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Mesure de l'équité des modes de financement et de distribution des soins de santé : aspects méthodologiques avec illustration sur l'Irlande

[fre] Mesure de l'équité des modes de financement et de distribution des soins de santé : aspects méthodologiques avec illustration sur l'Irlande par Brian Nolan Cet article présente les difficultés méthodologiques rencontrées dans la mesure de l'équité du financement et de la distribution des soins de santé. Certaines de ces difficultés sont communes à d'autres domaines de l'économie mais plus complexes demeurent spécifiques, comme celui de trouver une mesure convenable des besoins médicaux. Il est aussi difficile d'établir un lien univoque entre résultats macro-économiques et comportements micro-économiques de production et consommation. Encore plus complexe est le fait que l'évaluation des besoins devrait faire référence à la capacité des patients de bénéficier des soins plutôt qu'à l'importance de la maladie, et à la répartition dans la population de ces améliorations d'état de santé plutôt qu'à l'utilisation des soins médicaux. En effet, beaucoup des soins médicaux proposés actuellement ne sauraient réduire les inégalités de santé, quand bien même ils seraient ciblés sur les catégories socio-économiques les plus défavorisées. [eng] Measuring the Equity of Health-Care Distribution and Funding Methods: Methodological Aspects with Ireland as Illustration by Brian Nolan This paper sets out the methodological difficulties encountered in measuring the equity of health-care distribution and funding. Some of these difficulties are shared by other fields of the economy, but the most complex remain specific to this area, such as the problem of finding a suitable measurement for medical needs It is also difficult to establish a direct relationship between macroeconomic performance and microeconomic behaviour in terms of production and consumption. Yet more complicated is the fact that needs assessment should be based on patients' capacity to benefit from care rather than on the degree of illness, and on the distribution of health improvements among the community rather than on the utilisation of health care. Indeed, much of the health-care currently available would be unable to reduce health inequalities even if targeted at the most disadvantaged social and economic categories.

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Article provided by Programme National Persée in its journal Économie & prévision.

Volume (Year): 129 (1997)
Issue (Month): 3 ()
Pages: 121-130

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Handle: RePEc:prs:ecoprv:ecop_0249-4744_1997_num_129_3_5867
Note: DOI:10.3406/ecop.1997.5867
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  1. Jones, Andrew & O'Donnell, Owen, 1995. "Equivalence scales and the costs of disability," Journal of Public Economics, Elsevier, vol. 56(2), pages 273-289, February.
  2. O'Donnell, Owen & Propper, Carol, 1991. "Equity and the distribution of UK National Health Service resources," Journal of Health Economics, Elsevier, vol. 10(1), pages 1-19, May.
  3. Wagstaff, Adam & van Doorslaer, Eddy, 1992. "Equity in the finance of health care: Some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 361-387, December.
  4. Tony Culyer, 1991. "Health, health expenditures and equity," Working Papers 083chedp, Centre for Health Economics, University of York.
  5. Suits, Daniel B, 1977. "Measurement of Tax Progressivity," American Economic Review, American Economic Association, vol. 67(4), pages 747-52, September.
  6. Kakwani, Nanok C, 1977. "Measurement of Tax Progressivity: An International Comparison," Economic Journal, Royal Economic Society, vol. 87(345), pages 71-80, March.
  7. Nolan, Brian, 1993. "Economic incentives, health status and health services utilisation," Journal of Health Economics, Elsevier, vol. 12(2), pages 151-169, July.
  8. van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Equity in the delivery of health care: some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 389-411, December.
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