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A note on the decomposition of the health concentration index

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Author Info
Philip M. Clarke (Health Economics Research Centre, University of Oxford, UK)
Ulf-G Gerdtham
Luke B. Connelly (Brisbane Graduate School of Business, Queensland University of Technology, Australia)

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Abstract

In recent work, the concentration index has been widely used as a measure of income-related health inequality. The purpose of this note is to illustrate two different methods for decomposing the overall health concentration index using data collected from a Short Form (SF-36) survey of the general Australian population conducted in 1995. For simplicity, we focus on the physical functioning scale of the SF-36. Firstly we examine decomposition 'by component' by separating the concentration index for the physical functioning scale into the ten items on which it is based. The results show that the items contribute differently to the overall inequality measure, i.e. two of the items contributed 13% and 5%, respectively, to the overall measure. Second, to illustrate the 'by subgroup' method we decompose the concentration index by employment status. This involves separating the population into two groups: individuals currently in employment; and individuals not currently employed. We find that the inequality between these groups is about five times greater than the inequality within each group. These methods provide insights into the nature of inequality that can be used to inform policy design to reduce income related health inequalities. Copyright © 2002 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.767
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Publisher Info
Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 12 (2003)
Issue (Month): 6 ()
Pages: 511-516
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Handle: RePEc:wly:hlthec:v:12:y:2003:i:6:p:511-516

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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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.:

  1. Gerdtham, Ulf-G. & Johannesson, Magnus, 1999. "Income-Related Inequality in Life-Years and Quality-Adjusted Life-Years," Working Paper Series in Economics and Finance 334, Stockholm School of Economics. [Downloadable!]
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  2. Bourguignon, Francois, 1979. "Decomposable Income Inequality Measures," Econometrica, Econometric Society, vol. 47(4), pages 901-20, July. [Downloadable!] (restricted)
  3. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January. [Downloadable!] (restricted)
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  4. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & Citoni, Guido & Di Biase, Rita & Gerdtham, Ulf-G. & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "The redistributive effect of health care finance in twelve OECD countries," Journal of Health Economics, Elsevier, vol. 18(3), pages 291-313, June. [Downloadable!] (restricted)
  5. Mookherjee, Dilip & Shorrocks, Anthony F, 1982. "A Decomposition Analysis of the Trend in UK Income Inequality," Economic Journal, Royal Economic Society, vol. 92(368), pages 886-902, December. [Downloadable!] (restricted)
  6. Cowell, Frank A, 1984. "The Structure of American Income Inequality," Review of Income and Wealth, Blackwell Publishing, vol. 30(3), pages 351-75, September.
  7. Le Grand, Julian, 1978. "The Distribution of Public Expenditure: The Case of Health Care," Economica, London School of Economics and Political Science, vol. 45(178), pages 125-42, May. [Downloadable!] (restricted)
  8. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March. [Downloadable!] (restricted)
  9. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February. [Downloadable!] (restricted)
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Cited by:
(explanations, 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.)

  1. Tom Van Ourti & Eddy Van Doorslaer & Xander Koolman, 2006. "The Effect of Growth and Inequality in Incomes on Health Inequality: Theory and Empirical Evidence from the European Panel," Tinbergen Institute Discussion Papers 06-108/3, Tinbergen Institute. [Downloadable!]
  2. Saloua Sehili & Elamin H. Elbasha & David G. Moriarty & Matthew M. Zack, 2005. "Inequalities in self-reported physical health in the United States, 1993-1999," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 377-389. [Downloadable!]
  3. Dolores Jiménez-Rubio & Peter C. Smith & Eddy Van Doorslaer, 2008. "Equity in health and health care in a decentralised context: evidence from Canada," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 377-392. [Downloadable!]
  4. Adam Wagstaff, 2005. "Inequality decomposition and geographic targeting with applications to China and Vietnam," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 649-653. [Downloadable!]
  5. Jens Gundgaard & Jørgen Lauridsen, 2006. "A decomposition of income-related health inequality applied to EQ-5D," The European Journal of Health Economics, Springer, vol. 7(4), pages 231-237, December. [Downloadable!] (restricted)
  6. JØrgen Lauridsen & Terkel Christiansen & Jens Gundgaard & Unto Häkkinen & Harri Sintonen, 2007. "Decomposition of health inequality by determinants and dimensions," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 97-102. [Downloadable!]
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