Health insurance coverage: the peruvian case since the universal insurance act

Authors

  • Edward Mezones-Holguin Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud. Lima, Perú. Epi-gnosis Solutions. Piura, Perú. Médico cirujano, maestro en ciencias en Epidemiología Clínica
  • Elard Amaya Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud. Lima, Perú. economista
  • Luciana Bellido-Boza Superintendencia Nacional de Salud, Intendencia de Investigación y Desarrollo. Lima, Perú. Universidad Peruana de Ciencias Aplicadas, Facultad de Ciencias de la Salud. Lima, Perú. licenciada en Nutrición
  • Benoit Mougenot Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud. Lima, Perú. economista, doctor en Economía
  • Juan P. Murillo Superintendencia Nacional de Salud, Intendencia de Investigación y Desarrollo. Lima, Perú. Universidad Nacional Mayor de San Marcos, Facultad de Medicina de San Fernando. Lima, Perú. médico cirujano
  • José Villegas-Ortega Superintendencia Nacional de Salud, Intendencia de Investigación y Desarrollo. Lima, Perú. Universidad Peruana de Ciencias Aplicadas, Escuela de Postgrado. Lima, Perú. licenciado en Computación, magíster en Ingeniería de Sistemas
  • José Del-Carmen Universidad Nacional Mayor de San Marcos, Facultad de Medicina de San Fernando. Lima, Perú. Superintendencia Nacional de Salud, Alta Dirección. Lima, Perú. médico cirujano, especialista en Neurología, doctor en Salud Pública

DOI:

https://doi.org/10.17843/rpmesp.2019.362.3998

Keywords:

Universal Health Coverage, Financial Risk Protection, Social Security, Public Policy, Peru

Abstract

Objective. To describe the trends in health insurance coverage (HIC) in Peru during the period 2009-2017 and evaluate associations with demographic, social and economic factors. Materials and Methods. We carried out a secondary data-analysis from the Peruvian National Household Survey. For each year, we estimated the global HIC, for the Integral Health Insurance (SIS) and the Social Security system (EsSalud). In addition, we performed a trend analysis. For 2009 (Universal Health Insurance Act), 2013 (health care reform act) and 2017, we used a polytomous variable for the insurance type (SIS/EsSalud/Non-affiliated). We performed logistic multinomial regressions to estimate relative prevalence ratios (RPR) and their 95% CI with correction for complex sampling. Results. We observed an increasing trend in the global HIC (2009:60.5%; 2013:65.5%; 2017:76.4%), SIS coverage (2009:34%; 2013:35.4%; 2017:47%) and EsSalud coverage (2009:22.8%; 2013:26.4%; 2017:26.3%). Multinomial logistic regressions showed that being a woman increased the likelihood to be affiliated to the SIS (RPR= 2009:1.64 and 2017:1.53), while people between 18 and 39 years old, living in Lima Metropolitan area under non-poverty conditions reduced the likelihood to be affiliated to the SIS (RPR= 2009:0.16 and 2017:0.31; 2009:0.17 and 2017:0.37; 2009:0.51 and 2017:0.53; respectively). Furthermore, being a woman, 65 years old or over, living in urban Lima, and under non-poverty conditions increased the likelihood of being affiliated with the EsSalud (RPR= 2013:1.12 and 2017:1.24; 2013:1.32 and 2017:1.34; 2009:2.18 and 2017:2.08; 2009:2.14 and 2017:2.54; 2009:3.57 and 2017:2.53; respectively). Conclusions. HIC has increased during the period 2009-2017. However, the characteristics of those affiliated are different between the various types of health insurance.

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Published

2019-06-25

Issue

Section

Original Article

How to Cite

1.
Mezones-Holguin E, Amaya E, Bellido-Boza L, Mougenot B, Murillo JP, Villegas-Ortega J, et al. Health insurance coverage: the peruvian case since the universal insurance act. Rev Peru Med Exp Salud Publica [Internet]. 2019 Jun. 25 [cited 2024 Apr. 21];36(2):196-20. Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/3998

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