Abstract

GRILLO-ROJAS, Pedro  and  VASQUEZ, Ana. Assessment of the mechanism of payment capitated in the peruvian seguro integral de Salud. Rev. Fac. Med. Hum. [online]. 2019, vol.19, n.3, pp.11-18. ISSN 1814-5469.  http://dx.doi.org/10.25176/RFMH.v19i3.2168.

Objective:To Assess the impact of the capitated payment mechanism, implemented by the Comprehensive Health Insurance (SIS), in the execution of resources from the source of financing, donations and transfers, during the years 2012 to 2016, Peru. Methods: Assessment of the execution percentages of the regions, the number of preventive benefits versus the number of recuperative benefits and the impact on the increase of preventive care in the pilot regions versus the counterfactual regions was measured. A retrospective descriptive study was carried out pre post and difference of differences between the pilot regions Apurímac, Amazonas, Ayacucho, Callao and Huancavelica compared with a counterfactual paired by the Human Development Index; In addition, the regions of Moquegua, Loreto, Puno, Cajamarca and Huánuco were considered. Results: An increase in the average percentage of execution was observed, prior to the capitated mechanism, from 68.5% in 2012 to 92.3% in 2016; likewise, the increase at the national level of preventive benefits versus recuperative benefits, with the specific weight of preventive benefits being invested in favor of them and, using the difference in differences method, it was evident that the pilot regions had a positive difference of 1551 preventive benefits for every 10,000 insured persons versus the counterfactual regions.

Keywords : Impact; Payment Mechanism; Capitated; Pre Post; Sanitary Results; Intermediate results; Capitated; Payment mechanisms; Impact; Difference in differences; Health results; Intermediate results; Public insurance system.

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