IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v11y2002i6p537-549.html
   My bibliography  Save this article

Vertical and horizontal aspects of socio-economic inequity in general practitioner contacts in Scotland

Author

Listed:
  • Matthew Sutton

    (Department of General Practice, University of Glasgow, UK)

Abstract

Health status varies across socio-economic groups and health status is generally assumed to predict health care needs. Therefore the need for health care varies across socio-economic groups, and studies of equity in the distribution of health care between socio-economic groups must compare levels of utilisation with levels of need. Economic studies of equity in health care generally assume that health care needs can be derived from the current health-health care relationship. They therefore do not consider whether the current health-health care relationship is (vertically) equitable and the focus is restricted to horizontal inequity. This paper proposes a framework for incorporating the implications of vertical inequity for the socio-economic distribution of health care. An alternative to the current health-health care relationship is proposed using a restriction on the health-elasticity of health care. The health-elasticity of general practitioner contacts in Scotland is found to be generally negative, but positive at low levels of health status. Pro-rich estimates of horizontal inequity and vertical inequity are obtained but neither is statistically significant. Further analysis demonstrates that the magnitude of vertical inequity in health care may be larger than horizontal inequity. Copyright © 2002 John Wiley & Sons, Ltd.

Suggested Citation

  • Matthew Sutton, 2002. "Vertical and horizontal aspects of socio-economic inequity in general practitioner contacts in Scotland," Health Economics, John Wiley & Sons, Ltd., vol. 11(6), pages 537-549.
  • Handle: RePEc:wly:hlthec:v:11:y:2002:i:6:p:537-549
    DOI: 10.1002/hec.752
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1002/hec.752
    File Function: Link to full text; subscription required
    Download Restriction: no

    References listed on IDEAS

    as
    1. 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.
    2. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
    3. Culyer, A. J., 1995. "Need: The idea won't do--But we still need it," Social Science & Medicine, Elsevier, vol. 40(6), pages 727-730, March.
    4. 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.
    5. Mooney, Gavin & Jan, Stephen, 1997. "Vertical equity: weighting outcomes? or establishing procedures?," Health Policy, Elsevier, vol. 39(1), pages 79-87, January.
    6. Macintyre, Sally & Ford, Graeme & Hunt, Kate, 1999. "Do women 'over-report' morbidity? Men's and women's responses to structured prompting on a standard question on long standing illness," Social Science & Medicine, Elsevier, vol. 48(1), pages 89-98, January.
    7. Doorslaer, Eddy van & Jones, Andrew M., 2003. "Inequalities in self-reported health: validation of a new approach to measurement," Journal of Health Economics, Elsevier, vol. 22(1), pages 61-87, January.
    8. Mooney, Gavin & Hall, Jane & Donaldson, Cam & Gerard, Karen, 1991. "Utilisation as a measure of equity: weighing heat?," Journal of Health Economics, Elsevier, vol. 10(4), pages 475-480.
    9. O'Donnell, Owen & Propper, Carol, 1991. "Equity and the distribution of U.K. National Health Service resources," Journal of Health Economics, Elsevier, vol. 10(2), pages 247-249, July.
    10. Le Grand, Julian, 1991. "The distribution of health care revisited: A commentary on Wagstaff, van Doorslaer and Paci, and O'Donnell and Propper," Journal of Health Economics, Elsevier, vol. 10(2), pages 239-245, July.
    11. Matthew Sutton & Peter Lock, 2000. "Regional differences in health care delivery: implications for a national resource allocation formula," Health Economics, John Wiley & Sons, Ltd., vol. 9(6), pages 547-559.
    12. Kenneth J. Arrow, 1971. "A Utilitarian Approach to the Concept of Equality in Public Expenditures," The Quarterly Journal of Economics, Oxford University Press, vol. 85(3), pages 409-415.
    13. 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.
    14. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
    15. Le Grand, Julian, 1978. "The Distribution of Public Expenditure: The Case of Health Care," Economica, London School of Economics and Political Science, vol. 45(178), pages 125-142, May.
    16. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Richard Cookson & Carol Proppper & Miqdad Asaria & Rosalind Raine, 2016. "Socioeconomic inequalities in health care in England," Working Papers 129cherp, Centre for Health Economics, University of York.
    2. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    3. Vallejo-Torres, Laura & Morris, Stephen, 2010. "The contribution of smoking and obesity to income-related inequalities in health in England," Social Science & Medicine, Elsevier, vol. 71(6), pages 1189-1198, September.
    4. 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.
    5. Richard Layte & Anne Nolan, 2015. "Income-related inequity in the use of GP services by children: a comparison of Ireland and Scotland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(5), pages 489-506, June.
    6. Monika Sander, 2008. "Is There Migration-Related Inequity in Access to or in the Utilisation of Health Care in Germany?," SOEPpapers on Multidisciplinary Panel Data Research 147, DIW Berlin, The German Socio-Economic Panel (SOEP).
    7. Hugh Gravelle & Stephen Morris & Matt Sutton, 2006. "Are General Practitioners Good for Endogenous Supply and Health," Working Papers 020cherp, Centre for Health Economics, University of York.
    8. Layte, Richard & Nolan, Anne, 2013. "Income-Related Inequity in the Use of GP Services: A Comparison of Ireland and Scotland," Papers WP454, Economic and Social Research Institute (ESRI).
    9. Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
    10. 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.
    11. Van de Poel, Ellen & Van Doorslaer, Eddy & O’Donnell, Owen, 2012. "Measurement of inequity in health care with heterogeneous response of use to need," Journal of Health Economics, Elsevier, vol. 31(4), pages 676-689.
    12. Anselmi, Laura & Lagarde, Mylène & Hanson, Kara, 2015. "Going beyond horizontal equity: An analysis of health expenditure allocation across geographic areas in Mozambique," Social Science & Medicine, Elsevier, vol. 130(C), pages 216-224.
    13. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2011. "Equity in health and health care," CORE Discussion Papers 2011026, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    14. Hugh Gravelle & Stephen Morris & Matt Sutton, 2012. "Economic Studies of Equity in the Consumption of Health Care," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 18 Edward Elgar Publishing.
    15. Samuel L Brilleman & Hugh Gravelle & Sandra Hollinghurst & Sarah Purdy & Chris Salisbury & Frank Windmeijer, 2011. "Keep it Simple? Predicting Primary Health Care Costs with Measures of Morbidity and Multimorbidity," Working Papers 072cherp, Centre for Health Economics, University of York.

    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:wly:hlthec:v:11:y:2002:i:6:p:537-549. 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: (Wiley-Blackwell Digital Licensing) or (Christopher F. Baum). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    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 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.

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.