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Sometimes More Equal than Others How the choice of welfare indicator can affect the measurement of health inequalities and the incidence of public spending

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Magnus Lindelow (Centre for the Study of African Economies)
Abstract

In recent years, a large body of empirical work has focused on measuring and explaining socioeconomic inequalities in health outcomes and health service use. In any effort to address these questions, analysts must confront the issue of how to measure socioeconomic status. In developing countries, socioeconomic status has typically been measured by per capita consumption or an asset index. Currently, there is only limited information on how the choice of welfare indicators affect the analysis of health inequalities and the incidence of public spending. The paper focuses on five key health service outcomes in Mozambique. It uses the concentration index approach to measures both socioeconomic inequality in the utilization of health services and the sensitivity of measured inequality to the choice of welfare indicator. The results illustrate that, at least in some contexts, the choice of welfare indicator can have a large and significant impact on socioeconomic inequalities in service use and on the “perceived” incidence of public spending. The findings point at the need to be cautious in measuring inequality, but also to extend and deepen the analysis of service use.

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Paper provided by EconWPA in its series Development and Comp Systems with number 0409018.

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Length: 22 pages
Date of creation: 22 Sep 2004
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Handle: RePEc:wpa:wuwpdc:0409018

Note: Type of Document - pdf; pages: 22
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O - Economic Development, Technological Change, and Growth
P - Economic Systems

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  1. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "On the measurement of horizontal inequity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 169-205, July. [Downloadable!] (restricted)
  2. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 89-112, Spring.
  3. Heltberg, Rasmus & Simler, Kenneth & Tarp, Finn, 2001. "Public Spending and Poverty in Mozambique," Working Papers UNU-WIDER Research Paper , World Institute for Development Economic Research (UNU-WIDER). [Downloadable!]
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  4. Wolfe, Barbara L & Behrman, Jere R, 1984. "Determinants of Women's Health Status and Health-Care Utilization in a Developing Country: A Latent Variable Approach," The Review of Economics and Statistics, MIT Press, vol. 66(4), pages 696-703, November. [Downloadable!] (restricted)
  5. Russell Davidson & Jean-Yves Duclos, 1997. "Statistical Inference for the Measurement of the Incidence of Taxes and Transfers," Econometrica, Econometric Society, vol. 65(6), pages 1453-1466, November.
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  6. van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Equity in the delivery of health care: some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 389-411, December. [Downloadable!] (restricted)
  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. Newey, Whitney K & West, Kenneth D, 1994. "Automatic Lag Selection in Covariance Matrix Estimation," Review of Economic Studies, Blackwell Publishing, vol. 61(4), pages 631-53, October. [Downloadable!] (restricted)
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  9. Adam Wagstaff & Naoko Watanabe, 2003. "What difference does the choice of SES make in health inequality measurement?," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 885-890. [Downloadable!]
  10. Yitzhaki, Shlomo & Slemrod, Joel, 1991. "Welfare Dominance: An Application to Commodity Taxation," American Economic Review, American Economic Association, vol. 81(3), pages 480-96, June. [Downloadable!] (restricted)
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  11. David E. Sahn & Stephen D. Younger, 2000. "Expenditure incidence in Africa: microeconomic evidence," Fiscal Studies, Institute for Fiscal Studies, vol. 21(3), pages 329-347, September. [Downloadable!]
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