Horizontal equity in the delivery of health care

Wagstaff, Adam; Doorslaer, Eddy van; Paci, Pierella

doi:10.1016/0167-6296(91)90009-c

Cited by 29 publications

(17 citation statements)

References 4 publications

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“…A range of methods has been used to quantify health disparities/equity, each reflecting implicit assumptions about definitions (17,33,43,55,65,69,(102)(103)(104)112). In the work of recognized experts in the field of measuring health inequalities/disparities/equity, measurement almost always involves comparing an indicator of health or a health-related factor in one or more disadvantaged groups with the same indicator in a more advantaged group or groups.…”

Section: How Have Health Disparities/inequalities and Health Equity Bmentioning

confidence: 99%

HEALTH DISPARITIES AND HEALTH EQUITY: Concepts and Measurement

Braveman

2006

Annu. Rev. Public Health

1,142

806

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▪ Abstract There is little consensus about the meaning of the terms “health disparities,” “health inequalities,” or “health equity.” The definitions can have important practical consequences, determining the measurements that are monitored by governments and international agencies and the activities that will be supported by resources earmarked to address health disparities/inequalities or health equity. This paper aims to clarify the concepts of health disparities/inequalities (used interchangeably here) and health equity, focusing on the implications of different definitions for measurement and hence for accountability. Health disparities/inequalities do not refer to all differences in health. A health disparity/inequality is a particular type of difference in health (or in the most important influences on health that could potentially be shaped by policies); it is a difference in which disadvantaged social groups—such as the poor, racial/ethnic minorities, women, or other groups who have persistently experienced social disadvantage or discrimination—systematically experience worse health or greater health risks than more advantaged social groups. (“Social advantage” refers to one's relative position in a social hierarchy determined by wealth, power, and/or prestige.) Health disparities/inequalities include differences between the most advantaged group in a given category—e.g., the wealthiest, the most powerful racial/ethnic group—and all others, not only between the best- and worst-off groups. Pursuing health equity means pursuing the elimination of such health disparities/inequalities.

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Section: How Have Health Disparities/inequalities and Health Equity Bmentioning

confidence: 99%

HEALTH DISPARITIES AND HEALTH EQUITY: Concepts and Measurement

Braveman

2006

Annu. Rev. Public Health

1,142

806

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“…He assumed that the population could be divided into two groups, 'ill' and 'not-ill', and that the 'not-ill' had no need for health care. This was criticised for being an arbitrary vertical equity assumption [17] and has been shown to affect the measured level of inequity [9,18].…”

Section: The Importance Of Vertical Equitymentioning

confidence: 99%

Vertical and horizontal aspects of socio‐economic inequity in general practitioner contacts in Scotland

Sutton

2002

Health Economics

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Health status varies across socio-economic groups and health status is generally assumed to predict health care needs. Therefore the need for health care varies across socio-economic groups, and studies of equity in the distribution of health care between socio-economic groups must compare levels of utilisation with levels of need. Economic studies of equity in health care generally assume that health care needs can be derived from the current health-health care relationship. They therefore do not consider whether the current health-health care relationship is (vertically) equitable and the focus is restricted to horizontal inequity. This paper proposes a framework for incorporating the implications of vertical inequity for the socio-economic distribution of health care. An alternative to the current health-health care relationship is proposed using a restriction on the health-elasticity of health care. The health-elasticity of general practitioner contacts in Scotland is found to be generally negative, but positive at low levels of health status. Pro-rich estimates of horizontal inequity and vertical inequity are obtained but neither is statistically significant. Further analysis demonstrates that the magnitude of vertical inequity in health care may be larger than horizontal inequity.

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“…Carr-Hill et al's approach is similar to that adopted by Wagstaff et al to measure equity in the delivery of health care across socio-economic groups [5]. The principal assumption is that the current distribution of resources which results from decisions made by the various actors in the health care system reflects relative needs.…”

Section: Introductionmentioning

confidence: 99%

“…We extend the focus of geographical resource allocation to consider the impact on different population groups. We adopt the distinction proposed by Wagstaff et al [5] for distinguishing between horizontal and vertical equity. Horizontal equity occurs when persons in equal need receive the same level of resources irrespective of their characteristics, e.g.…”

Section: Introductionmentioning

confidence: 99%