IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v126y2015icp154-163.html
   My bibliography  Save this article

Inequities in health care utilization by people aged 50+: Evidence from 12 European countries

Author

Listed:
  • Terraneo, Marco

Abstract

The aim of this study is to describe the magnitude of educational inequities in the use of health care services, by people aged 50+, in 12 European countries, controlling for country-level heterogeneity. We consider four services: having seen or talked to 1) a general practitioner (GP) or 2) specialist, 3) having been hospitalized, and 4) having visited a dentist (only for prevention). Data derived from the SHARE (Survey of Health, Ageing and Retirement in Europe) project, a cross-national panel that collects information from individuals aged 50 and over. A Fixed Effects approach is applied, which is a valuable alternative to the application of conventional multilevel models in country-comparative analysis. The main findings of this study confirm that there is substantial educational inequity in the use of health care, although relevant differences arise between services. A clear pro-educated gradient is found for specialists and dentist visits, whereas no evidence of educational disparities was found for GP use. On the other hand, less clear results emerge regarding hospitalizations. However, the analysis shows that micro-level dimensions, i.e. individual needs and predisposing and enabling population characteristics, and macro level factors, i.e. health care system and welfare regime, interact to determine people's use of health services. It can be concluded that people with more education level have more resources (cognitive, communicative, relational) that allow them to make more informed choices and take more effective actions for their health goals, however, the institutional context may modify this relationship.

Suggested Citation

  • Terraneo, Marco, 2015. "Inequities in health care utilization by people aged 50+: Evidence from 12 European countries," Social Science & Medicine, Elsevier, vol. 126(C), pages 154-163.
    • Handle: RePEc:eee:socmed:v:126:y:2015:i:c:p:154-163
    DOI: 10.1016/j.socscimed.2014.12.028
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953614008363
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2014.12.028?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Marion Devaux & Michael de Looper, 2012. "Income-Related Inequalities in Health Service Utilisation in 19 OECD Countries, 2008-2009," OECD Health Working Papers 58, OECD Publishing.
    2. Eddy van Doorslaer & Cristina Masseria, 2004. "Income-Related Inequality in the Use of Medical Care in 21 OECD Countries," OECD Health Working Papers 14, OECD Publishing.
    3. Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
    4. Chad D. Meyerhoefer & Samuel H. Zuvekas & Richard Manski, 2014. "The Demand For Preventive And Restorative Dental Services," Health Economics, John Wiley & Sons, Ltd., vol. 23(1), pages 14-32, January.
    5. Culyer, A. J., 1995. "Need: The idea won't do--But we still need it," Social Science & Medicine, Elsevier, vol. 40(6), pages 727-730, March.
    6. Valérie Paris & Marion Devaux & Lihan Wei, 2010. "Health Systems Institutional Characteristics: A Survey of 29 OECD Countries," OECD Health Working Papers 50, OECD Publishing.
    7. L. Bryan, Mark & P. Jenkins, Stephen, 2013. "Regression analysis of country effects using multilevel data: a cautionary tale," ISER Working Paper Series 2013-14, Institute for Social and Economic Research.
    8. Dunlop, Sheryl & Coyte, Peter C. & McIsaac, Warren, 2000. "Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(1), pages 123-133, July.
    9. Keskimäki, Ilmo & Salinto, Marjo & Aro, Seppo, 1995. "Socioeconomic equity in finnish hospital care in relation to need," Social Science & Medicine, Elsevier, vol. 41(3), pages 425-431, August.
    10. Zeynep Or & Florence Jusot & Engin Yilmaz, 2008. "Impact of health care system on socioeconomic inequalities in doctor use," Working Papers DT17, IRDES institut for research and information in health economics, revised Sep 2008.
    11. repec:dau:papers:123456789/7006 is not listed on IDEAS
    12. Edward Kelley & Jeremy Hurst, 2006. "Health Care Quality Indicators Project: Conceptual Framework Paper," OECD Health Working Papers 23, OECD Publishing.
    13. Alberts, Jantina F. & Sanderman, Robbert & Eimers, J. Marietta & Van Den Heuvel, Wim J. A., 1997. "Socioeconomic inequity in health care: A study of services utilization in Curaçao," Social Science & Medicine, Elsevier, vol. 45(2), pages 213-220, July.
    14. Goddard, Maria & Smith, Peter, 2001. "Equity of access to health care services: : Theory and evidence from the UK," Social Science & Medicine, Elsevier, vol. 53(9), pages 1149-1162, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Raskina, Yulia & Podkorytova, Olga & Kuchakov, Ruslan, 2022. "Health determinants and the reporting heterogeneity bias in Russia: Anchoring vignettes approach," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 66, pages 118-143.
    2. Vincens, Natalia & Emmelin, Maria & Stafström, Martin, 2018. "Social capital, income inequality and the social gradient in self-rated health in Latin America: A fixed effects analysis," Social Science & Medicine, Elsevier, vol. 196(C), pages 115-122.
    3. Thomas Leoni & Martin Spielauer & Peter Reschenhofer, 2020. "Soziale Unterschiede, Lebenserwartung und Gesundheitsausgaben im Lebensverlauf," WIFO Studies, WIFO, number 66626, February.
    4. Chen, Yuanyuan & Wang, Haining & Cheng, Zhiming & Smyth, Russell, 2023. "Education and Migrant Health in China," Economic Modelling, Elsevier, vol. 121(C).
    5. Chaofan Li & Lei Dou & Haipeng Wang & Shanshan Jing & Aitian Yin, 2017. "Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China," IJERPH, MDPI, vol. 14(8), pages 1-13, July.
    6. Davillas, Apostolos & Pudney, Stephen, 2020. "Biomarkers, disability and health care demand," Economics & Human Biology, Elsevier, vol. 39(C).
    7. Davillas, Apostolos & Pudney, Stephen, 2019. "Baseline health and public healthcare costs five years on: a predictive analysis using biomarker data in a prospective household panel," ISER Working Paper Series 2019-01, Institute for Social and Economic Research.
    8. Pamela Barbadoro & Antonella D’Alleva & Sara Galmozzi & Gemma Zocco & Francesco Di Stanislao & Emilia Prospero & Marcello Mario D’Errico, 2018. "Variations in diagnostic testing utilization in Italy: Secondary analysis of a national survey," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-13, June.
    9. Natasa Popovic & Zorica Terzic-Supic & Snezana Simic & Biljana Mladenovic, 2017. "Predictors of unmet health care needs in Serbia; Analysis based on EU-SILC data," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-20, November.
    10. Sarti, Simone & Terraneo, Marco & Tognetti Bordogna, Mara, 2017. "Poverty and private health expenditures in Italian households during the recent crisis," Health Policy, Elsevier, vol. 121(3), pages 307-314.
    11. Thomson, Michael, 2019. "Who had access to doctors before and after new universal capitated subsidies in New Zealand?," Health Policy, Elsevier, vol. 123(8), pages 756-764.
    12. Denzil G. Fiebig & Kees van Gool & Jane Hall & Chunzhou Mu, 2021. "Health care use in response to health shocks: Does socio‐economic status matter?," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 3032-3050, December.
    13. David Cantarero-Prieto & Marta Pascual-Sáez & Carla Blázquez-Fernández, 2018. "Does social isolation affect medical doctor visits? New evidence among European older adults," Working Papers. Collection B: Regional and sectoral economics 1805, Universidade de Vigo, GEN - Governance and Economics research Network.
    14. Aimée Hartford Kvæl, Linda & Gautun, Heidi, 2023. "Social inequality in navigating the healthcare maze: Care trajectories from hospital to home via intermediate care for older people in Norway," Social Science & Medicine, Elsevier, vol. 333(C).
    15. David Cantarero-Prieto & Marta Pascual-Sáez & Carla Blázquez-Fernández, 2021. "Does Social Isolation Affect Medical Doctor Visits? New Evidence Among European Older Adults," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 16(2), pages 787-804, April.
    16. Zhao, Guangchuan & Cao, Xinbang & Ma, Chao, 2020. "Accounting for horizontal inequity in the delivery of health care: A framework for measurement and decomposition," International Review of Economics & Finance, Elsevier, vol. 66(C), pages 13-24.
    17. Pulok, Mohammad Habibullah & Hajizadeh, Mohammad, 2022. "Equity in the use of physician services in Canada's universal health system: A longitudinal analysis of older adults," Social Science & Medicine, Elsevier, vol. 307(C).
    18. Sabah T Alharbi & Muneeb M Alzghool, 2019. "Factors Associated With Access, Utilization, and Level of Satisfaction With Primary Health Care Services in Hafar Al-batain City of Saudi Arabia," Global Journal of Health Science, Canadian Center of Science and Education, vol. 11(13), pages 1-34, December.
    19. Jens Hoebel & Petra Rattay & Franziska Prütz & Alexander Rommel & Thomas Lampert, 2016. "Socioeconomic Status and Use of Outpatient Medical Care: The Case of Germany," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-14, May.
    20. Hongyun Zhou & Jiqing Hong & Su Yang & Yuxuan Huang, 2022. "The Impact of Social Capital on Rural Residents’ Medical Service Utilization in China—An Empirical Study Based on CFPS Data," IJERPH, MDPI, vol. 19(23), pages 1-19, November.
    21. dos Santos, Anderson Moreira Aristides & Triaca, Lívia Madeira & Tejada, Cesar Augusto Oviedo, 2021. "Evolution of inequalities in health care use among older people in Brazil: Evidence for the period 1998–2019," The Journal of the Economics of Ageing, Elsevier, vol. 20(C).
    22. Jens Hoebel & Alexander Rommel & Sara Lena Schröder & Judith Fuchs & Enno Nowossadeck & Thomas Lampert, 2017. "Socioeconomic Inequalities in Health and Perceived Unmet Needs for Healthcare among the Elderly in Germany," IJERPH, MDPI, vol. 14(10), pages 1-18, September.
    23. Jongsay Yong & Ou Yang, 2021. "Does socioeconomic status affect hospital utilization and health outcomes of chronic disease patients?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 329-339, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Marion Devaux, 2015. "Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 21-33, January.
    2. Tavares, Lara Patrício & Zantomio, Francesca, 2017. "Inequity in healthcare use among older people after 2008: The case of southern European countries," Health Policy, Elsevier, vol. 121(10), pages 1063-1071.
    3. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    4. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    5. Hudson, Eibhlin & Nolan, Anne, 2015. "Public healthcare eligibility and the utilisation of GP services by older people in Ireland," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 24-43.
    6. Van der Heyden, J. H. A. & Demarest, S. & Tafforeau, J. & Van Oyen, H., 2003. "Socio-economic differences in the utilisation of health services in Belgium," Health Policy, Elsevier, vol. 65(2), pages 153-165, August.
    7. Kurt R. Brekke & Tor Helge Holmås & Karin Monstad & Odd Rune Straume, 2018. "Socio‐economic status and physicians' treatment decisions," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 77-89, March.
    8. Cormac O'Dea & Ian Preston, 2012. "The distributional impact of public spending in the UK," IFS Working Papers W12/06, Institute for Fiscal Studies.
    9. repec:dau:papers:123456789/7006 is not listed on IDEAS
    10. Zhao, Guangchuan & Cao, Xinbang & Ma, Chao, 2020. "Accounting for horizontal inequity in the delivery of health care: A framework for measurement and decomposition," International Review of Economics & Finance, Elsevier, vol. 66(C), pages 13-24.
    11. Sofia Löfvendahl & Anna Jöud & Ingemar F. Petersson & Elke Theander & Åke Svensson & Katarina Steen Carlsson, 2018. "Income disparities in healthcare use remain after controlling for healthcare need: evidence from Swedish register data on psoriasis and psoriatic arthritis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(3), pages 447-462, April.
    12. Sarti, Simone & Terraneo, Marco & Tognetti Bordogna, Mara, 2017. "Poverty and private health expenditures in Italian households during the recent crisis," Health Policy, Elsevier, vol. 121(3), pages 307-314.
    13. Jonas Fooken & Varinder Jeet, 2022. "Using Australian panel data to account for unobserved factors in measuring inequities for different channels of healthcare utilization," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(4), pages 717-728, June.
    14. Gao, Qiuming & Wang, Derek, 2021. "Hospital efficiency and equity in health care delivery: A study based in China," Socio-Economic Planning Sciences, Elsevier, vol. 76(C).
    15. André, Christine, 2015. "Les systèmes de santé européens en longue période," Revue de la Régulation - Capitalisme, institutions, pouvoirs, Association Recherche et Régulation, vol. 17.
    16. Hugh Gravelle & Stephen Morris & Matt Sutton, 2012. "Economic Studies of Equity in the Consumption of Health Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 18, Edward Elgar Publishing.
    17. Selcuk Beduk, 2018. "Missing the Unhealthy? Examining Empirical Validity of Material Deprivation Indices (MDIs) Using a Partial Criterion Variable," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 135(1), pages 91-115, January.
    18. Grignon Michel, 2012. "Roadblocks to Reform: Beyond the Usual Suspects," Centre for Health Economics and Policy Analysis Working Paper Series 2012-01, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    19. E. Xie, 2011. "Income-related inequalities of health and health care utilization," Frontiers of Economics in China, Springer;Higher Education Press, vol. 6(1), pages 131-156, March.
    20. Jan Michael Bauer & Jörg Schiller & Christopher Schreckenberger, 2020. "Heterogeneous selection in the market for private supplemental dental insurance: evidence from Germany," Empirical Economics, Springer, vol. 59(1), pages 205-231, July.
    21. repec:nip:nipewp:05/2015 is not listed on IDEAS
    22. García-Gómez, Pilar & Hernández-Quevedo, Cristina & Jiménez-Rubio, Dolores & Oliva-Moreno, Juan, 2015. "Inequity in long-term care use and unmet need: Two sides of the same coin," Journal of Health Economics, Elsevier, vol. 39(C), pages 147-158.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:126:y:2015:i:c:p:154-163. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.