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The roll-out of a health insurance program and its impact on the supply of healthcare services: a new method to evaluate time-varying continuous interventions

International Journal for Equity in Health. 2018;17(1):1-20 DOI 10.1186/s12939-018-0874-1


Journal Homepage

Journal Title: International Journal for Equity in Health

ISSN: 1475-9276 (Online)

Publisher: BMC

Society/Institution: WONCA Health Special Interest Group: Health Equity

LCC Subject Category: Medicine: Public aspects of medicine

Country of publisher: United Kingdom

Language of fulltext: English

Full-text formats available: PDF, HTML



Curtis Huffman (Programa Universitario de Estudios del Desarrollo, Universidad Nacional Autónoma de México, National Autonomous University of Mexico, Development Studies Program)

Edwin van Gameren (Center for Economic Studies, El Colegio de México)


Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 28 weeks


Abstract | Full Text

Abstract Background We analyze the effects of the Mexican universal health insurance program, Seguro Popular, on key variables associated with the provision of healthcare services. Given that the program was introduced gradually over a period that lasted more than a decade, the dynamics of the roll-out of the program and its reaction to the expansion of healthcare services it caused should be accounted for when evaluating the program. Methods We present a new semiparametric procedure to analyze time-varying continuous interventions. This is accomplished by bringing together the literatures on continuous and on dynamic treatments. Our approach allows the researcher to estimate mean and quantile dose-response functions by applying local regression methods to appropriately weighted samples that control for time-dependent confounding. Results Using administrative data, we show compelling evidence that Seguro Popular has incremented the human and physical resources available for healthcare services over the period 2001–2013. Moreover, we show that these effects have been heterogeneously distributed. Conclusions The program has proven most helpful in less vulnerable territories, leaving behind those in greater need.