Inequity and inequality in the use of health care in England: an empirical investigation

Stephen Morris (), Matthew Sutton and Hugh Gravelle

Social Science & Medicine, 2005, vol. 60, issue 6, 1251-1266

Abstract: Achieving equity in healthcare, in the form of equal use for equal need, is an objective of many healthcare systems. The evaluation of equity requires value judgements as well as analysis of data. Previous studies are limited in the range of health and supply variables considered but show a pro-poor distribution of general practitioner consultations and inpatient services and a pro-rich distribution of outpatient visits. We investigate inequality and inequity in the use of general practitioner consultations, outpatient visits, day cases and inpatient stays in England with a unique linked data set that combines rich information on the health of individuals and their socio-economic circumstances with information on local supply factors. The data are for the period 1998-2000, just prior to the introduction of a set of National Health Service (NHS) reforms with potential equity implications. We find inequalities in utilisation with respect to income, ethnicity, employment status and education. Low-income individuals and ethnic minorities have lower use of secondary care despite having higher use of primary care. Ward level supply factors affect utilisation and are important for investigating health care inequality. Our results show some evidence of inequity prior to the reforms and provide a baseline against which the effects of the new NHS can be assessed.

Keywords: Inequity; Inequality; Ethnicity; Health; measures; Utilisation; UK (search for similar items in EconPapers)
Date: 2005
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (87)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0277-9536(04)00356-9
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:socmed:v:60:y:2005:i:6:p:1251-1266

Ordering information: This journal article can be ordered from
http://www.elsevier.com/wps/find/supportfaq.cws_home/regional
http://www.elsevier. ... _01_ooc_1&version=01

Access Statistics for this article

Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian

More articles in Social Science & Medicine from Elsevier
Bibliographic data for series maintained by Catherine Liu ().