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

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  • Matthew Sutton

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.

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  • 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, September.
  • Handle: RePEc:wly:hlthec:v:11:y:2002:i:6:p:537-549
    DOI: 10.1002/hec.752
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    Cited by:

    1. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    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. A. Akhtar & Nadeem Ahmad & Indrani Roy Chowdhury, 2020. "Socio-economic inequality in catastrophic health expenditure among households in India: A decomposition analysis," Indian Economic Review, Springer, vol. 55(2), pages 339-369, December.
    9. 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).
    10. 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.
    11. 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, October.
    12. 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.
    13. 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.
    14. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2011. "Equity in health and health care," LIDAM Discussion Papers CORE 2011026, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    15. Laura Vallejo‐Torres & Stephen Morris, 2013. "Income‐Related Inequity In Healthcare Utilisation Among Individuals With Cardiovascular Disease In England—Accounting For Vertical Inequity," Health Economics, John Wiley & Sons, Ltd., vol. 22(5), pages 533-553, May.
    16. Hugh Gravelle & Stephen Morris & Matt Sutton, 2012. "Economic Studies of Equity in the Consumption of Health Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 18, Edward Elgar Publishing.
    17. Marianne Tenand & Pieter Bakx & Eddy van Doorslaer, 2020. "Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 435-451, April.
    18. 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.
    19. Mohammad Habibullah Pulok & Kees Gool & Mohammad Hajizadeh & Sara Allin & Jane Hall, 2020. "Measuring horizontal inequity in healthcare utilisation: a review of methodological developments and debates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 171-180, March.
    20. Jongsay Yong & Ou Yang, 2021. "Does socioeconomic status affect hospital utilization and health outcomes of chronic disease patients?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(2), pages 329-339, March.

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