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Income-Related Inequality in the Use of Medical Care in 21 OECD Countries

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Author Info
Eddy van Doorslaer
Cristina Masseria ()

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Abstract

  1. This study updates and extends a previous study on equity in physician utilisation for a subset of the countries analyzed here (Van Doorslaer, Koolman and Puffer, 2002). It updates results to 2000 for 13 countries and adds new results for eight countries: Australia, Finland, France, Hungary, Mexico, Norway, Switzerland and Sweden. Both simple quintile distributions and concentration indices were used to assess horizontal equity, i.e. the extent to which adults in equal need for physician care appear to have equal rates of medical care utilisation.
  2. With respect to physician utilisation, need is more concentrated among the worse off, but after “standardizing out” these need differences, significant horizontal inequity favoring the better off is found in about half of the countries, both for the probability and the total number of visits. The degree of pro-rich inequity in doctor use is highest in the US, followed by Mexico, Finland, Portugal and Sweden.
  3. In the majority ...


  1. Cette étude actualise et étend le champ d'investigation d'une étude antérieure sur l'équité de l'utilisation des services des médecins effectuée pour un sous-ensemble de pays analysés ici (Van Doorslaer, Koolman et Puffer, 2002). Elle actualise les résultats jusqu’à l’année 2000 pour treize pays et incorpore de nouveaux résultats pour huit autres pays de l'OCDE : l’Australie, la Finlande, la France, la Hongrie, le Mexique, la Norvège, la Suisse et la Suède. Elle utilise à la fois les distributions par quintile et les indices de concentration pour évaluer l'équité horizontale, c’est-à-dire dans quelle mesure des adultes ayant un égal besoin de soins médicaux ont apparemment des taux identiques d'utilisation de soins médicaux.
  2. Pour ce qui est de l'utilisation des médecins, les besoins en services médicaux ont tendance à être plus concentrés parmi les catégories défavorisées, mais après avoir pris en compte ces différences de besoins, on observe une iniquité horizontale positive ...

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Paper provided by OECD Directorate for Employment, Labour and Social Affairs in its series OECD Health Working Papers with number 14.

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Date of creation: 11 May 2004
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Handle: RePEc:oec:elsaad:14-en

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Find related papers by JEL classification:
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
I19 - Health, Education, and Welfare - - Health - - - Other

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  2. Justina A.V. Fischer & Benno Torgler, 2006. "Does Envy Destroy Social Fundamentals? The Impact Of Relative Income Position On Social Capital," STICERD - Development Economics Papers 46, Suntory and Toyota International Centres for Economics and Related Disciplines, LSE. [Downloadable!]
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  4. Hai Zhong, 2007. "Equity in Pharmaceutical Utilization in Ontario: A Cross Section and Over Time Analysis," University of Western Ontario, RBC Financial Group Economic Policy Research Institute Working Papers 20071, University of Western Ontario, RBC Financial Group Economic Policy Research Institute. [Downloadable!]
  5. Unto Häkkinen, 2005. "The impact of changes in Finland's health care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S101-S118. [Downloadable!]
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  7. 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!]
  8. DAVID DORN & Justina Fischer & GEBHARD KIRCHGÄSSNER & ALFONSO SOUSA-POZA, 2005. "Is It Culture or Democracy? The Impact of Democracy, Income, and Culture on Happiness," University of St. Gallen Department of Economics working paper series 2005 2005-12, Department of Economics, University of St. Gallen. [Downloadable!]
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