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A note on the decomposition of the health concentration index

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  • Philip M. Clarke

    (Health Economics Research Centre, University of Oxford, UK)

  • Ulf-G Gerdtham
  • Luke B. Connelly

    (Brisbane Graduate School of Business, Queensland University of Technology, Australia)

Abstract

In recent work, the concentration index has been widely used as a measure of income-related health inequality. The purpose of this note is to illustrate two different methods for decomposing the overall health concentration index using data collected from a Short Form (SF-36) survey of the general Australian population conducted in 1995. For simplicity, we focus on the physical functioning scale of the SF-36. Firstly we examine decomposition 'by component' by separating the concentration index for the physical functioning scale into the ten items on which it is based. The results show that the items contribute differently to the overall inequality measure, i.e. two of the items contributed 13% and 5%, respectively, to the overall measure. Second, to illustrate the 'by subgroup' method we decompose the concentration index by employment status. This involves separating the population into two groups: individuals currently in employment; and individuals not currently employed. We find that the inequality between these groups is about five times greater than the inequality within each group. These methods provide insights into the nature of inequality that can be used to inform policy design to reduce income related health inequalities. Copyright © 2002 John Wiley & Sons, Ltd.

Suggested Citation

  • Philip M. Clarke & Ulf-G Gerdtham & Luke B. Connelly, 2003. "A note on the decomposition of the health concentration index," Health Economics, John Wiley & Sons, Ltd., vol. 12(6), pages 511-516.
  • Handle: RePEc:wly:hlthec:v:12:y:2003:i:6:p:511-516
    DOI: 10.1002/hec.767
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    References listed on IDEAS

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    Cited by:

    1. Bleichrodt, Han & van Doorslaer, Eddy, 2006. "A welfare economics foundation for health inequality measurement," Journal of Health Economics, Elsevier, vol. 25(5), pages 945-957, September.
    2. Tom Van Ourti & Eddy Van Doorslaer & Xander Koolman, 2006. "The Effect of Growth and Inequality in Incomes on Health Inequality: Theory and Empirical Evidence from the European Panel," Tinbergen Institute Discussion Papers 06-108/3, Tinbergen Institute.
    3. Dolores Jiménez-Rubio & Peter C. Smith & Eddy Van Doorslaer, 2008. "Equity in health and health care in a decentralised context: evidence from Canada," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 377-392.
    4. Gundgaard, Jens & Lauridsen, Jørgen, 2013. "Explaining the Sources of IncomeRelated Inequality in Health Care Utilization in Denmark," COHERE Working Paper 2013:1, University of Southern Denmark, COHERE - Centre of Health Economics Research.
    5. Guido Erreygers & Roselinde Kessels & Linkun Chen & Philip Clarke, 2016. "Decomposing Socioeconomic Inequality of Health," EcoMod2016 9574, EcoMod.
    6. Lumme, Sonja & Sund, Reijo & Leyland, Alastair H. & Keskimäki, Ilmo, 2012. "Socioeconomic equity in amenable mortality in Finland 1992–2008," Social Science & Medicine, Elsevier, vol. 75(5), pages 905-913.
    7. Kyusuk Chung & Jun Hyup Lee, 2012. "A decomposition of income-related inequality in EQ-5D: a South Korea study," International Journal of Public Policy, Inderscience Enterprises Ltd, vol. 8(1/2/3), pages 53-68.
    8. Adam Wagstaff, 2005. "Inequality decomposition and geographic targeting with applications to China and Vietnam," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 649-653.
    9. Jens Gundgaard & Jørgen Lauridsen, 2006. "A decomposition of income-related health inequality applied to EQ-5D," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(4), pages 231-237, December.
    10. Hai Zhong, 2010. "The impact of missing data in the estimation of concentration index: a potential source of bias," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 255-266, June.
    11. Abu-Zaineh, Mohammad & Mataria, Awad & Luchini, Stéphane & Moatti, Jean-Paul, 2008. "Equity in health care financing in Palestine: The value-added of the disaggregate approach," Social Science & Medicine, Elsevier, vol. 66(11), pages 2308-2320, June.
    12. Lee, Miaw-Chwen & Jones, Andrew Michael, 2007. "Understanding differences in income-related health inequality between geographic regions in Taiwan using the SF-36," Health Policy, Elsevier, vol. 83(2-3), pages 186-195, October.
    13. Yuejen ZHAO, 2013. "Decomposition of Concentration Index using Generalised Linear Model: Analysis of Socio-Economic Determinants of Health Inequality in the Northern Territory of Australia," Regional and Sectoral Economic Studies, Euro-American Association of Economic Development, vol. 13(1), pages 145-154.
    14. JØrgen Lauridsen & Terkel Christiansen & Jens Gundgaard & Unto Häkkinen & Harri Sintonen, 2007. "Decomposition of health inequality by determinants and dimensions," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 97-102.
    15. Van Ourti, Tom & van Doorslaer, Eddy & Koolman, Xander, 2009. "The effect of income growth and inequality on health inequality: Theory and empirical evidence from the European Panel," Journal of Health Economics, Elsevier, vol. 28(3), pages 525-539, May.
    16. Saloua Sehili & Elamin H. Elbasha & David G. Moriarty & Matthew M. Zack, 2005. "Inequalities in self-reported physical health in the United States, 1993-1999," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 377-389.
    17. ERREYGERS, Guido & KESSELS, Roselinde, 2013. "Regression-based decompositions of rank-dependent indicators of socioeconomic inequality of health," Working Papers 2013007, University of Antwerp, Faculty of Applied Economics.
    18. Makdissi, Paul & Sylla, Daouda & Yazbeck, Myra, 2013. "Decomposing health achievement and socioeconomic health inequalities in presence of multiple categorical information," Economic Modelling, Elsevier, vol. 35(C), pages 964-968.
    19. Mototsugu Fukushige & Noriko Ishikawa & Satoko Maekawa, 2012. "A modified Kakwani measure for health inequality," Health Economics Review, Springer, vol. 2(1), pages 1-7, December.

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