The Impact of the Introduction of the Popular Health Insurance Programme on the Utilisation of Health Services Among the Most Vulnerable Population in México

Abstract

Background The Popular Health Insurance Programme (PHIP) was launched recently (2001) to protect the jobless and poor populations (around 48 million people) without any financial protection against catastrophic spending due to an unexpected health condition. Various strategies have been implemented alongside this programme to protect this population: i. To offer financial protection to population without any social insurance; ii. To promote the prepayment of health services; iii. To reduce the number of families on risk to impoverishment due to catastrophic expenses. This programme also encouraged the improvement of the access to health resources trough the extension of the basic health package which includes; health consultations to the health centres, medicines, hospital treatments, etc. In this paper we estimate the impact of the PHIP on the use of prenatal health services to determine if this programme have contributed to ameliorate the utilisation of health centres.

Objective The main objective is to assess if the PHIP has improved the demand of health services whose utilisation can represent catastrophic expenses among the poorest families in Mexico.

Methodology We apply count data models that particularly replicate overdispersion due to the heterogeneity found among the users of public health services. Two nationally-representative cross sectional health surveys for 2001 and 2005 are used. We compare two different samples of population from the NHS (from 2001 and 2005 years) in order to analyse the potential changes in the demand of public health services before and after the implementation of the PHIP for health centres and hospital services.

Results We found that the use of prenatal health services was higher among those women within families with members enrolled in the PHIP programme in 2005. This reveals that the introduction of the PHIP encouraged the use of health services among women in their reproductive age who use public health services. We found also evidence about the greater probability of having a delivery attention in the clinics where the health insurance is available.

Keywords: Key words: health insurance, utilisation, prenatal care, vulnerable population, Mexico