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Health care deprivation profiles in the measurement of inequality and inequity: an application to GP fundholding in the English NHS

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  • Laudicella, M
  • Cookson, R
  • Jones, A.M
  • Rice, N

Abstract

This paper proposes a new approach to the measurement of inequality and inequity in the delivery of health care based on contributions from the literature on poverty and deprivation. This approach has some appealing characteristics: 1) inequity is additively decomposable by population subgroups; 2) the approach does not rely on socio-economic ranks; 3) it provides a graphical representation of the distribution of inequity; 4) it offers a range of indices consistent with dominance. An empirical application is provided investigating the effect of the GP fundholding reform on equity in English NHS. The results show that the most equitable GP practices self-selected into the scheme in 1991; evidence of an inequity-reducing treatment effect as well as a selfselection effect are found in 1992 and 1993; the self-selection process reduces and no evidence of a treatment effect is present thereafter.

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  • Laudicella, M & Cookson, R & Jones, A.M & Rice, N, 2008. "Health care deprivation profiles in the measurement of inequality and inequity: an application to GP fundholding in the English NHS," Health, Econometrics and Data Group (HEDG) Working Papers 08/06, HEDG, c/o Department of Economics, University of York.
    • Handle: RePEc:yor:hectdg:08/06
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    3. Mendonça, Sandro & Crespo, Nuno & Simões, Nadia, 2015. "Inequality in the network society: An integrated approach to ICT access, basic skills, and complex capabilities," Telecommunications Policy, Elsevier, vol. 39(3), pages 192-207.
    4. Tapager, Ina & Olsen, Kim Rose & Vrangbæk, Karsten, 2022. "Exploring equity in accessing diabetes management treatment: A healthcare gap analysis," Social Science & Medicine, Elsevier, vol. 292(C).
    5. Olsen, Kim Rose & Laudicella, Mauro, 2019. "Health care inequality in free access health systems: The impact of non-pecuniary incentives on diabetic patients in Danish general practices," Social Science & Medicine, Elsevier, vol. 230(C), pages 174-183.
    6. Nádia Simões & Nuno Crespo & Sandrina B. Moreira & Celeste A. Varum, 2016. "Measurement and determinants of health poverty and richness: evidence from Portugal," Empirical Economics, Springer, vol. 50(4), pages 1331-1358, June.
    7. Nasir Iqbal & Saima Nawaz, 2017. "Spatial Differences and Socioeconomic Determinants of Health Poverty," The Pakistan Development Review, Pakistan Institute of Development Economics, vol. 56(3), pages 221-248.

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    More about this item

    Keywords

    inequality; inequity; health care; poverty; deprivation; dominance; GP fundholding.;
    All these keywords.

    JEL classification:

    • C72 - Mathematical and Quantitative Methods - - Game Theory and Bargaining Theory - - - Noncooperative Games
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • L14 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Transactional Relationships; Contracts and Reputation

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