Higuera, LucasPrada Ríos, Sergio Iván2017-07-072017-07-072016-10-011175-5652https://www.scopus.com/inward/record.uri?eid=2-s2.0-84975486656&doi=10.1007%2fs40258-016-0251-4&partnerID=40&md5=3f8dce1292f2ff8faa8b798c797097b7http://hdl.handle.net/10906/81733Background: Copayments, deductibles, and coinsurance, are elements of health-care systems to make prices salient for the insured. Individuals may respond differently to cost sharing, according to the type of care they seek; dental care, as a combination of both acute and elective care, is an ideal setting to study the effects of cost-sharing mechanisms on utilization. Objective: To test how coinsurance affects dental-care utilization in a middle-income country context. Methods: This study uses policy variations in the Colombian health-care system to analyze changes in dental-care utilization due to different levels of coinsurance. We used matching procedures to balance observed differences in pre-treatment variables between those who face coinsurance (non-policy holders, or beneficiaries) and those who don’t (policyholders). We use zero-inflated negative binomial models for the count of visits and two-part models for total expenditures, and test for unobservable confounders with random-effect models and instrumental variables. Results: Individuals who face coinsurance are less likely to have any dental-care utilization, at a relatively small scale. Facing coinsurance does not correlate with changes in total expenditures. Falsification tests with dental-care visits exempt from coinsurance show no statistically distinguishable changes in utilization. Random-effect models and instrumental variable models show results similar to the main specification. Conclusions: Cost-sharing policies in Colombia seem to be well designed because they don’t represent an important barrier to dental-care access. © 2016, Springer International Publishing Switzerland.9 páginasDigitalapplication/pdfengEL AUTOR, expresa que la obra objeto de la presente autorización es original y la elaboró sin quebrantar ni suplantar los derechos de autor de terceros, y de tal forma, la obra es de su exclusiva autoría y tiene la titularidad sobre éste. PARÁGRAFO: en caso de queja o acción por parte de un tercero referente a los derechos de autor sobre el artículo, folleto o libro en cuestión, EL AUTOR, asumirá la responsabilidad total, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos, la Universidad Icesi actúa como un tercero de buena fe. Esta autorización, permite a la Universidad Icesi, de forma indefinida, para que en los términos establecidos en la Ley 23 de 1982, la Ley 44 de 1993, leyes y jurisprudencia vigente al respecto, haga publicación de este con fines educativos. Toda persona que consulte ya sea la biblioteca o en medio electrónico podrá copiar apartes del texto citando siempre la fuentes, es decir el título del trabajo y el autor.http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://dx.doi.org/10.1007/s40258-016-0251-4Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)Tratamiento dentalSistema de salud - ColombiaEconomicsEconomíahttp://purl.org/coar/resource_type/c_2df8fbb1instname:Universidad Icesireponame:Biblioteca Digitalrepourl:https://repository.icesi.edu.co/http://purl.org/coar/access_right/c_abf2