Medical care use and selection in a social health insurance with an equalization fund: evidence from Colombia.
Health Econ
; 12(3): 231-46, 2003 Mar.
Article
em En
| MEDLINE
| ID: mdl-12605467
This paper studies the relationship between health status and insurance participation, and between insurance status and medical use in the context of a social health insurance with an equalization fund (SHIEF). Under this system, revenues from a mandatory payroll tax are collected into a single pool (equalization fund) that reimburses for-profit insurance companies according to a capitated formula. Although competition should induce insurers to control costs without reducing the quality of service necessary to attract consumers, limitations in the capitation formula might induce insurers to select against bad risks, and limitations in the contribution system might induce more healthy individuals to evade enrollment. A three-equation model having social health insurance, private health insurance, and using medical services is estimated using a 1997 Colombian household survey. Consistent with similar studies, participation in SHIEF increases medical care use. On the other hand, the evidence on selection is somewhat mixed: individuals who report good health status are more likely to participate in SHIEF, while those without a chronic condition are less likely to participate in SHIEF.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mecanismo de Reembolso
/
Capitação
/
Seleção Tendenciosa de Seguro
/
Nível de Saúde
/
Planos de Assistência de Saúde para Empregados
/
Programas Nacionais de Saúde
Tipo de estudo:
Prognostic_studies
Aspecto:
Determinantes_sociais_saude
/
Patient_preference
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
America do sul
/
Colombia
Idioma:
En
Revista:
Health Econ
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Estados Unidos
País de publicação:
Reino Unido