医疗保险系统的分裂和COVID-19死亡率:来自秘鲁的证据
Misael Anaya-Montes1,2, Hugh Gravelle2
1Ministry of Economics and Finance, Lima, Peru.
PloS one
|August 27, 2024
概括
秘鲁的双重医疗保险显著降低了0.23%的COVID-19死亡风险. 扩大双重保险可以防止数千人死亡,改善公共卫生结果.
科学领域:
- 卫生经济学 卫生经济学
- 流行病学 流行病学
- 公共卫生政策 公共卫生政策
背景情况:
- 秘鲁的医疗保险系统是分散的,限制了供应商的网络特定个人的访问.
- 两个主要的子系统覆盖了人口的很大一部分,有些人持有双重保险.
- 双重保险允许从两个子系统的提供商访问,可能减轻访问障碍.
研究的目的:
- 调查双重医疗保险对秘鲁COVID-19死亡率的影响.
- 量化与双重保险覆盖相关的COVID-19死亡风险的减少.
主要方法:
- 利用了2470万个在秘鲁主要医疗保险子系统中的一个或两个注册的人员的数据.
- 采用了递归的双变量探针模型,采用了仪器变量方法.
- 工具变量基于两个保险子系统中距离最近医院的差异.
主要成果:
- 双重保险与COVID-19死亡风险降低0.23%有关.
- 这与样本平均死亡风险为0.54%相比,相当于相对降低风险.
- 据估计,如果实施通用双重保险,那么在样本中可以避免56,418例COVID-19死亡.
结论:
- 秘鲁的双重医疗保险明显降低了COVID-19死亡风险.
- 扩大双重保险覆盖面是一个可行的策略,以减轻与流行病相关的死亡率.
- 促进双重保险的政策干预可以显著提高公共卫生结果,减少可预防的死亡.
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