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Inequality and Polarisation in Health Systems’ Responsiveness: A Cross-Country Analysis

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  • Janoes, A
  • Rice, N
  • Robone, S
  • Rosa Dias, P

Abstract

The World Health Report 2000 proposed three fundamental goals for health systems encompassing population health, health care finance and health systems responsiveness. Each of the goals incorporates both an efficiency and equity dimension. While inequalities in population health and health care finance have motivated two important strands of research, inequalities in responsiveness have received less attention in health economics. This paper examines inequality and polarisation in responsiveness, bridging this gap in the literature and contributing towards an integrated analysis of health systems performance. It uses data from the World Health Survey to measure and compare inequalities in responsiveness across 25 European countries. In order to respect the inherently ordinal nature of the responsiveness data, median-based measures of inequality and polarisation are employed. The results suggest that, in the face of wide differences in the health systems analysed, there exists large variability in inequalit in responsiveness across countries.

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  • Janoes, A & Rice, N & Robone, S & Rosa Dias, P, 2010. "Inequality and Polarisation in Health Systems’ Responsiveness: A Cross-Country Analysis," Health, Econometrics and Data Group (HEDG) Working Papers 10/27, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:10/27
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    2. Indranil Dutta & James Foster, 2013. "Inequality of Happiness in the U.S.: 1972–2010," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 59(3), pages 393-415, September.
    3. Cinzia Di Novi & Massimiliano Piacenza & Silvana Robone & Gilberto Turati, 2015. "How does fiscal decentralization affect within-regional disparities in well-being? Evidence from health inequalities in Italy," Working Papers 2015:21, Department of Economics, University of Venice "Ca' Foscari".
    4. Martyna Kobus & Radosław Kurek, 2019. "Multidimensional polarization for ordinal data," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 17(3), pages 301-317, September.
    5. Knott, R. & Lorgelly, P. & Black, N. & Hollingsworth, B., 2016. "Differential item functioning in the EQ-5D: An exploratory analysis using anchoring vignettes," Health, Econometrics and Data Group (HEDG) Working Papers 16/14, HEDG, c/o Department of Economics, University of York.
    6. Fiorentini, Gianluca & Ragazzi, Giovanni & Robone, Silvana, 2015. "Are bad health and pain making us grumpy? An empirical evaluation of reporting heterogeneity in rating health system responsiveness," Social Science & Medicine, Elsevier, vol. 144(C), pages 48-58.
    7. Paul Makdissi & Myra Yazbeck, 2017. "Robust rankings of socioeconomic health inequality using a categorical variable," Health Economics, John Wiley & Sons, Ltd., vol. 26(9), pages 1132-1145, September.
    8. Van de Poel, Ellen & Van Doorslaer, Eddy & O’Donnell, Owen, 2012. "Measurement of inequity in health care with heterogeneous response of use to need," Journal of Health Economics, Elsevier, vol. 31(4), pages 676-689.
    9. Abul Naga, Ramses H. & Stapenhurst, Christopher, 2015. "Estimation of inequality indices of the cumulative distribution function," Economics Letters, Elsevier, vol. 130(C), pages 109-112.
    10. Marta Pascual & David Cantarero & Paloma Lanza, 2018. "Health polarization and inequalities across Europe: an empirical approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(8), pages 1039-1051, November.
    11. Ramses Abul Naga & Christopher Stapenhurst & Gaston Yalonetzky, 2020. "Asymptotic Versus Bootstrap Inference for Inequality Indices of the Cumulative Distribution Function," Econometrics, MDPI, Open Access Journal, vol. 8(1), pages 1-15, February.
    12. Werbeck, Anna & Wübker, Ansgar & Ziebarth, Nicolas R., 2020. "Cream skimming by health care providers and inequality in health care access: Evidence from a randomized field experiment," Ruhr Economic Papers 846, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    13. Knott, Rachel J. & Lorgelly, Paula K. & Black, Nicole & Hollingsworth, Bruce, 2017. "Differential item functioning in quality of life measurement: An analysis using anchoring vignettes," Social Science & Medicine, Elsevier, vol. 190(C), pages 247-255.
    14. Naga, Ramses H. Abul & Yalcin, Tarik, 2010. "Median Independent Inequality Orderings," SIRE Discussion Papers 2010-118, Scottish Institute for Research in Economics (SIRE).
    15. Roemling, Cornelia & Qaim, Matin, 2013. "Dual burden households and intra-household nutritional inequality in Indonesia," Economics & Human Biology, Elsevier, vol. 11(4), pages 563-573.

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    Keywords

    Health systems; responsiveness; Ordered response data; Inequality; Polarisation;
    All these keywords.

    JEL classification:

    • I28 - Health, Education, and Welfare - - Education - - - Government Policy
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement

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