado, 2002. "Latent class versus two-part models in the demand for physician services across the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 301-321.
    9. Meer, Jonathan & Rosen, Harvey S., 2004. "Insurance and the utilization of medical services," Social Science & Medicine, Elsevier, vol. 58(9), pages 1623-1632, May.
    10. Parker, Susan W. & Wong, Rebeca, 1997. "Household income and health care expenditures in Mexico," Health Policy, Elsevier, vol. 40(3), pages 237-255, June.
    11. Coulson, N Edward, et al, 1995. "Estimating the Moral-Hazard Effect of Supplemental Medical Insurance in the Demand for Prescription Drugs by the Elderly," American Economic Review, American Economic Association, vol. 85(2), pages 122-26, May.
    12. Martin Schellhorn, 2001. "The effect of variable health insurance deductibles on the demand for physician visits," Health Economics, John Wiley & Sons, Ltd., vol. 10(5), pages 441-456.
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    Cited by:
    1. Sosa-Rubí, Sandra G. & Galárraga, Omar & Harris, Jeffrey E., 2009. "Heterogeneous impact of the "Seguro Popular" program on the utilization of obstetrical services in Mexico, 2001-2006: A multinomial probit model with a discrete endogenous variable," Journal of Health Economics, Elsevier, vol. 28(1), pages 20-34, January.
    2. van Gameren, Edwin, 2010. "Health insurance and use of alternative medicine in Mexico," Health Policy, Elsevier, vol. 98(1), pages 50-57, November.
    3. Fernando Riosmena & Rebeca Wong & Alberto Palloni, 2013. "Migration Selection, Protection, and Acculturation in Health: A Binational Perspective on Older Adults," Demography, Springer, vol. 50(3), pages 1039-1064, June.
    4. Jürgen Maurer, 2008. "Assessing horizontal equity in medication treatment among elderly Mexicans: which socioeconomic determinants matter most?," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1153-1169.

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