Background:Background: In many countries, health insurance coverage is the primary way for individuals to access care. Governments can support access through social insurance programmes; however, after a certain period, governments struggle to achieve universal coverage. Evidence suggests that...

This paper uses a benefit incidence analysis (BIA) to evaluate whether public health expenditure in Ecuador is regressive or progressive. This paper overcomes several limitations of previous BIA analyses in developing countries: a) it develops a framework to allocate the operational and...

Undetected diabetes (UD) worsens prognosis, increases healthcare costs and reduces productivity in the long term. However, its determinants have not been previously explored in developing countries. In this paper, we assess the determinants of UD in Colombia. We conducted logistic regression...

White seniors report better health than Black seniors in urban areas in Sao Paulo, Brazil. This is the case even after controlling for baseline health conditions and several demographic, socio-economic and family support characteristics. Furthermore, adjusted racial disparities in self-reported...

This paper studies the relationship between health status and insurance participation, and between insurance status and medical use in the context of a social health insurance with an equalization fund (SHIEF). Under this system, revenues from a mandatory payroll tax are collected into a single...

One of the primary objectives of Colombian social health insurance reform was to increase competition among for-profit insurers. Unfortunately, the flat capitated formula creates an opportunity for sickness funds to maximize reimbursement gains by “cream skimming”-selecting against unhealthy...