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Am Econ J Appl Econ. 2013 Oct;5(4):61-91.

Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor.

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Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 94305-6019, USA, and National Bureau of Economic Research.
Inter-American Development Bank, 1300 New York Avenue, N.W., Washington, DC 20577, USA.
Department of Economics, University College London, Gordon street, London, WC1E 6BT, UK, and Institute for Fiscal Studies (IFS).


Unexpected medical care spending imposes considerable financial risk on developing country households. Based on managed care models of health insurance in wealthy countries, Colombia's Régimen Subsidiado is a publicly financed insurance program targeted to the poor, aiming both to provide risk protection and to promote allocative efficiency in the use of medical care. Using a "fuzzy" regression discontinuity design, we find that the program has shielded the poor from some financial risk while increasing the use of traditionally under-utilized preventive services - with measurable health gains.

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