Assessing inequalities in preventive care use in Europe
This paper presents new international evidence on the extent of inequalities in breast cancer screening and blood test (cholesterol and blood sugar test) in 13 European Countries using data from the 2009 wave of the Survey of Health, Ageing and Retirement in Europe (SHARE). One important contribution of the paper is the inclusion of preexisting health conditions in the needs standardization procedure with the aim of taking into account utilization due to diagnosis or follow-up reasons. We find evidence of pro-rich inequalities in blood test use in some countries while high inequalities emerge in virtually every country with respect to mammography use. Decomposition analysis reveals that inequalities in mammography use are mostly driven by income while preventive needs distribution is only slightly pro-rich. On the other side, richer individuals appear to be much more likely to do blood tests despite their substantially lower diagnostic needs for that care. Generally, inequalities in mammography use are higher in countries without national breast cancer screening programs or in countries with only regional or less participated programs. Inequalities in blood tests are higher in countries with a high share of out-of-pocket payments and/or non universalistic entitlement to insurance coverage.
If you experience problems downloading a file, check if you have the proper application to view it first. 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.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
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.:
- 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.
- 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.
- Kjellsson , Gustav & Gerdtham, Ulf-G, 2011. "Correcting the Concentration Index for Binary Variables," Working Papers 2011:4, Lund University, Department of Economics.
- Cawley, John & Ruhm, Christopher J., 2011.
"The Economics of Risky Health Behaviors,"
IZA Discussion Papers
5728, Institute for the Study of Labor (IZA).
- 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.
- Kjellsson, Gustav & Gerdtham, Ulf-G., 2013. "On correcting the concentration index for binary variables," Journal of Health Economics, Elsevier, vol. 32(3), pages 659-670.
- Erreygers, Guido, 2009.
"Correcting the Concentration Index,"
Journal of Health Economics,
Elsevier, vol. 28(2), pages 504-515, March.
- 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.
- 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.
- Kenkel, D., 1988. "The Demand For Preventive Medical Care," Papers 3-88-4, Pennsylvania State - Department of Economics.
- Crespo-Cebada, Eva & Urbanos-Garrido, Rosa M., 2012. "Equity and equality in the use of GP services for elderly people: The Spanish case," Health Policy, Elsevier, vol. 104(2), pages 193-199.
- Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
- 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.
- Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding Differences in Health Behaviors by Education," Scholarly Articles 5344195, Harvard University Department of Economics.
- Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "Horizontal equity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 251-256, July.
- 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.
- Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications, The World Bank, number 6896.
- Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666.
- 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.
- 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.
- 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.
- 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.
- Wagstaff, Adam, 2009. "Correcting the concentration index: A comment," Journal of Health Economics, Elsevier, vol. 28(2), pages 516-520, March.
- Aniko Biro;, 2012. "An analysis of mammography decisions with a focus on educational differences," Health, Econometrics and Data Group (HEDG) Working Papers 12/11, HEDG, c/o Department of Economics, University of York.
- Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
- 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.
When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:113:y:2013:i:3:p:247-257. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Shamier, Wendy)or ()
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 references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.