Sometimes More Equal than Others How the choice of welfare indicator can affect the measurement of health inequalities and the incidence of public spending
In recent years, a large body of empirical work has focused on measuring and explaining socioeconomic inequalities in health outcomes and health service use. In any effort to address these questions, analysts must confront the issue of how to measure socioeconomic status. In developing countries, socioeconomic status has typically been measured by per capita consumption or an asset index. Currently, there is only limited information on how the choice of welfare indicators affect the analysis of health inequalities and the incidence of public spending. The paper focuses on five key health service outcomes in Mozambique. It uses the concentration index approach to measures both socioeconomic inequality in the utilization of health services and the sensitivity of measured inequality to the choice of welfare indicator. The results illustrate that, at least in some contexts, the choice of welfare indicator can have a large and significant impact on socioeconomic inequalities in service use and on the “perceived” incidence of public spending. The findings point at the need to be cautious in measuring inequality, but also to extend and deepen the analysis of service use.
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- Le Grand, Julian, 1978. "The Distribution of Public Expenditure: The Case of Health Care," Economica, London School of Economics and Political Science, vol. 45(178), pages 125-142, May.
- David E. Sahn & Stephen D. Younger, 2000. "Expenditure incidence in Africa: microeconomic evidence," Fiscal Studies, Institute for Fiscal Studies, vol. 21(3), pages 329-347, September.
- 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.
- DAVIDSON, Russell & DUCLOS, Jean-Yves, 1995.
"Statistical Inference for the Measurement of the Incidences of Taxes and Transfers,"
Cahiers de recherche
9521, Université Laval - Département d'économique.
- Russell Davidson & Jean-Yves Duclos, 1997. "Statistical Inference for the Measurement of the Incidence of Taxes and Transfers," Econometrica, Econometric Society, vol. 65(6), pages 1453-1466, November.
- Davidson, R. & Duclos, J.Y., 1995. "Statistical Inference for the Measurement of the Incidence of Taxes and Transfers," Papers 9521, Laval - Recherche en Politique Economique.
- Davidson, R. & Duclos, J.Y., 1995. "Statistical Inference for the Measurement of the Incidence of Taxes and Transfers," G.R.E.Q.A.M. 95a30, Universite Aix-Marseille III.
- David E. Sahn & David Stifel, 2003. "Exploring Alternative Measures of Welfare in the Absence of Expenditure Data," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 49(4), pages 463-489, December.
- Jenkins, Stephen, 1988. "Calculating Income Distribution Indices From Micro-Data," National Tax Journal, National Tax Association, vol. 41(1), pages 139-142, March.
- Kenneth D. West & Whitney K. Newey, 1995.
"Automatic Lag Selection in Covariance Matrix Estimation,"
NBER Technical Working Papers
0144, National Bureau of Economic Research, Inc.
- Whitney K. Newey & Kenneth D. West, 1994. "Automatic Lag Selection in Covariance Matrix Estimation," Review of Economic Studies, Oxford University Press, vol. 61(4), pages 631-653.
- Newey, W.K. & West, K.D., 1992. "Automatic Lag Selection in Covariance Matrix Estimation," Working papers 9220, Wisconsin Madison - Social Systems.
- Yitzhaki, Shlomo & Slemrod, Joel, 1991.
"Welfare Dominance: An Application to Commodity Taxation,"
American Economic Review,
American Economic Association, vol. 81(3), pages 480-496, June.
- Shlomo Yitzhaki & Joel Slemrod, 1987. "Welfare Dominance: An Application to Commodity Taxation," NBER Working Papers 2451, National Bureau of Economic Research, Inc.
- repec:ntj:journl:v:41:y:1988:i:no._1:p:139-42 is not listed on IDEAS
- 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.
- Heltberg, Rasmus & Simler, Kenneth & Tarp, Finn, 2003.
"Public spending and poverty in Mozambique,"
FCND discussion papers
167, International Food Policy Research Institute (IFPRI).
- Heltberg, Rasmus & Simler, Kenneth & Tarp, Finn, 2001. "Public Spending and Poverty in Mozambique," WIDER Working Paper Series 063, World Institute for Development Economic Research (UNU-WIDER).
- Heltberg, Rasmus & Simler, Kenneth & Tarp, Finn, 2003. "Public spending and poverty in Mozambique," FCND briefs 167, International Food Policy Research Institute (IFPRI).
- Wolfe, Barbara L & Behrman, Jere R, 1984. "Determinants of Women's Health Status and Health-Care Utilization in a Developing Country: A Latent Variable Approach," The Review of Economics and Statistics, MIT Press, vol. 66(4), pages 696-703, November.
- Adam Wagstaff & Naoko Watanabe, 2003. "What difference does the choice of SES make in health inequality measurement?," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 885-890.
- 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.
- Mackenbach, Johan P. & Kunst, Anton E., 1997. "Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe," Social Science & Medicine, Elsevier, vol. 44(6), pages 757-771, March.
- 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.
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