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Older People Health and Access to Healthcare: A Retrospective Look at Inequality Dynamics over the Past Decade

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  • Dino Rizzi
  • Carlo Simionato
  • Francesca Zantomio

Abstract

The past decade of austerity measures has severely hit Public Healthcare provision in Italy, entailing significant reductions in per capita expenditure, particularly in Regions put under «Healthcare Budget Recovery Plans», mostly in the South of the country. Building on data on individuals aged 50 or older drawn from the Survey of Health, Ageing and Retirement in Europe, we compute time- and area-specific Concentration and Horizontal Inequity indexes, to assess the evolution of inequity in older people health and healthcare access (i.e. GP contacts and specialists’ visits) across Italian macro-areas since the Great Recession onset. Results show that in the North, while health has been improving on average, income-related inequality in health has increased; in the South, while on average health has not improved, the concentration of bad health among the income-poor has decreased. Sizeable inequity in access to specialists’ visits emerges throughout the country, and generally worsened since before the crisis onset. Evidence overall suggests that in the South, along the crisis, under worsened income conditions and Public Healthcare budget cuts, poorer older individuals might have substituted specialised care with increased family doctors’ visits.

Suggested Citation

  • Dino Rizzi & Carlo Simionato & Francesca Zantomio, 2019. "Older People Health and Access to Healthcare: A Retrospective Look at Inequality Dynamics over the Past Decade," Politica economica, Società editrice il Mulino, issue 3, pages 335-366.
  • Handle: RePEc:mul:je8794:doi:10.1429/95405:y:2019:i:3:p:335-366
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    1. Luisa Franzini & Margherita Giannoni, 2009. "Determinants of Health Disparities in Italian Regions," Quaderni del Dipartimento di Economia, Finanza e Statistica 70/2009, Università di Perugia, Dipartimento Economia.
    2. Annamaria Lusardi & Daniel J. Schneider & Peter Tufano, 2010. "The economic crisis and medical care usage," NBER Working Papers 15843, National Bureau of Economic Research, Inc.
    3. Butler, J S, et al, 1987. "Measurement Error in Self-reported Health Variables," The Review of Economics and Statistics, MIT Press, vol. 69(4), pages 644-650, November.
    4. Vincenzo Atella & Francesco Brindisi & Partha Deb & Furio C. Rosati, 2004. "Determinants of access to physician services in Italy: a latent class seemingly unrelated probit approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 657-668, July.
    5. de Belvis, Antonio Giulio & Ferrè, Francesca & Specchia, Maria Lucia & Valerio, Luca & Fattore, Giovanni & Ricciardi, Walter, 2012. "The financial crisis in Italy: Implications for the healthcare sector," Health Policy, Elsevier, vol. 106(1), pages 10-16.
    6. Michele Belloni & Elena Meschi & Giacomo Pasini, 2016. "The Effect on Mental Health of Retiring During the Economic Crisis," Health Economics, John Wiley & Sons, Ltd., vol. 25(S2), pages 126-140, November.
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    More about this item

    Keywords

    Health; Healthcare; Inequity; Concentration Indexes; Great Recession.;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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