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Equity in the delivery of health care in Europe and the US

Van Doorslaer, Eddy ; Wagstaff, Adam ; Van Der Burg, Hattem ; Christiansen, Terkel ; De Graeve, Diana ; Duchesne, Inge ; Gerdtham, Ulf G. LU orcid ; Gerfin, Michael ; Geurts, José and Gross, Lorna , et al. (2000) In Journal of Health Economics 19(5). p.553-583
Abstract

This paper presents a comparison of horizontal equity in health care utilization in 10 European countries and the US. It does not only extend previous work by using more recent data from a larger set of countries, but also uses new methods and presents disaggregated results by various types of care. In all countries, the lower-income groups are more intensive users of the health care system. But after indirect standardization for need differences, there is little or no evidence of significant inequity in the delivery of health care overall, though in half of the countries, significant pro-rich inequity emerges for physician contacts. This seems to be due mainly to a higher use of medical specialist services by higher-income groups and a... (More)

This paper presents a comparison of horizontal equity in health care utilization in 10 European countries and the US. It does not only extend previous work by using more recent data from a larger set of countries, but also uses new methods and presents disaggregated results by various types of care. In all countries, the lower-income groups are more intensive users of the health care system. But after indirect standardization for need differences, there is little or no evidence of significant inequity in the delivery of health care overall, though in half of the countries, significant pro-rich inequity emerges for physician contacts. This seems to be due mainly to a higher use of medical specialist services by higher-income groups and a higher use of GP care among lower-income groups. These findings appear to be fairly general and emerge in countries with very diverse characteristics regarding access and provider incentives. (C) 2000 Elsevier Science B.V.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Health care utilization, Horizontal equity, International comparison
in
Journal of Health Economics
volume
19
issue
5
pages
31 pages
publisher
Elsevier
external identifiers
  • scopus:18544404784
  • pmid:11184794
ISSN
0167-6296
DOI
10.1016/S0167-6296(00)00050-3
language
English
LU publication?
no
id
842a3657-9007-42de-8d43-0ad2d212f7b2
date added to LUP
2018-10-09 12:21:51
date last changed
2024-04-15 13:28:31
@article{842a3657-9007-42de-8d43-0ad2d212f7b2,
  abstract     = {{<p>This paper presents a comparison of horizontal equity in health care utilization in 10 European countries and the US. It does not only extend previous work by using more recent data from a larger set of countries, but also uses new methods and presents disaggregated results by various types of care. In all countries, the lower-income groups are more intensive users of the health care system. But after indirect standardization for need differences, there is little or no evidence of significant inequity in the delivery of health care overall, though in half of the countries, significant pro-rich inequity emerges for physician contacts. This seems to be due mainly to a higher use of medical specialist services by higher-income groups and a higher use of GP care among lower-income groups. These findings appear to be fairly general and emerge in countries with very diverse characteristics regarding access and provider incentives. (C) 2000 Elsevier Science B.V.</p>}},
  author       = {{Van Doorslaer, Eddy and Wagstaff, Adam and Van Der Burg, Hattem and Christiansen, Terkel and De Graeve, Diana and Duchesne, Inge and Gerdtham, Ulf G. and Gerfin, Michael and Geurts, José and Gross, Lorna and Häkkinen, Unto and John, Jürgen and Klavus, Jan and Leu, Robert E. and Nolan, Brian and O'Donnell, Owen and Propper, Carol and Puffer, Frank and Schellhorn, Martin and Sundberg, Gun and Winkelhake, Olaf}},
  issn         = {{0167-6296}},
  keywords     = {{Health care utilization; Horizontal equity; International comparison}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{5}},
  pages        = {{553--583}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Health Economics}},
  title        = {{Equity in the delivery of health care in Europe and the US}},
  url          = {{http://dx.doi.org/10.1016/S0167-6296(00)00050-3}},
  doi          = {{10.1016/S0167-6296(00)00050-3}},
  volume       = {{19}},
  year         = {{2000}},
}