The impact of increasing health insurance coverage on disparities in mortality: health care reform in Colombia, 1998-2007.
Details
Serval ID
serval:BIB_6BA49EA3914B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The impact of increasing health insurance coverage on disparities in mortality: health care reform in Colombia, 1998-2007.
Journal
American journal of public health
ISSN
1541-0048 (Electronic)
ISSN-L
0090-0036
Publication state
Published
Issued date
03/2013
Peer-reviewed
Oui
Volume
103
Number
3
Pages
e100-6
Language
english
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
We examined the impact of expanding health insurance coverage on socioeconomic disparities in total and cardiovascular disease mortality from 1998 to 2007 in Colombia.
We used Poisson regression to analyze data from mortality registries (633 905 deaths) linked to population census data. We used the relative index of inequality to compare disparities in mortality by education between periods of moderate increase (1998-2002) and accelerated increase (2003-2007) in health insurance coverage.
Disparities in mortality by education widened over time. Among men, the relative index of inequality increased from 2.59 (95% confidence interval [CI] = 2.52, 2.67) in 1998-2002 to 3.07 (95% CI = 2.99, 3.15) in 2003-2007, and among women, from 2.86 (95% CI = 2.77, 2.95) to 3.12 (95% CI = 3.03, 3.21), respectively. Disparities increased yearly by 11% in men and 4% in women in 1998-2002, whereas they increased by 1% in men per year and remained stable among women in 2003-2007.
Mortality disparities widened significantly less during the period of increased health insurance coverage than the period of no coverage change. Although expanding coverage did not eliminate disparities, it may contribute to curbing future widening of disparities.
We used Poisson regression to analyze data from mortality registries (633 905 deaths) linked to population census data. We used the relative index of inequality to compare disparities in mortality by education between periods of moderate increase (1998-2002) and accelerated increase (2003-2007) in health insurance coverage.
Disparities in mortality by education widened over time. Among men, the relative index of inequality increased from 2.59 (95% confidence interval [CI] = 2.52, 2.67) in 1998-2002 to 3.07 (95% CI = 2.99, 3.15) in 2003-2007, and among women, from 2.86 (95% CI = 2.77, 2.95) to 3.12 (95% CI = 3.03, 3.21), respectively. Disparities increased yearly by 11% in men and 4% in women in 1998-2002, whereas they increased by 1% in men per year and remained stable among women in 2003-2007.
Mortality disparities widened significantly less during the period of increased health insurance coverage than the period of no coverage change. Although expanding coverage did not eliminate disparities, it may contribute to curbing future widening of disparities.
Keywords
Adult, Age Factors, Colombia/epidemiology, Educational Status, Female, Health Care Reform/statistics & numerical data, Health Status Disparities, Humans, Insurance Coverage/statistics & numerical data, Insurance, Health/statistics & numerical data, Male, Middle Aged, Mortality, Sex Factors
Pubmed
Web of science
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Create date
18/10/2021 14:59
Last modification date
04/11/2021 7:40