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Equity in the Utilization of Health Care in Ireland

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  • Layte, Richard

    (Economic and Social Research Institute (ESRI))

  • Nolan, Brian

    (Economic and Social Research Institute (ESRI))

Abstract

This paper analyses the extent of equity of health service delivery across the income distribution in Ireland – that is the extent to which there is equal treatment for equal need irrespective of income. We find that almost all services, apart from dental and optician services, are used more by those at the lower end of the income distribution, but that this group also have the greatest need for health care. The comparison of health need to health care delivery across the income distribution without standardising for confounding factors suggests that those in higher income groups receive more health care for a given health status indicating inequity. However, need for health care is highest among the elderly and this group also tend to be at the bottom of the income distribution. Once we standardise for age, sex and location we find that hospital services are distributed equitably across the income distribution, whereas GP and prescription services tend to be pro-poor (used more by those with lower incomes for a given health status) and dental and optician services tend to be pro-rich (used more by those with higher incomes for a given health status).
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Suggested Citation

  • Layte, Richard & Nolan, Brian, 2003. "Equity in the Utilization of Health Care in Ireland," Papers HRBWP02, Economic and Social Research Institute (ESRI).
    • Handle: RePEc:esr:wpaper:hrb02
    Note: Published by ESRI, ISSC & University of Ulster
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    File URL: http://www.esri.ie/pubs/OPEA36.pdf
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    References listed on IDEAS

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    1. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    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. Fadden, Lillian, 2003. "The Impact of the Extension of the General Medical Services Scheme to Cover All Persons Aged 70 Years and Over: A Case Study," Papers HRBWP06, Economic and Social Research Institute (ESRI).
    4. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 89-112, Spring.
    5. Mooney, Gavin & Hall, Jane & Donaldson, Cam & Gerard, Karen, 1992. "Reweighing heat: Response to Culyer, van Doorslaer and Wagstaff," Journal of Health Economics, Elsevier, vol. 11(2), pages 199-205, August.
    6. Culyer, A. J. & van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Utilisation as a measure of equity by Mooney, Hall, Donaldson and Gerard," Journal of Health Economics, Elsevier, vol. 11(1), pages 93-98, May.
    7. Nolan, Brian, 1991. "The Utilisation and Financing of Health Services in Ireland," Research Series, Economic and Social Research Institute (ESRI), number GRS155.
    8. 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.
    9. Culyer, A. J. & van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Access, utilisation and equity: A further comment," Journal of Health Economics, Elsevier, vol. 11(2), pages 207-210, August.
    10. 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.
    11. 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.
    12. 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.
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    Citations

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    Cited by:

    1. Richard Layte & Anne Nolan, 2015. "Eligibility for free GP care and the utilisation of GP services by children in Ireland," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 3-27, March.
    2. Nolan, Anne, 2011. "An extension in eligibility for free primary care and avoidable hospitalisations: A natural experiment," Social Science & Medicine, Elsevier, vol. 73(7), pages 978-985.
    3. Smyth, Emer & McCoy, Selina, 2009. "Investing in Education: Combating Educational Disadvantage," Research Series, Economic and Social Research Institute (ESRI), number RS006.
    4. 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.
    5. 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).
    6. Briggs, Adam D.M., 2013. "How changes to Irish healthcare financing are affecting universal health coverage," Health Policy, Elsevier, vol. 113(1), pages 45-49.
    7. Layte, Richard, 2006. "An Analysis of the Impact of Age and Proximity of Death on Health Care Costs in Ireland," Papers HRBWP24, Economic and Social Research Institute (ESRI).
    8. repec:eee:joecag:v:6:y:2015:i:c:p:24-43 is not listed on IDEAS
    9. Miriam M. Wiley, 2005. "The Irish health system: developments in strategy, structure, funding and delivery since 1980," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 169-186.
    10. Richard Layte, 2007. "An Analysis of the Impact of Age and Proximity of Death on Health Care Costs in Ireland," Papers WP193, Economic and Social Research Institute (ESRI).
    11. Thomas, Stephen & Layte, Richard, 2009. "General Practitioner Care," Book Chapters,in: Layte, Richard (ed.), Projecting the Impact of Demographic Change on the Demand for and Delivery of Healthcare in Ireland Economic and Social Research Institute (ESRI).
    12. repec:eee:hepoli:v:122:y:2018:i:2:p:147-156 is not listed on IDEAS
    13. Richard Layte, 2007. "Equity in the Utilisation of Hospital Inpatient Services in Ireland? An Improved Approach to the Measurement of Health Need," The Economic and Social Review, Economic and Social Studies, vol. 38(2), pages 191-210.
    14. Edel Doherty & Anne Dee & Ciaran O’Neill, 2012. "Estimating the Amount of Overweight and Obesity Related Health-Care Use in the Republic of Ireland Using SLÁN Data," The Economic and Social Review, Economic and Social Studies, vol. 43(2), pages 227-250.
    15. Samantha Smith, 2010. "The Irish ‘health basket’: a basket case?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 343-350, June.

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