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Equity in the Use of Health Care Services by Immigrants in the Spanish National Health Care System



    () (Departamento Economía Aplicada. UNIVERSIDAD DE GRANADA.)


The increasing proportion of immigrants in the Spanish society is creating pressures for the National Health Care System to accommodate the needs of this population group while keeping their costs under control. The Spanish health care system establishes that all people, regardless of their nationality, should be entitled to use health care services with the same conditions as Spanish citizens provided that they are registered in the local population census. Empirical evidence about differences in health status or utilisation between immigrant and Spanish-born population is however insufficient. This study uses the 2003 Spanish National Health Survey to explore whether non-Spaniards, for the same level of need, use health care services at the same rate as national citizens. The findings suggest that the nationality of an individual is an important predictor of health care utilisation, independent of other factors. These results may indicate horizontal inequity in the utilisation of health care with respect to nationality. La creciente proporción de inmigrantes en la sociedad española supone el importante reto para el Sistema Nacional de Salud de satisfacer las necesidades de este grupo de población manteniendo su presupuesto bajo control. El sistema sanitario español establece que todos los individuos, independientemente de su nacionalidad, deberían tener acceso a los servicios sanitarios con las mismas condiciones que los ciudadanos españoles, siempre que estén registrados en el padrón municipal. La evidencia empírica sobre las diferencias en el nivel de salud o la utilización sanitaria entre la población inmigrante y autóctona es sin embargo insuficiente. Este estudio utiliza la Encuesta Nacional de Salud del año 2003 para investigar si, para el mismo nivel de necesidad sanitaria, los individuos no autóctonos utilizan los servicios sanitarios al mismo nivel que los españoles. Los resultados sugieren que la nacionalidad es un importante factor determinante de la utilización sanitaria, independientemente de otros factores. Estos resultados pueden indicar la existencia de inequidad horizontal en la utilización de servicios sanitarios con respecto a la nacionalidad de un individuo.

Suggested Citation

  • Jiménez Rubio, Dolores, 2008. "Equity in the Use of Health Care Services by Immigrants in the Spanish National Health Care System," Estudios de Economía Aplicada, Estudios de Economía Aplicada, vol. 26, pages 211-230, Septiembr.
  • Handle: RePEc:lrk:eeaart:26_3_7

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    References listed on IDEAS

    1. 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.
    2. Andrew M. Jones, 2012. "health econometrics," The New Palgrave Dictionary of Economics, Palgrave Macmillan.
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    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J15 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Minorities, Races, Indigenous Peoples, and Immigrants; Non-labor Discrimination


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