Inpatient care of the elderly in Brazil and India: Assessing social inequalities
AbstractThe rapidly growing older adult populations in Brazil and India present major challenges for health systems in these countries, especially with regard to the equitable provision of inpatient care. The objective of this study was to contrast inequalities in both the receipt of inpatient care and the length of time that care was received among adults aged over 60 in two large countries with different modes of health service delivery. Using the Brazilian National Household Survey from 2003 and the Indian National Sample Survey Organisation survey from 2004 inequalities by wealth (measured by income in Brazil and consumption in India) were assessed using concentration curves and indices. Inequalities were also examined through the use of zero-truncated negative binomial models, studying differences in receipt of care and length of stay by region, health insurance, education and reported health status. Results indicated that there was no evidence of inequality in Brazil for both receipt and length of stay by income per capita. However, in India there was a pro-rich bias in the receipt of care, although once care was received there was no difference by consumption per capita for the length of stay. In both countries the higher educated and those with health insurance were more likely to receive care, while the higher educated had longer stays in hospital in Brazil. The health system reforms that have been undertaken in Brazil could be credited as a driver for reducing healthcare inequalities amongst the elderly, while the significant differences by wealth in India shows that reform is still needed to ensure the poor have access to inpatient care. Health reforms that move towards a more public funding model of service delivery in India may reduce inequality in elderly inpatient care in the country.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Elsevier in its journal Social Science & Medicine.
Volume (Year): 75 (2012)
Issue (Month): 12 ()
Contact details of provider:
Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Murakami, Yuki & Blom, Andreas, 2008. "Accessibility and affordability of tertiary education in Brazil, Colombia, Mexico and Peru within a global context," Policy Research Working Paper Series 4517, The World Bank.
- de Carvalho Filho, Irineu Evangelista, 2008. "Old-age benefits and retirement decisions of rural elderly in Brazil," Journal of Development Economics, Elsevier, vol. 86(1), pages 129-146, April.
- Kenya Valeria Micaela de Souza Noronha & Mônica Viegas Andrade, 2002. "Social inequality in the access to healthcare services in Brazil," Textos para DiscussÃ£o Cedeplar-UFMG td172, Cedeplar, Universidade Federal de Minas Gerais.
- Grundy, Emily & Sloggett, Andy, 2003. "Health inequalities in the older population: the role of personal capital, social resources and socio-economic circumstances," Social Science & Medicine, Elsevier, vol. 56(5), pages 935-947, March.
- 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.
- Owen O'Donnell & Eddy van Doorslaer & Ravi P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Deni Harbianto & Charu C. Garg & Piya Hanvoravongchai & Mohammed N. Huq & Anup Karan & Gabriel M., 2007. "The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia," World Bank Economic Review, World Bank Group, vol. 21(1), pages 93-123.
- David E. Bloom & Ajay Mahal & Larry Rosenberg & Jaypee Sevilla, 2010. "Economic security arrangements in the context of population ageing in India," PGDA Working Papers 6010, Program on the Global Demography of Aging.
- Yuki Murakami & Andreas Blom, 2008. "Accessibility and Affordability of Tertiary Education in Brazil, Colombia, Mexico and Peru within a Global Context," World Bank Other Operational Studies 10282, The World Bank.
- Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications, The World Bank, number 6896, March.
- Roy, Kakoli & Chaudhuri, Anoshua, 2008. "Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India," Social Science & Medicine, Elsevier, vol. 66(9), pages 1951-1962, May.
- Mullahy, John, 1986. "Specification and testing of some modified count data models," Journal of Econometrics, Elsevier, vol. 33(3), pages 341-365, December.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei).
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 references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.