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New Mexican health-care program successful at reducing crippling health care costs
Date:4/7/2009

ercent of households reported participating in the program, compared to 7.3 percent in control communities, which was approximately as expected. Among participating households, those suffering catastrophic health expenses were reduced by almost 60 percent, contributing to a 30 percent reduction in catastrophic health expenses across treatment communities.

The evaluation also highlighted areas in which the program was ineffective. Contrary to prior non-randomized studies, the researchers found no increase in utilization of health services, although longer-term research may show an increase. Health outcomes will also take longer to show an effect.

Before the program was instituted, 174 communities were paired up based on having similar background variables, such as the health of the community, size, and the number of schools. Then one community within each pair was randomly chosen to receive treatment: Families were encouraged to enroll in Seguro Popular, health facilities were built or upgraded, and medical personnel, drugs, and other supplies were provided. In the other community within each pair, no changes were made.

"One advantage of this design is that if one of the communities was to drop out of the study, due to interventions by politicians or for other reasons, the paired community would be removed as well, and the balance between the treated and control groups would not be affected. In contrast, classical randomized experiments are destroyed when even one community is lost. The matched pair design also decreased the margin of error to as little as one-sixth of what it would be with traditional experimental methods," says King. "That's the equivalent of collecting many more respondents, or randomizing throughout many more communities, for the same cost."

Seguro Popular in Mexico covers about the same number of people as are uninsured in America. King points out that there may be lessons for other countries to learn in t
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Contact: Amy Lavoie
amy_lavoie@harvard.edu
617-496-9982
Harvard University
Source:Eurekalert

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