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. Conclusion 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.