Bulletin of the World Health Organization

Diabetes treatment and control: the effect of public health insurance for the poor in Mexico

Sandra G Sosa-Rubí, Omar Galárraga & Ruy López-Ridaura

Volume 87, Number 7, July 2009, 512-519

Table 3. Average effect of enrolment in the Seguro Popular in terms of diabetes treatment and control, Mexico, 2006a

Outcome variable Mean
 Unmatched
 Matched
Seguro Popular Uninsured Unmatched differenceb t-value P-value Matched ATTc (95% CI) t-value P-value
Health care access outcome
Regular use of any blood glucose control testd 0.809 0.754 0.055 2.300 *** 0.095 (0.020‑0.161) 2.626 ***
No. of insulin users 0.0415 0.0479 –0.0064 –0.504 NS 0.001 (–0.032–0.034) 0.066 NS
No. of insulin shots per week among insulin users 12.6 8.99 3.600 2.922 *** 3.133 (0.04–6.22) 1.988 **
No. of blood sugar control tests per month 1.02 0.87 0.144 0.825 NS 0.142 (0.024–0.260) 2.371 ***
Four or more physician visits per year 0.918 0.811 0.107 4.795 *** 0.093 (0.032–0.154) 3.019 ***
Biological outcome
Proportion of diabetics with appropriate glucose controle 0.089 0.074 0.015 0.624 NS 0.056 (0.009–0.103) 2.316 ***
Proportion of diabetics with very poor glucose controlf 0.367 0.462 –0.095 –2.122 *** –0.175 (–0.285–0.065) –3.159 ***

**P < 0.05; ***P < 0.01, using t tests, of mean differences between treatment and control (unmatched and matched) groups.ATT, average treatment effect on the treated; CI, confidence interval; NS, not significant.
a The data are not weighted.
b This is the raw difference between unmatched samples, or the difference between the mean observed in Seguro Popular enrollees and the mean observed in the uninsured population.
c The ATT is based on the differences in mean outcome for propensity-score-matched individuals using nearest neighbour matching.
d Tests may include urine or capillary blood reactive strips, blood glucose, or glycosylated haemoglobin (HbA1c).
e Appropriate glucose control (HbA1c ≤ 7%) compared with poor glucose control (HbA1c > 7%).
f Very poor glucose control (HbA1c > 12%) compared with normal and poor glucose control (HbA1c ≤ 12%).