Regional differences in health care delivery: implications for a national resource allocation formula
In several countries formulae for allocating resources to regions are derived using national average relationships between population characteristics and health service use. However, there may be significant regional heterogeneity in health care delivery which, has two main implications for a national resource allocation formula. First, it offers alternative ways of measuring the relative needs of different population groups. Since the primary focus of research and policy is on the difficulty of targeting resources at high-need populations, it is proposed that progressivity in the delivery of health care could be seen as a frontier problem analogous to efficiency. The effects of using the slope parameters from the most progressive region are simulated. Second, regional heterogeneity may thwart the objective of the formula of securing equitable use of resources by different population groups. An adjustment mechanism is developed to illustrate the trade-off between the levels of geographical and vertical equity achieved. A locus of equity possibilities for acute care in Scotland is derived. Traditional formulae represent a corner solution indicating extreme relative aversion to geographical inequity. Because regional variation in need dominates regional variation in progressivity in Scotland, high-need rather than progressive regions gain from the pursuit of vertical equity. Copyright © 2000 John Wiley & Sons, Ltd.
To our knowledge, this item is not available for
download. To find whether it is available, there are three
1. Check below under "Related research" whether another version of this item is available online.
2. Check on the provider's web page whether it is in fact available.
3. Perform a search for a similarly titled item that would be available.
Volume (Year): 9 (2000)
Issue (Month): 6 ()
|Contact details of provider:|| Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749|
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Fare,Rolf & Grosskopf,Shawna & Lovell,C. A. Knox, 2008.
Cambridge University Press, number 9780521072069, November.
- Fare,Rolf & Grosskopf,Shawna & Lovell,C. A. Knox, 1993. "Production Frontiers," Cambridge Books, Cambridge University Press, number 9780521420334, December.
- Kakwani, Nanok C, 1977. "Measurement of Tax Progressivity: An International Comparison," Economic Journal, Royal Economic Society, vol. 87(345), pages 71-80, March.
- Roy Carr-Hill & Geoffrey Hardman & Stephen Martin & Stuart Peacock & Trevor Sheldon & Peter Smith, 1994. "A formula for distributing NHS revenues based on small area use of hospital beds," Working Papers 022cheop, Centre for Health Economics, University of York.
- Richard Blundell & Frank Windmeijer, 1997. "Cluster effects and simultaneity in multilevel models," Health Economics, John Wiley & Sons, Ltd., vol. 6(4), pages 439-443.
- Richard Blundell & Frank Windmeijer, 1997. "Cluster effects and simultaneity in multilevel models," IFS Working Papers W97/05, Institute for Fiscal Studies.
- Nigel Rice & Peter Smith, 1999. "Approaches to capitation and risk adjustment in health care: an international survey," Working Papers 038cheop, Centre for Health Economics, University of York.
- Godfrey, L. G. & Hutton, J. P., 1994. "Discriminating between errors-in- variables/simultaneity and misspecification in linear regression models," Economics Letters, Elsevier, vol. 44(4), pages 359-364, April.
- 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.
- 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.
- 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.
- 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. Full references (including those not matched with items on IDEAS)