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Efficiency, equity and equality in health and health care

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  • Anthony J Culyer

    (Emeritus Professor, Centre for Health Economics, University of York, UK. Adjunct Professor, University of Toronto, Canada)

Abstract

Three common Es have high ethical and political content for health policy: efficiency, equity and equality. This article examines the links between the three, with especial attention given to (a) the claimed conflict between efficiency and equity, (b) the equity of inequalities and (c) the conflict between six equity principles: equal health, equal health gain, equal value of additional health, maintaining existing distributions, allocation according to need and equal per capita resources. Conclusions include - ï‚· Efficiency and equity do not inherently conflict ï‚· an inefficient allocation can be equitable ï‚· an efficient allocation can be inequitable ï‚· an inefficient allocation can become more efficient without increasing inequity ï‚· what is equitable often requires inequality in health and inequality in resource distribution per capita ï‚· equality in health requires inequality in resource allocation ï‚· equality in resource allocation typically leads to inequality in health ï‚· allocation according to need typically leads to inequality in health

Suggested Citation

  • Anthony J Culyer, 2015. "Efficiency, equity and equality in health and health care," Working Papers 120cherp, Centre for Health Economics, University of York.
    • Handle: RePEc:chy:respap:120cherp
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    File URL: http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP120_Efficiency_Equity_Equality_Health_Care.pdf
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    References listed on IDEAS

    as
    1. 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.
    2. Paul Revill & Simon Walker & Jason Madan & Andrea Ciaranello & Takondwa Mwase & Diana M Gibb & Karl Claxton & Mark J Sculpher, 2014. "Using cost-effectiveness thresholds to determine value for money in low- and middle-income country healthcare systems: Are current international norms fit for purpose?," Working Papers 098cherp, Centre for Health Economics, University of York.
    3. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    4. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
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    Cited by:

    1. Erwin J. Delgado & Xavier Cabezas & Carlos Martin-Barreiro & Víctor Leiva & Fernando Rojas, 2022. "An Equity-Based Optimization Model to Solve the Location Problem for Healthcare Centers Applied to Hospital Beds and COVID-19 Vaccination," Mathematics, MDPI, vol. 10(11), pages 1-24, May.
    2. Rikke Lambertz-Nilssen Hjort & Sine Agergaard, 2022. "Sustaining Equality and Equity. A Scoping Review of Interventions Directed towards Promoting Access to Leisure Time Physical Activity for Children and Youth," IJERPH, MDPI, vol. 19(3), pages 1-17, January.
    3. Iveta Vrabková & Sabrina Lee, 2023. "Approximating the influence of external factors on the technical efficiency score of hospital care: evidence from the federal states of Germany," Health Economics Review, Springer, vol. 13(1), pages 1-14, December.
    4. V. Meusel & E. Mentzakis & P. Baji & G. Fiorentini & F. Paolucci, 2023. "Priority setting in the German healthcare system: results from a discrete choice experiment," International Journal of Health Economics and Management, Springer, vol. 23(3), pages 411-431, September.
    5. Sonia Chien-I. Chen & Chenglian Liu, 2020. "Factors Influencing the Application of Connected Health in Remote Areas, Taiwan: A Qualitative Pilot Study," IJERPH, MDPI, vol. 17(4), pages 1-20, February.

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