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Morbilidad autoreportada y los retornos a la salud para los varones urbanos en el Perú: enfermedad vs. incapacidad

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Abstract
El efecto del nivel de salud de los individuos sobre su productividad y sus ingresos es incuestionable desde varios puntos de vista. Sin embargo, la medición de ese efecto ha sido bastante más complicada que, por ejemplo, la correspondiente al efecto de la educación. Las razones de esta complejidad son de carácter conceptual, técnico y de calidad de la información. Esta medición se complica aún más en países en desarrollo debido a las limitaciones de los indicadores de salud disponibles, en su mayoría afectados por la propia percepción del individuo. En este sentido, el presente reporte muestra evidencia acerca de los determinantes de salud para los varones adultos de zonas urbanas y sus efectos en la productividad, usando dos medidas de morbilidad autoreportadas: el número de días de enfermedad y el número de días de incapacidad. Ambas se encuentran afectadas por el problema de la endogeneidad, pero parecen diferir en la magnitud del error de reporte asociado a ellas. La literatura relacionada tiende a adjudicar una menor subjetividad a la medida de días de incapacidad respecto a la de días de enfermedad, y los resultados de este estudio apoyan esa idea. En primer lugar, el efecto de la educación sobre los días de enfermedad y los días de incapacidad reportados es negativo, fuerte y claramente en aumento con la edad para varones mayores de 35 años. Sin embargo, los jóvenes más educados tienden a reportar más días de enfermedad, patrón que no se observa en los días de incapacidad reportados. El uso de infraestructura sanitaria en el hogar y los costos de atención en salud, medidos a través de la distancia al centro de salud y el tiempo promedio de espera para la atención a nivel distrital, permiten la construcción de un estimador de variable instrumental para los efectos de la salud sobre los salarios. Estos instrumentos son estadísticamente significativos para ambas medidas de morbilidad. Los efectos de la salud (morbilidad) sobre los salarios son positivos (negativos) y robustos entre los varones peruanos de zonas urbanas. Los retornos a la salud promedio estimados son mayores cuando se utiliza los días de incapacidad como medida de morbilidad. Esta diferencia, sin embargo, desaparece cuando la muestra se restringe a grupos de población más homogéneos, tales como aquéllos en el mismo grupo de edad y en similar ubicación en la distribución de salarios. Mayores efectos de un día de enfermedad o de incapacidad adicional se encuentran entre los varones mayores independientes y entre aquéllos ubicados en la parte inferior de la distribución de salarios por hora. Los retornos a la salud entre los asalariados en el sector privado son mayores que en el sector público, pero la magnitud depende de la medida de morbilidad utilizada. Finalmente, en términos de una agenda futura de investigación, los resultados del presente estudio pueden interpretarse como evidencia a favor de la recopilación de medidas objetivas de salud, tales como las medidas antropométricas, o del nivel de hemoglobina en la sangre, en las encuestas a hogares que se realizan en países en desarrollo, y en el Perú en particular.

Suggested Citation

  • Edmundo Murrugarra & Martín Valdivia, 2000. "Morbilidad autoreportada y los retornos a la salud para los varones urbanos en el Perú: enfermedad vs. incapacidad," Documentos de Investigación dt31, Grupo de Análisis para el Desarrollo (GRADE).
    • Handle: RePEc:gad:doctra:dt31
    Note: Documento de Trabajo, 31
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    References listed on IDEAS

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    More about this item

    Keywords

    Condiciones de salud; Productividad del trabajo; Economia de la salud; Zonas urbanas; Health conditions; Labour productivity; Health economics; Urban areas; Peru;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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