03573cam a22003377 4500001000700000003000500007005001700012008004100029100002300070245020800093260006600301490004200367500001400409520172900423530006102152538007202213538003602285690006902321690011402390690006902504690010102573690005502674690006502729690010602794690011602900700002503016710004203041830007703083856003803160856003703198w14995NBER20141021201852.0141021s2009 mau||||fs|||| 000 0 eng d1 aHarris, Jeffrey E.10aImpact of "Seguro Popular" on Prenatal Visits in Mexico, 2002-2005h[electronic resource]:bLatent Class Model of Count Data with a Discrete Endogenous Variable /cJeffrey E. Harris, Sandra G. Sosa-Rubi. aCambridge, Mass.bNational Bureau of Economic Researchc2009.1 aNBER working paper seriesvno. w14995 aMay 2009.3 aWe employ a latent class model to assess the impact of Mexico's Seguro Popular ("SP") program on the number of prenatal visits in a cross-sectional sample of 4,381 women who gave birth during 2002-2005. We specify an ordered probit model to permit a pregnant woman's probability of membership in one of three latent classes to depend on observed covariates. In the ordered probit model, enrollment in SP is explicitly treated as an endogenous variable. We model the number of prenatal visits, conditional upon membership in a particular latent class, as a Poisson regression. We employ the EM algorithm to reduce the computational burden of model estimation. At any iteration of the algorithm, the parameters of the model of latent class membership can be estimated separately from the parameters of the model of prenatal care utilization. We find that enrollment in SP was associated with a mean increase in 1.65 prenatal visits during pregnancy. Approximately 59 percent of this treatment effect is the result of increased prenatal care among women in the first latent class, that is, women who had with little or no access to care. The remaining 41 percent of the treatment effect is the result of a shift in membership from the second to the third latent class, which we interpret as increased recognition of complications of pregnancy prior to labor and delivery. Our model has a better fit and predicts a larger impact of SP than alternative models that relax the assumption of endogeneity, do not impose ordering on the latent classes, or incorporate only two latent classes. Our findings are consistent with prior work on the favorable impact of SP on maternal health (Sosa-RubĂ, GalĂˇrraga, Harris 2009). aHardcopy version available to institutional subscribers. aSystem requirements: Adobe [Acrobat] Reader required for PDF files. aMode of access: World Wide Web. 7aC13 - Estimation: General2Journal of Economic Literature class. 7aC34 - Truncated and Censored Models • Switching Regression Models2Journal of Economic Literature class. 7aC5 - Econometric Modeling2Journal of Economic Literature class. 7aC63 - Computational Techniques • Simulation Modeling2Journal of Economic Literature class. 7aI1 - Health2Journal of Economic Literature class. 7aI12 - Health Behavior2Journal of Economic Literature class. 7aI18 - Government Policy • Regulation • Public Health2Journal of Economic Literature class. 7aI38 - Government Policy • Provision and Effects of Welfare Programs2Journal of Economic Literature class.1 aSosa-Rubi, Sandra G.2 aNational Bureau of Economic Research. 0aWorking Paper Series (National Bureau of Economic Research)vno. w14995.4 uhttp://www.nber.org/papers/w1499541uhttp://dx.doi.org/10.3386/w14995