Assessing inequalities in preventive care use in Europe: A special case of health-care inequalities?
AbstractThis paper presents the first cross-country estimation of needs-adjusted income and education-related inequalities in the use of a whole set of preventive care treatments. Analysis is based on the last three waves of the Survey of Health, Ageing and Retirement (SHARE) for individuals aged 50 and over living in 13 European countries. We employ alternative concentration indices based on the CI-corrections for binary outcomes to compute inequalities in the use of breast cancer screening, of colorectal cancer screening, of influenza vaccination, and of routine prevention tests, such as blood pressure, cholesterol, and blood sugar tests. After controlling for needs, we find that in many European countries strong pro-rich and educational inequalities exist with respect to breast cancer screening, cholesterol and blood sugar tests. Furthermore, we find that poor and less educated people are more likely than the better off to use preventive care late, e.g. when health shocks occurred or health problems display already symptoms. Finally, results suggest that access to treatments within a specialist setting is generally less equal than access to treatments provided within a GP setting. Equity implications of the results are then discussed according to different possible theories of distributive justice in health care delivery.
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Bibliographic InfoPaper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 12/25.
Date of creation: Aug 2012
Date of revision:
Contact details of provider:
Postal: HEDG/HERC, Department of Economics and Related Studies, University of York, York, YO10 5DD, United Kingdom
Phone: (0)1904 323776
Fax: (0)1904 323759
Web page: http://www.york.ac.uk/economics/postgrad/herc/hedg/
More information through EDIRC
Preventive care; socio-economic related inequalities; concentration indices;
Find related papers by JEL classification:
- I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
- D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
This paper has been announced in the following NEP Reports:
- NEP-ALL-2012-09-30 (All new papers)
- NEP-EUR-2012-09-30 (Microeconomic European Issues)
- NEP-HEA-2012-09-30 (Health Economics)
- NEP-HME-2012-09-30 (Heterodox Microeconomics)
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.:
- Hugh Gravelle, 2003. "Measuring income related inequality in health: standardisation and the partial concentration index," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 803-819.
- Erreygers, Guido, 2009.
"Correcting the Concentration Index,"
Journal of Health Economics,
Elsevier, vol. 28(2), pages 504-515, March.
- Erreygers, Guido & Van Ourti, Tom, 2011.
"Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: A recipe for good practice,"
Journal of Health Economics,
Elsevier, vol. 30(4), pages 685-694, July.
- Guido Erreygers & Tom Van Ourti, 2010. "Measuring Socioeconomic Inequality in Health, Health Care and Health Financing by Means of Rank-Dependent Indices: A Recipe for Good Practice," Tinbergen Institute Discussion Papers 10-076/3, Tinbergen Institute.
- Hendrik Schmitz & Ansgar Wübker, 2011. "What determines influenza vaccination take‐up of elderly Europeans?," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1281-1297, November.
- 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.
- Wagstaff, Adam & Van Doorslaer, Eddy & Watanabe, Naoko, 2001. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Policy Research Working Paper Series 2714, The World Bank.
- Wagstaff, Adam, 2009. "Correcting the concentration index: A comment," Journal of Health Economics, Elsevier, vol. 28(2), pages 516-520, March.
- Cawley, John & Ruhm, Christopher J., 2011.
"The Economics of Risky Health Behaviors,"
IZA Discussion Papers
5728, Institute for the Study of Labor (IZA).
- Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666.
- Kenkel, D., 1988. "The Demand For Preventive Medical Care," Papers 3-88-4, Pennsylvania State - Department of Economics.
- Teresa Bago d’Uva & Andrew M. Jones & Eddy van Doorslaer, 2007.
"Measurement of horizontal inequity in health care utilisation using European Panel data,"
Health, Econometrics and Data Group (HEDG) Working Papers
07/17, HEDG, c/o Department of Economics, University of York.
- Bago d'Uva, Teresa & Jones, Andrew M. & van Doorslaer, Eddy, 2009. "Measurement of horizontal inequity in health care utilisation using European panel data," Journal of Health Economics, Elsevier, vol. 28(2), pages 280-289, March.
- Teresa Bago d'Uva & Andrew M. Jones & Eddy van Doorslaer, 2007. "Measurement of Horizontal Inequity in Health Care Utilisation using European Panel Data," Tinbergen Institute Discussion Papers 07-059/3, Tinbergen Institute.
- Vincenzo Carrieri & Marcel Bilger, 2013. "Preventive care: underused even when free. Is there something else at work?," Applied Economics, Taylor & Francis Journals, vol. 45(2), pages 239-253, January.
- Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-55, March-Apr.
- 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.
- Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
- Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
- Kjellsson , Gustav & Gerdtham, Ulf-G, 2011. "Correcting the Concentration Index for Binary Variables," Working Papers 2011:4, Lund University, Department of Economics.
- Lerman, Robert I. & Yitzhaki, Shlomo, 1989. "Improving the accuracy of estimates of Gini coefficients," Journal of Econometrics, Elsevier, vol. 42(1), pages 43-47, September.
- Lairson, David R. & Chan, Wenyaw & Newmark, Georgina R., 2005. "Determinants of the demand for breast cancer screening among women veterans in the United States," Social Science & Medicine, Elsevier, vol. 61(7), pages 1608-1617, October.
- Agar Brugiavini & Tullio Jappelli & Guglielmo Weber, 2002. "The Survey on Health, Aging and Wealth," CSEF Working Papers 86, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
- Adam Wagstaff, 2005. "The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 429-432.
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