Inequalities in access to medical care by income in developed countries

Doorslaer, Eddy van; Masseria, Cristina; Koolman, Xander

doi:10.1503/cmaj.050584

Cited by 761 publications

(589 citation statements)

References 11 publications

(6 reference statements)

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“…Although in Europe almost universal coverage of the population is provided for the majority of health care services, there are large differences between countries in the specific public/private insurance mix. For Belgium, analyses even indicate inequity favoring the poor [43], which might help to explain why in the referred group youngsters displayed lower SES. We hypothesize that the stigma associated with help seeking prevents the high SES group from looking for treatment.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric disorders and symptom severity in referred versus non-referred overweight children and adolescents

Vlierberghe

Braet

Goossens

et al. 2008

Eur Child Adolesc Psychiatry

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Background: This study aimed firstly to investigate whether youngsters referred for overweight treatment differ from non-referred overweight youngsters on the prevalence of psychiatric disorders and psychological symptoms. Secondly, the potentially moderating role of age, gender, socio-economic status and degree of overweight in the association of referral status and mental disorder in overweight youth was explored. Methods: Participants were 155 overweight youngsters enrolled in an obesity treatment programme (mean age = 13.76; mean BMI = 33.99) and 73 non-referred overweight youngsters (mean age = 13.74; mean BMI = 27.35). The Structured Clinical Interview for DSM-IV-Childhood version and the Child version of the Eating Disorder Examination were administered and participants filled out the Children’s Depression Inventory, the Spence Children’s Anxiety Scale and the Youth Self Report. Parents were asked to complete the Child Behavior Checklist. Results: In the referred group 37.50% and in the non-referred group 23.29% of the participants met criteria for at least one mental disorder. In both groups, anxiety disorders were most prominent. Overall, a higher prevalence of mental disorders was found in the referred group. Referred youth displayed significantly more ‘full blown’ eating disorders and binge eating than non-referred youngsters and exhibited a significantly greater severity of self- and parent-reported internalizing symptoms. Referral was also associated with a significantly higher degree of overweight and significantly lower SES. After controlling for these pre-existing differences in degree of overweight and SES, only the greater severity of parent-reported internalizing symptoms in referred youth remained significant. Older age was generally predictive for the presence of mental disorders and in the non-referred group SES was positively associated with psychiatric disorder. Conclusions: A substantial proportion of overweight youngsters suffer from mental disorders. Referral status and age are associated with the presence of psychopathology. However, differences between referred and non-referred youngsters are not as pronounced as expected on the basis of earlier research in the field

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Section: Discussionmentioning

confidence: 99%

Psychiatric disorders and symptom severity in referred versus non-referred overweight children and adolescents

Vlierberghe

Braet

Goossens

et al. 2008

Eur Child Adolesc Psychiatry

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“…Evidence of socio-economic inequity in the utilisation of non-emergency specialist care relative to need has been found even in high income countries with universal and comprehensive health programmes like the English National Health Service (NHS) [3][4][5]. This is often interpreted as an important indicator of broader socio-economic inequity of access to health care, since utilisation of non-emergency specialist care is potentially sensitive to all of the important financial and non-financial access barriers that people may face in navigating their way through the health system.…”

Section: What This Study Addsmentioning

confidence: 99%

“…Much of this evidence is cross sectional, and much methodological development has centred on improving the accuracy and cross country comparability of equity measures [2,4].…”

Section: What This Study Addsmentioning

confidence: 99%

Measuring change in health care equity using small-area administrative data – Evidence from the English NHS 2001–2008

Cookson

Laudicella

Donni

2012

Social Science & Medicine

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“…Income does not explain the probability of visiting a general practitioner across most of the OECD countries, while it is associated with inequity in visits to a specialist in almost all countries (van Doorslaer et al, 2006). However, income is not always the most important factor in explaining subsequent visits to a specialist (van Doorslaer et al, 2004).…”

Section: Introductionmentioning

confidence: 91%

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

Laudicella

Cookson

Jones

et al. 2009

Journal of Health Economics

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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

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Inequalities in access to medical care by income in developed countries

Cited by 761 publications

References 11 publications

Psychiatric disorders and symptom severity in referred versus non-referred overweight children and adolescents

Psychiatric disorders and symptom severity in referred versus non-referred overweight children and adolescents

Measuring change in health care equity using small-area administrative data – Evidence from the English NHS 2001–2008

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

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