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Decomposing the causes of inequalities in health care use: A micro-simulations approach

  • Huber, Hélène

We propose an innovative method for the decomposition of factors associated with inequalities in the use of health care. We analyze individual data and make use of micro-simulations to evaluate the effect of heterogeneity of individual behaviors on inequality in access to care. Our study employs methods that, unlike earlier work, permits evaluation of heterogeneity of individual behaviors. We provide an application of this method by decomposing inequality of health care use in France in 1998. We show that half of the inequity in access to care is due to the heterogeneity of behaviors relative to the rank of individuals in the income distribution. This approach reconciles Oaxaca-like decompositions of inequality, focused on outcome gaps, with analyses involving decompositions of inequality by factors, focused on inequity indices.

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File URL: http://www.sciencedirect.com/science/article/B6V8K-4T5TPG6-1/2/31998a5d9d813ef099d7bfc8b0eba589
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Article provided by Elsevier in its journal Journal of Health Economics.

Volume (Year): 27 (2008)
Issue (Month): 6 (December)
Pages: 1605-1613

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Handle: RePEc:eee:jhecon:v:27:y:2008:i:6:p:1605-1613
Contact details of provider: Web page: http://www.elsevier.com/locate/inca/505560

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  1. 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.
  2. Grogger, J T & Carson, Richard T, 1991. "Models for Truncated Counts," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 6(3), pages 225-38, July-Sept.
  3. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
  4. Wagstaff, Adam & van Doorslaer, Eddy, 2000. "Chapter 34 Equity in health care finance and delivery," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 34, pages 1803-1862 Elsevier.
  5. 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.
  6. Eddy van Doorslaer & Cristina Masseria, 2004. "Income-Related Inequality in the Use of Medical Care in 21 OECD Countries," OECD Health Working Papers 14, OECD Publishing.
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