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

✍ Scribed by Eddy van Doorslaer; Adam Wagstaff; Hattem van der Burg; Terkel Christiansen; Diana De Graeve; Inge Duchesne; Ulf-G Gerdtham; Michael Gerfin; José Geurts; Lorna Gross; Unto Häkkinen; Jürgen John; Jan Klavus; Robert E Leu; Brian Nolan; Owen O'Donnell; Carol Propper; Frank Puffer; Martin Schellhorn; Gun Sundberg; Olaf Winkelhake

• Book ID: 117359222
• Publisher: Elsevier Science
• Year: 2000
• Tongue: English
• Weight: 170 KB
• Volume: 19
• Category: Article
• ISSN: 0167-6296
• DOI: 10.1016/s0167-6296(00)00050-3

✦ Synopsis

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.