ArticlePloS one2024
Health insurance system fragmentation and COVID-19 mortality: Evidence from Peru.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Socioeconomic Inequalities in Health Service Utilization in the Peruvian Population: A National Population-Based Study.Healthcare (Basel, Switzerland) · 2026Article
- Trends and Factors Associated with the Non-Use of Formal Health Services in Peru, 2015-2024.International journal of environmental research and public health · 2026Article
- Temporal costs of access to formal health care among adult users in Peru: a national analysis of inequalities in travel and waiting times, 2016-2024.Frontiers in health services · 2026Article
- Article
- Analysis of disparities in medical check-ups for patients with diabetes and hypertension: associated factors and trends in a nine-year national survey.Frontiers in clinical diabetes and healthcare · 2025Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Peru has a fragmented health insurance system in which most insureds can only access the providers in their insurer's network. The two largest sub-systems covered about 53% and 30% of the population at the start of the pandemic; however, some individuals have dual insurance and can thereby access both sets of providers. We use data on 24.7 million individuals who belonged to one or both sub-systems to investigate the effect of dual insurance on COVID-19 mortality. We estimate recursive bivariate probit models using the difference in the distance to the nearest hospital in the two insurance sub-systems as Instrumental Variable. The effect of dual insurance was to reduce COVID-19 mortality risk by 0.23% compared with the sample mean risk of 0.54%. This implies that the 133,128 COVID-19 deaths in the sample would have been reduced by 56,418 (95%CI: 34,894, 78,069) if all individuals in the sample had dual insurance.
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