The effect of primary healthcare on mortality: Evidence from Costa Rica

IF 3.6 2区 经济学 Q1 ECONOMICS Journal of Health Economics Pub Date : 2023-11-08 DOI:10.1016/j.jhealeco.2023.102833
Claudio A. Mora-García , Madeline Pesec , Andrea M. Prado
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Abstract

This paper uses the gradual implementation of a primary healthcare (PHC) intervention in Costa Rica to examine the long-term effect of PHC on mortality. Nine years after opening a primary care center, known as a Health Area, there was an associated 13% reduction in age-adjusted mortality rate in the assigned patient population. The effect was highest among adults over 65 years of age and for those with noncommunicable diseases, such as cardiovascular-related causes of death. We also show that as Health Areas opened, more individuals sought care at primary care clinics, while fewer sought care at emergency rooms; these changes may have partially mediated the effect of the intervention on mortality.

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初级保健对死亡率的影响:来自哥斯达黎加的证据
本文利用哥斯达黎加逐步实施的初级卫生保健(PHC)干预来研究初级卫生保健对死亡率的长期影响。在开办初级保健中心(即健康区)9年后,指定患者人群的年龄调整死亡率相应降低了13%。这种影响在65岁以上的成年人和患有非传染性疾病(如心血管相关死因)的人中最为明显。我们还表明,随着“卫生区”的开放,越来越多的人在初级保健诊所寻求治疗,而在急诊室寻求治疗的人越来越少;这些变化可能部分调节了干预对死亡率的影响。
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来源期刊
Journal of Health Economics
Journal of Health Economics 医学-卫生保健
CiteScore
6.10
自引率
2.90%
发文量
96
审稿时长
49 days
期刊介绍: This journal seeks articles related to the economics of health and medical care. Its scope will include the following topics: Production and supply of health services; Demand and utilization of health services; Financing of health services; Determinants of health, including investments in health and risky health behaviors; Economic consequences of ill-health; Behavioral models of demanders, suppliers and other health care agencies; Evaluation of policy interventions that yield economic insights; Efficiency and distributional aspects of health policy; and such other topics as the Editors may deem appropriate.
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