3.2.1.3. Definition of inequality and inequity in health care
The egalitarianism and libertarianism are the two different concepts of justice in philosophy that are frequent in the current debate on equity in health and health care. In the egalitarian view, health care should be dominated by a publicly financing approach. Furthermore, health care is financed on the basis of ability to pay and distributed regarding the need. The concept emphasizes that everyone has a right to have the same access to care and that should not be affected by individuals’ characteristics, such as income. On the contrary, libertarianism suggests that health care ought to be financed privately and the government involvement is the least possible. The health care …show more content…
The horizontal equity is frequently measured when the aim is to ensure equitable services to access for those who have the same needs, while the vertical equity is appropriate to measure when funding, e.g. progressivity, in financial contribution is the center of concern (Wagstaff, Van Doorslaer 2000).
3.2.2. Measuring socioeconomic-related inequality and inequity in health and health care utilization
3.2.2.1. Measuring socioeconomic-related inequality in health and health care utilization
This section is a review of the methods for analyzing socioeconomic-related inequity in health and health care which have been developed and applied in the health economics field. The section starts with the concentration index and its corrections. The required variables, including health outcome, living standard, need and non-need variables, are presented in the next section. The following section provides indirect and direct standardization method. The section ends with decomposition methodology.
Concentration index
The measurements of socioeconomic-related inequality in health and health care in the health economics field is relatively young comparing to the measurements in public health and …show more content…
In 1977, Kakwani developed the concentration index as a measurement of tax progressivity (Kakwani, Wagstaff & van Doorslaer 1997) and later the method was adopted in the health economics field (Wagstaff, Van Doorslaer & Paci 1989).
It is worth emphasizing that the concentration index has a number of advantages comparing to other methods to measure health inequality. Wagstaff et al. (1991) stated that the concentration index simultaneously meets the following minimal requirements of an inequality measure in health (Wagstaff, Paci & Van Doorslaer 1991): The concentration index is sensitive to the socioeconomic dimension to inequalities in health; The concentration index reflects the experience of the entire population. (rather than comparing only the top and bottom socioeconomic
The egalitarianism and libertarianism are the two different concepts of justice in philosophy that are frequent in the current debate on equity in health and health care. In the egalitarian view, health care should be dominated by a publicly financing approach. Furthermore, health care is financed on the basis of ability to pay and distributed regarding the need. The concept emphasizes that everyone has a right to have the same access to care and that should not be affected by individuals’ characteristics, such as income. On the contrary, libertarianism suggests that health care ought to be financed privately and the government involvement is the least possible. The health care …show more content…
The horizontal equity is frequently measured when the aim is to ensure equitable services to access for those who have the same needs, while the vertical equity is appropriate to measure when funding, e.g. progressivity, in financial contribution is the center of concern (Wagstaff, Van Doorslaer 2000).
3.2.2. Measuring socioeconomic-related inequality and inequity in health and health care utilization
3.2.2.1. Measuring socioeconomic-related inequality in health and health care utilization
This section is a review of the methods for analyzing socioeconomic-related inequity in health and health care which have been developed and applied in the health economics field. The section starts with the concentration index and its corrections. The required variables, including health outcome, living standard, need and non-need variables, are presented in the next section. The following section provides indirect and direct standardization method. The section ends with decomposition methodology.
Concentration index
The measurements of socioeconomic-related inequality in health and health care in the health economics field is relatively young comparing to the measurements in public health and …show more content…
In 1977, Kakwani developed the concentration index as a measurement of tax progressivity (Kakwani, Wagstaff & van Doorslaer 1997) and later the method was adopted in the health economics field (Wagstaff, Van Doorslaer & Paci 1989).
It is worth emphasizing that the concentration index has a number of advantages comparing to other methods to measure health inequality. Wagstaff et al. (1991) stated that the concentration index simultaneously meets the following minimal requirements of an inequality measure in health (Wagstaff, Paci & Van Doorslaer 1991): The concentration index is sensitive to the socioeconomic dimension to inequalities in health; The concentration index reflects the experience of the entire population. (rather than comparing only the top and bottom socioeconomic