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

Abstract

This is the submitted version of the paper.This version of the publication may differ from the final published version. 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. Permanent repository link

Spatial Differences and Socioeconomic Determinants of Health Poverty

“…To address the health issues, this study concludes that further research is required to developed comprehensive measure of health poverty. Few attempts have been made to construct Health Poverty Index (HPI) using several social, economic, medical and resource factors [Laudicella, Cookson, Jones, and Rice (2009); Spinakis, et al (2011)]. Spinakis, et al (2011) use standardised death rate, life expectancy at birth and self-perceived health to develop health inequality index.…”

Health care inequality in free access health systems: The impact of non-pecuniary incentives on diabetic patients in Danish general practices

“…This paper offers an application of the Health Care Deprivation (HCD) profiles' approach to the analysis of inequality in primary care services accessed by diabetic patients in Denmark (Laudicella, Cookson, Jones, & Rice, 2009). The HCD profiles introduce methods from the literature on poverty and deprivation (Jenkins, 1997;Shorrocks, 1998) to the analysis of inequality in health care, thereby expanding the scope of well-established approaches based on concentration curves and concentration indices and addressing some key issues that are discussed later in this paper.…”

“…Finally, The HCD profiles offer a graphical representation of the distribution of inequality and a range of indices consistent with dominance, which allows for non-parametric analysis and distributional analysis of inequality stretching beyond standard regression analysis. A detailed illustration of the HCD profiles' approach can be found in Laudicella et al (2009).…”

Socio-economic health inequalities in use of health care services in Bulgaria

“…Някои автори дори твърдят, че други променливи като етническа принадлежност, образование и професия са основни фактори на неравнопоставеността в доболничната помощ (17). Част от изследванията разглеждат вероятността за използване на здравни услуги като функция на набор от променливи, свързани с потребностите, както и комплекс от индивидуални характеристики и политически решения (11). Индивидуалните характеристики и предпочитания също оказват голямо влияние и от тази гледна точка съществуващите различия между индивидите, както и разминаването между разходи и ползи в здравеопазването могат да обяснят до голяма степен наблюдаваните неравенства в използването на здравни услуги при едно и също здравословно състояние.…”