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The Impact of Increasing Health Insurance Coverage on Disparities in Mortality: Health Care Reform in Colombia, 1998-2007.
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- Author(s): Arroyave, Ivan; Cardona, Doris; Burdorf, Alex; Avendano, Mauricio
- Source:
American Journal of Public Health. Mar2013, Vol. 103 Issue 3, pe100-e106. 7p. 2 Charts, 3 Graphs. - Source:
- Additional Information
- Subject Terms: CARDIOVASCULAR disease related mortality; CENSUS; CONFIDENCE intervals; HEALTH services accessibility; HEALTH status indicators; INSURANCE; LONGITUDINAL method; POISSON distribution; REGRESSION analysis; RESEARCH funding; SEX distribution; DEATH certificates; EDUCATIONAL attainment; HEALTH equity; STATISTICAL models
- Subject Terms:
- Abstract: Objectives. We examined the impact of expanding health insurance coverage on socioeconomic disparities in total and cardiovascular disease mortality from 1998 to 2007 in Colombia. Methods. 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. Results. Disparities in mortality by education widened over time. Among men, the relative index of inequality increased from2.59 (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. Conclusions. 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. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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