UCLA

The launch of Seguro Popular by the Mexican government in the early 2000s has been one of the main highlights of Mexican health reform during this century. Essentially a voluntary health insurance program, Seguro Popular was implemented with the aim to expand health insurance coverage to the uninsured population, provide financial protection to families, and improve access to care. Gaining insight as to whether the program is meeting its proposed objectives and responding to the health needs of the Mexican population is crucial, given the adverse economic and social conditions imposed by the epidemiological and demographic transitions that are currently coexisting in the country. Numerous research studies have analyzed the impact of the program on different outcomes and sectors of Mexico’s population. However, the majority of these studies have addressed the effects of the program at the individual level (rather than from a state or regional perspective), most of them have analyzed the impact of Seguro Popular on the short term, and very few have focused on the population of older Mexican adults with chronic conditions, which represent one of the most vulnerable and fastest growing segments of Mexico’s population.

This dissertation consists of three studies that analyze: (a) the effect of state-level Seguro Popular health-related resources on outpatient health care utilization (primarily); (b) the impact of Seguro Popular on health care utilization among the population of older Mexican adults with diabetes and/or hypertension at the individual level; and (c) the individual-level effect of Seguro Popular on out-of-pocket expenditures among older Mexican adults with diabetes and/or hypertension

While the first study makes use of a panel dataset on state-level characteristics that was compiled from publicly available data, the second and third studies use data from the first and third waves of the Mexican Health and Aging Study, a nationally representative longitudinal study of Mexican adults aged 50 or more. Different methodological approaches were used to address the research questions in each of the studies.

Findings from the first study indicate that greater availability of Seguro Popular health-related resources at the state level are associated with higher outpatient health care utilization rates. Moreover, results from the second and third study suggest that older Mexican adults who were enrolled in Seguro Popular were associated with higher utilization rates and lower out-of-pocket expenditures compared to those who were uninsured.