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Income-Related Inequalities in Health Service Utilisation in 19 OECD Countries, 2008-2009


  • Marion Devaux


  • Michael de Looper



This Working Paper examines income-related inequalities in health care service utilisation in OECD countries. It extends a previous analysis (Van Doorslaer and Masseria, 2004) to 2008-2009 for 13 countries, and adds new results for 6 countries, for doctor and dentist visits, and cancer screening. Quintile distributions and concentration indices were used to assess inequalities. For doctor visits, horizontal equity was assessed, i.e. the extent to which adults in equal need of physician care appear to have equal rates of utilisation. The paper considers the evolution of inequalities over time by comparing results with the previous study, as data permit. Health system financing arrangements are examined to see how these might affect inequalities in health service use. Ce document de travail examine les inégalités liées aux revenus dans l’utilisation des services de santé dans les pays de l’OCDE. Il met à jour une étude précédente (Van Doorslaer and Masseria, 2004) pour 13 pays, et inclut 6 nouveaux pays, utilisant des données de 2008-2009, portant sur les consultations de médecins et dentistes, et le dépistage du cancer. Les inégalités sont mesurées à l’aide de distributions par quintile et d’indices de concentration. Cette étude s’intéresse à l’équité horizontale pour les consultations de médecins, i.e. dans quelle mesure des adultes ayant un besoin égal de soins médicaux ont apparemment des taux identiques d’utilisation de soins. Elle examine l’évolution des inégalités en comparant les résultats avec l’étude précédente lorsque les données le permettent. Le cadre d’analyse s’intéresse aux caractéristiques de financement des systèmes de santé et à leurs possibles influences sur les inégalités d’utilisation des services de santé.

Suggested Citation

  • Marion Devaux & Michael de Looper, 2012. "Income-Related Inequalities in Health Service Utilisation in 19 OECD Countries, 2008-2009," OECD Health Working Papers 58, OECD Publishing.
  • Handle: RePEc:oec:elsaad:58-en

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    Cited by:

    1. Georgia Kaplanoglou & Vassilis T. Rapanos & Ioanna C. Bardakas, 2015. "Does Fairness Matter for the Success of Fiscal Consolidation?," Kyklos, Wiley Blackwell, vol. 68(2), pages 197-219, May.
    2. Jean-Jacques Hallaert & Maximilien Queyranne, 2016. "From Containment to Rationalization; Increasing Public Expenditure Efficiency in France," IMF Working Papers 16/7, International Monetary Fund.
    3. Terraneo, Marco, 2015. "Inequities in health care utilization by people aged 50+: Evidence from 12 European countries," Social Science & Medicine, Elsevier, vol. 126(C), pages 154-163.
    4. Damien Bricard & Florence Jusot, 2012. "Intergenerational transmission of health care habits in France," Post-Print hal-01593803, HAL.
    5. Helene Barroy & Zeynep Or & Ankit Kumar & David Bernstein, 2014. "Sustaining Universal Health Coverage in France: A Perpetual Challenge," Health, Nutrition and Population (HNP) Discussion Paper Series 91323, The World Bank.
    6. Sarti, Simone & Terraneo, Marco & Tognetti Bordogna, Mara, 2017. "Poverty and private health expenditures in Italian households during the recent crisis," Health Policy, Elsevier, vol. 121(3), pages 307-314.

    More about this item


    health care; inequality; private health insurance;

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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