IDEAS home Printed from https://ideas.repec.org/a/bla/ijhplm/v40y2025i5p1093-1105.html

Is Public‐Private Partnership a Significant Factor when Achieving Horizontal Equity in Public Healthcare Resources in Spain?

Author

Listed:
  • J. De Haro‐García
  • A. Caro

Abstract

Achieving horizontal equity in the access and use of public health resources is one of the main goals of the 17 Spanish regions. We analyse geographical inequities in the allocation of human and material resources for specialised care in Spanish hospitals, paying attention to the public‐private partnership. We measure inequity using Gini, Concentration and Dissimilarity indices, and Lorenz and Concentration curves, and find that regions having fewer resources in the public sector and less public health spending tend to have higher levels of resources in the private sector, which could contribute to achieve horizontal equity in the public health system.

Suggested Citation

  • J. De Haro‐García & A. Caro, 2025. "Is Public‐Private Partnership a Significant Factor when Achieving Horizontal Equity in Public Healthcare Resources in Spain?," International Journal of Health Planning and Management, Wiley Blackwell, vol. 40(5), pages 1093-1105, September.
    • Handle: RePEc:bla:ijhplm:v:40:y:2025:i:5:p:1093-1105
    DOI: 10.1002/hpm.3944
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hpm.3944
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hpm.3944?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Fang, Pengqian & Dong, Siping & Xiao, Jingjing & Liu, Chaojie & Feng, Xianwei & Wang, Yiping, 2010. "Regional inequality in health and its determinants: Evidence from China," Health Policy, Elsevier, vol. 94(1), pages 14-25, January.
    2. Alex Jingwei He & Shaolong Wu, 2017. "Towards Universal Health Coverage via Social Health Insurance in China: Systemic Fragmentation, Reform Imperatives, and Policy Alternatives," Applied Health Economics and Health Policy, Springer, vol. 15(6), pages 707-716, December.
    3. Hai Zhong, 2010. "On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?," International Journal of Health Economics and Management, Springer, vol. 10(4), pages 369-386, December.
    4. Angela Caro & Julia De Haro-García, 2024. "The waiting times distribution of public hospitals using a GAMLSS approach: the case of Andalusia (Spain)," INVESTIGACIONES REGIONALES - Journal of REGIONAL RESEARCH, Asociación Española de Ciencia Regional, issue 59, pages 167-191.
    5. Yi Tao & Kizito Henry & Qinpei Zou & Xiaoni Zhong, 2014. "Methods for measuring horizontal equity in health resource allocation: a comparative study," Health Economics Review, Springer, vol. 4(1), pages 1-10, December.
    6. Mohammad Habibullah Pulok & Kees Gool & Mohammad Hajizadeh & Sara Allin & Jane Hall, 2020. "Measuring horizontal inequity in healthcare utilisation: a review of methodological developments and debates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 171-180, March.
    7. Sebastian Hinde & Dan Howdon & James Lomas & Matthew Franklin, 2022. "Health Inequalities: To What Extent are Decision-Makers and Economic Evaluations on the Same Page? An English Case Study," Applied Health Economics and Health Policy, Springer, vol. 20(6), pages 793-802, November.
    8. Carol Propper & Jenny Eachus & Philip Chan & Nicky Pearson & George Davey Smith, 2005. "Access to health care resources in the UK: the case of care for arthritis," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 391-406, April.
    9. Gabriel M. Leung & Keith Y. K. Tin & Owen O'Donnell, 2009. "Redistribution or horizontal equity in Hong Kong's mixed public–private health system: a policy conundrum," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 37-54, January.
    10. Van Doorslaer, Eddy & Clarke, Philip & Savage, Elizabeth & Hall, Jane, 2008. "Horizontal inequities in Australia's mixed public/private health care system," Health Policy, Elsevier, vol. 86(1), pages 97-108, April.
    11. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    12. Mackenbach, Johan P. & Kunst, Anton E., 1997. "Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe," Social Science & Medicine, Elsevier, vol. 44(6), pages 757-771, March.
    13. A. Isabel Tavares, 2025. "Voluntary private health insurance and cancer screening utilisation in Europe," International Journal of Health Planning and Management, Wiley Blackwell, vol. 40(1), pages 30-56, January.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Pulok, Mohammad Habibullah & van Gool, Kees & Hall, Jane, 2020. "Horizontal inequity in the utilisation of healthcare services in Australia," Health Policy, Elsevier, vol. 124(11), pages 1263-1271.
    2. Azharuddin Akhtar & Indrani Roy Chowdhury, 2023. "The socioeconomic inequity in healthcare utilization among individuals with cardiovascular diseases in India," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1000-1018, May.
    3. Peng Nie & Andrew E. Clarck & Conchita D'Ambrosio & Lanlin Ding, 2020. "Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions," Working Papers 524, ECINEQ, Society for the Study of Economic Inequality.
    4. Wagstaff, Adam, 2002. "Inequalities in health in developing countries - swimming against the tide?," Policy Research Working Paper Series 2795, The World Bank.
    5. Denzil G. Fiebig & Kees van Gool & Jane Hall & Chunzhou Mu, 2021. "Health care use in response to health shocks: Does socio‐economic status matter?," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 3032-3050, December.
    6. Magnus Lindelow, 2002. "Sometimes More Equal than Others How the choice of welfare indicator can affect the measurement of health inequalities and the incidence of public spending," Economics Series Working Papers WPS/2002-15, University of Oxford, Department of Economics.
    7. E. Xie, 2011. "Income-related inequalities of health and health care utilization," Frontiers of Economics in China, Springer;Higher Education Press, vol. 6(1), pages 131-156, March.
    8. Zhongliang Zhou & Yu Fang & Zhiying Zhou & Dan Li & Dan Wang & Yanli Li & Li Lu & Jianmin Gao & Gang Chen, 2017. "Assessing Income-Related Health Inequality and Horizontal Inequity in China," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 132(1), pages 241-256, May.
    9. Shreya Banerjee & Indrani Roy Chowdhury, 2020. "Inequities in curative health-care utilization among the adult population (20–59 years) in India: A comparative analysis of NSS 71 st (2014) and 75 th (2017–18) rounds," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-23, November.
    10. Udaya S. Mishra, 2016. "Measuring Progress Towards MDGs in Child Health: Should Base Line Sensitivity and Inequity Matter?," Working Papers id:10705, eSocialSciences.
    11. Cleon Tsimbos, 2010. "An assessment of socio-economic inequalities in health among elderly in Greece, Italy and Spain," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 55(1), pages 5-15, February.
    12. Wiktoria Wróblewska, 2012. "Nierówności społeczne w stanie zdrowia w Polsce – analiza na podstawie samooceny stanu zdrowia oraz poziomu wykształcenia," Collegium of Economic Analysis Annals, Warsaw School of Economics, Collegium of Economic Analysis, issue 28, pages 65-84.
    13. Costa-Font, Joan & Nicinska, Anna & Rosselló Roig, Melcior, 2025. "The Inequality and Mobility of Exposure to European Soviet Communism," IZA Discussion Papers 17934, IZA Network @ LISER.
    14. Carmen Elisa Fl√≥rez & Rocio Ribero & Belen Samper, 2003. "Health, Nutrition, Human Capital And Economic Growth In Colombia 1995-2000," Documentos CEDE 2785, Universidad de los Andes, Facultad de Economía, CEDE.
    15. Pulok, Mohammad Habibullah & Hajizadeh, Mohammad, 2022. "Equity in the use of physician services in Canada's universal health system: A longitudinal analysis of older adults," Social Science & Medicine, Elsevier, vol. 307(C).
    16. Xinyu Zhang & Lin Zhao & Zhuang Cui & Yaogang Wang, 2015. "Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-15, December.
    17. Mohammad Hajizadeh & M. Karen Campbell & Sisira Sarma, 2014. "Socioeconomic inequalities in adult obesity risk in Canada: trends and decomposition analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(2), pages 203-221, March.
    18. Pathak, Praveen Kumar & Singh, Abhishek, 2011. "Trends in malnutrition among children in India: Growing inequalities across different economic groups," Social Science & Medicine, Elsevier, vol. 73(4), pages 576-585, August.
    19. Pulok, Mohammad Habibullah & van Gool, Kees & Hall, Jane, 2020. "Inequity in physician visits: the case of the unregulated fee market in Australia," Social Science & Medicine, Elsevier, vol. 255(C).
    20. Rohde, Kirsten I.M. & Van Ourti, Tom & Soebhag, Amar, 2023. "Reducing socioeconomic health inequalities? A questionnaire study of majorization and invariance conditions," Journal of Health Economics, Elsevier, vol. 90(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ijhplm:v:40:y:2025:i:5:p:1093-1105. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0749-6753 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.