title: [Impact of Macao Medical Voucher Program on health outcomes of the residents: changes of mortality from circulatory system diseases].
abstract: OBJECTIVE
  To examine whether the implementation of Macao Medical Voucher Program has helped promote the health outcomes of the residents in the case of mortality from circulatory system diseases.
  
  
  METHODS
  Based on 144 monthly observations of the mortality from circulatory system diseases in Macao during 2001-2012, we carried out a trend analysis of the time series to identify significant differences in the mortality data after the implementation of the Medical Voucher in Macao. This study was controlled for the compounding factors including medical resources (numbers of physicians, nurses and patient beds per thousand population and public healthcare expenditure), economic development level (GDP per capita), social human development level, population aging factor, natural seasonal effects and long-term trends.
  
  
  RESULTS
  During 2010-2012 when the Medical Voucher Program in Macao was implemented, the annual mortality rates from circulatory system diseases were significantly lowered by 24% as compared with those recorded during 2001-2009 (P<0.01), which was equivalent to avoiding 123 deaths related of circulatory system diseases per year.
  
  
  CONCLUSIONS
  Evidence in this study suggests a robust connection between the timing of the implementation of Macao Medical Voucher Program and a significant decrease in the mortality from circulatory system diseases in Macao, but their causal relationship awaits confirmation in further research.
authors.affiliation: School of Business, Macau University of Science and Technology, Macao, China.E-mail: jhuzhang@must.edu.mo.
authors.forename: Jinghua
authors.initials: J
authors.lastname: Zhang
authors.forename: Chuan
authors.initials: C
authors.lastname: Pang
authors.forename: Kwoping
authors.initials: K
authors.lastname: Tam
mesh_terms: D000375:Aging; D002318:Cardiovascular Diseases / Q000401:mortality*; D006801:Humans; D008256:Macau / Q000453:epidemiology; D009313:National Health Programs