This paper proposes a new approach to the measurement of inequality and inequity in the delivery of health care based on recent contributions to the literature of poverty and deprivation. This approach has some appealing characteristics that enlarge the scope of inequity analysis: 1) the measure of inequity does not rely on socio-economic ranks; 2) inequity can be additively decomposed by population subgroups; 3) the approach provides some indirect control for unobserved need variables; 4) it provides a graphical representation of important aspects of the distribution of inequity; 5) it offers a wide range of indices that are consistent with dominance. The paper provides an empirical illustration investigating the effect of the GP fundholding reform on equity in the most deprived quartile of electoral wards of England in the years 1991 to 1996. Elective hip replacements are used as an indicator of inequity in secondary care. The results show that the most equitable GP practices self-selected into the fundholding scheme in 1991; evidence of an inequity-reducing treatment effect as well as a self-selection effect are found in 1992 and 1993; the self-selection process reduces and no evidence of a treatment effect is present from 1994 to 1996.
Download Info
To download:
If you experience problems downloading a file, check if you have the
proper application to
view it first. Information about this may be contained
in the File-Format links below. In case of further problems read
the IDEAS help
page. Note that these files are not on the IDEAS
site. Please be patient as the files may be large.
References listed on IDEAS 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.:
Did you know? Citation analysis on IDEAS includes online papers that are freely accessible and whose text could be automatically analyzed, currently about 210000 papers.