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Utilización y tiempos de espera: dos vertientes inseparables del análisis de la equidad en el acceso al sistema sanitario público

Author

Listed:
  • Ignacio Abásolo

    (Universidad de La Laguna)

  • Miguel Negrín

    (Universidad de Las Palmas de Gran Canaria)

  • Jaime Pinilla

    (Universidad de Las Palmas de Gran Canaria)

Abstract

El objetivo de esta investigación consiste en analizar si existe equidad en el acceso a los servicios sanitarios públicos por niveles socioeconómicos. Se analiza conjuntamente la probabilidad de utilizar los servicios sanitarios y los tiempos de espera hasta ser atendidos, corrigiéndose así el sesgo de selección que se derivaría de su estudio separado, tal y como se evidencia en esta investigación. Se propone una aproximación bayesiana y se hace uso de la información a nivel individual sobre la utilización sanitaria, tiempos de espera, nivel socioeconómico, necesidad sanitaria y otras variables sociodemográficas contenidas en la En-cuesta nacional de salud (2006). Los resultados muestran que hay inequidad en el acceso a los servicios especializados y hospitalarios (tanto en utilización como en tiempos de espera) que perjudica a los niveles socioeconómicos inferiores. En los servicios de medicina general, si bien la utilización beneficia relativa-mente más a los grupos de menor nivel socioeconómico, los tiempos de espera perjudican a los de menor nivel educativo.

Suggested Citation

  • Ignacio Abásolo & Miguel Negrín & Jaime Pinilla, 2014. "Utilización y tiempos de espera: dos vertientes inseparables del análisis de la equidad en el acceso al sistema sanitario público," Hacienda Pública Española / Review of Public Economics, IEF, vol. 208(1), pages 11-38, March.
    • Handle: RePEc:hpe:journl:y:2014:v:208:i:1:p:11-38
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    References listed on IDEAS

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    1. James J. Heckman, 1976. "The Common Structure of Statistical Models of Truncation, Sample Selection and Limited Dependent Variables and a Simple Estimator for Such Models," NBER Chapters, in: Annals of Economic and Social Measurement, Volume 5, number 4, pages 475-492, National Bureau of Economic Research, Inc.
    2. de Vos, Klaas & Zaidi, M Asghar, 1997. "Equivalence Scale Sensitivity of Poverty Statistics for the Member States of the European Community," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 43(3), pages 319-333, September.
    3. Silvio R. Rendon, 2013. "Fixed and Random Effects in Classical and Bayesian Regression," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 75(3), pages 460-476, June.
    4. Tom Van Ourti, 2004. "Measuring horizontal inequity in Belgian health care using a Gaussian random effects two part count data model," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 705-724, July.
    5. Philip Heidelberger & Peter D. Welch, 1983. "Simulation Run Length Control in the Presence of an Initial Transient," Operations Research, INFORMS, vol. 31(6), pages 1109-1144, December.
    6. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income‐related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647, July.
    7. Francis Vella, 1998. "Estimating Models with Sample Selection Bias: A Survey," Journal of Human Resources, University of Wisconsin Press, vol. 33(1), pages 127-169.
    8. Guillem Lopez‐Casasnovas & Joan Costa‐Font & Ivan Planas, 2005. "Diversity and regional inequalities in the Spanish ‘system of health care services’," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 221-235, September.
    9. Ignacio Abasolo & Rob Manning & Andrew Jones, 2001. "Equity in utilization of and access to public-sector GPs in Spain," Applied Economics, Taylor & Francis Journals, vol. 33(3), pages 349-364.
    10. 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.
    11. Laura Vallejo‐Torres & Stephen Morris, 2013. "Income‐Related Inequity In Healthcare Utilisation Among Individuals With Cardiovascular Disease In England—Accounting For Vertical Inequity," Health Economics, John Wiley & Sons, Ltd., vol. 22(5), pages 533-553, May.
    12. Patrick Puhani, 2000. "The Heckman Correction for Sample Selection and Its Critique," Journal of Economic Surveys, Wiley Blackwell, vol. 14(1), pages 53-68, February.
    13. Ignacio Abásolo & Miguel Negrín-Hernández & Jaime Pinilla, 2014. "Equity in specialist waiting times by socioeconomic groups: evidence from Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(3), pages 323-334, April.
    14. Partha Deb & Murat K. Munkin & Pravin K. Trivedi, 2006. "Bayesian analysis of the two‐part model with endogeneity: application to health care expenditure," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 21(7), pages 1081-1099, November.
    15. Ding, Peng, 2014. "Bayesian robust inference of sample selection using selection-t models," Journal of Multivariate Analysis, Elsevier, vol. 124(C), pages 451-464.
    16. Crespo-Cebada, Eva & Urbanos-Garrido, Rosa M., 2012. "Equity and equality in the use of GP services for elderly people: The Spanish case," Health Policy, Elsevier, vol. 104(2), pages 193-199.
    17. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 31(3), pages 129-137.
    18. Klaas de Vos & M. Asghar Zaidi, 1997. "Equivalence Scale Sensitivity Of Poverty Statistics For The Member States Of The European Community," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 43(3), pages 319-333, September.
    19. van Hasselt, Martijn, 2011. "Bayesian inference in a sample selection model," Journal of Econometrics, Elsevier, vol. 165(2), pages 221-232.
    20. Arnesen, Kjell E. & Erikssen, Jan & Stavem, Knut, 2002. "Gender and socioeconomic status as determinants of waiting time for inpatient surgery in a system with implicit queue management," Health Policy, Elsevier, vol. 62(3), pages 329-341, December.
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    Cited by:

    1. David Cantarero-Prieto & Marta Pascual-Sáez & Javier Lera Torres, 2018. "Socioeconomic determinants and health care utilization among elderly people living in Europe: Evidence from the Survey of Health, Ageing and Retirement," Working Papers. Collection B: Regional and sectoral economics 1801, Universidade de Vigo, GEN - Governance and Economics research Network.

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    More about this item

    Keywords

    Equidad en acceso; utilización de servicios sanitarios; tiempos de espera; sesgo de selección; modelos bayesianos;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • C01 - Mathematical and Quantitative Methods - - General - - - Econometrics
    • D39 - Microeconomics - - Distribution - - - Other

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