equity and efficiency

Question 0

what is horizontal equity

Answer 0

equal people should be treated equally or equal people for equal medical care , equal people should recieve the same amount of care of should use the same amount of care
horizontal equity is about the needs/acces to health care

Question 1

what is equity

Answer 1

any individual should be able to recieve as much health care as anyone else with the same medical needs,regardless the factors that are thought to be irrelevant ,for example income,gender and ethnicity .

Question 2

what is vertical equity

Answer 2

this is about the ability to pay. unequal people should be treated unequally from each according the ability to pay. you should pay healthcare according to what you can pay.

Question 3

in what kind of situations can you have equity

Answer 3

acces or utilisation hc
supply induced demands : doctors tells a patient to not come back anymore because he has too much work
equality in acces or in use
health outcomes
payments devoted to health care

Question 4

how can equity be examined

Answer 4

equity could be examined in relation to income,education,wealth,gender,ethnicity. here we focus on equity by socio economic status,usually measured by income,wealth or education. equity is always investigated with ses

Question 5

why do we have to be careful with data collection on ses

Answer 5

non response ( if a lot of rich people don’t answer,then the data is not representative) and it will be biased.
respondents may not know
comprehensiveness of measure
be aware of data limitations. if you have income it doesn’t tell anything.

Question 6

a=25
b=4
c=3
d=12
e=17
f=30   how to calculate and draw the lorenz curve

Answer 6

1) je berekent het proportie inkomen van elk bedrijf
dus 25/61,4/61,3/61,12/61,17/61

op de Y -as zet je % income en op de X-as cum proportion of the population . dit is dus de lorenzcurve/

Question 7

what is the interpretation of the lorenz curve

Answer 7

the further you are from the line of equality the more unequal the income is distributed in the society. a lorentzcurve is only for one variable. usually they apply it on income but you can also apply it on the use of healthcare

Question 8

can you draw a lorentzcurve above the line of equality ?

what does it mean if the lorentzcurve is above the concentration curve?

Answer 8

1. no you can never draw it above the line of equality

2. it means that the lorentzcurve dominates the concentration curve.

Question 9

what is the interpretation of the gini coefficient

Answer 9

you cannot draw any conclusion ,it doesn’t tell everything about the distribution but summarize the info from the curve so look to the lorenzcurve and the gini

if the gini is 1: indicates perfect inequality
if gini is 0 : it is in line of equality ( everyone has exactly the same amount of money )

Question 10

what is a concentration curve

Answer 10

this is an instrument measuring variation in a specific health mesure acrosss variation in living standards: the main difference with the lorenzcurve is that we use 2 variables here.

Question 11

how do we plot the concentration curve

Answer 11

on the Y axis we put the cumulative % of the health variable against the cumulative % of the population ranked by living standards,beginning with the poorest and ending with the richest ( X-axis)

to draw a curve you need to know for example how many birth did occur in each quantile

Question 12

how do you interpretate the concentration curve

Answer 12

when the concentration curve is above the diagonal then it is among the poor ( progressive )
when the concentration curve is below the diagonal then it is among the rich ( progressive)

when it is on the diagonal then there is equality

Question 13

what are the steps before plotting a concentration curve and how do you interpretate a concentration index.

Answer 13

step 1 : you rank the people from poor to rich
step 2 : consider what are you going to put on the Y as and what are you putting on the X as
step 3 : compute all means of the cumulative cases
the ci is between -1 and 1 if it is negative then it is among the poor ,if it is positive then it is among the rich

Question 14

Draw the lorenz curve with this numbers with the following cumul. % income 
 % population
0 have 0
10 have 1,5
20 have 4,8
40 have 15,3
60 have 31,3
80 have 54,8
90 have 71,8
100 have 100 

Calculate also the gini coefficient

Answer 14

Look at the picture in photo camera

Question 15

What is the difference between regressive and progressive

Answer 15

In a progressive system, the rich pay a higher share of their incomes than the poor. In contrast, in a regressive system, it is the poor that pay a higher share

Question 16

What is the procedure to build a lorenz curve

Answer 16

To build a Lorenz Curve you first need to calculate the proportion of income belonging to each individual and which proportion of total population that same individual represents,
Step 2. The next step is to cumulate both proportions,
Step 3.
Step 4, instead, defines the benchmark for the Lorenz Curve, the equidistributed line.

Question 17

Individual Income
1               has 2,417
2               has 7,800
3               has 8,489
4               has 10,072
5               has 12,957

How are you going to calculate and draw the gini coefficient

Answer 17

In this income distribution, individual 1 owns US$2,417/year (he/she is the poorest), while individual 5 owns US$12,957/year (he/she is the richest).
The total income is 41,735
Step 1. Define the proportion of income owned by each individual and the proportion of population corresponding to him dus 2,417/41,735 etc…
Step 2 you calculate the Cumulative proportion of income ( dus je telt ze allemaal op (
Step 3 Plot the cumulativ proportion of income
against the cumulative proportion of population

Question 18

Draw the lorenz curve based on this numbers and draw lorenz curve when income would be equally distributed

Answer 18

Zie foto camera

Question 19

When is something not horizontal equitable

Answer 19

If the the people with same needs do not receive the same health care. You will see then that the line of need of care is above the line of use of care

Question 20

When is the use of care not vertical equitable

Answer 20

If the higher income groups pay proportionally less health care payments than the lower income groups.

Question 21

What does it mean when a system is progressive.

Answer 21

The poorer individuals have to spend proportionally less health care payments than their income share.

Question 22

What is a The concentration curve

Answer 22

The concentration curve plots the cumulative percentage of the health variable (y-axis) against the cumulative percentage of the population, ranked by living standards, beginning with the poorest, and ending with the richest (x-axis)

Question 23

6) Draw in Figure 2 a hypothetical concentration curve for “use of care” in France assuming that there is inequality in “use of care” in favor of the poor individuals. (1 point)

Answer 23

Tekenen

Question 24

6) Draw in Figure 2 a hypothetical concentration curve for “use of care” in France assuming that there is inequality in “use of care” in favor of the rich individuals. (1 point)

Answer 24

Tekenen

Question 25

Which 2 Equity fields are there in health care:

Answer 25

 Access to health care: This is only the access to health not the use!

 Use of health care: This is according to the preference and education level of the patient.

Question 26

How to interpretate a concentration curve

Answer 26

From -1 to +1, - means concentrated among poor, + among rich, 0 equal.

Question 27

How to access whether the health care payments are unequal in relation to SES?

Answer 27

You will compare a concentration curve and Lorenz within one graph. Besides that you can calculate a Kakwani coefficient. How to interpretate:

Progressivity: Poor populations are paying proportionally less Health Care payments than rich (Share of health care payments is larger in the top income quintiles.)

Regressivity: Poor populations are paying proportionally more Health Care payments than rich (Share of health care payments is larger in the lower income groups).

Question 28

What is the kakwani coefficient and how to interpretate it

Answer 28

Kakwani coefficient: This is the space between the Lorenz curve and the Concentration curve.
How to Calculate: Not needed. Only interpretate
How to interpretate: – positive => progressivity
​​ – negative => regressivity
Visual interpretation:
– proportionality: the curves coincide
– progressivity: Lorenz curve dominate concentration curve.
– regressivity: Concentration curve dominates Lorenz curve.

Question 29

How to see vertical equity and how to assess whether health care is equitably distributed across SES groups.

Answer 29

Vertical equity shown using concentration curves (or using Lorenz curves before of after health care payments)

Two ways to assess it:

1: Compare actual distribution of care (by income) with distribution of need for such care
2: Need correction on the (in)equality distribution =>look at the need-standardized distribution of care)

Question 30

There are 2 ways to investigate whether HC payments are regressive or progressive:

Answer 30

1. Investigate regressivity and progressivity with the Lorenz curve
2. Or with Concentration curve

Investigate regressivity and progressivity with the Lorenz curve
Before and after health care payments

Question 31

What in the kakwani index and what does it mean

Answer 31

Kakwani progressivity index(grey) : summary indicator = twice the area between the health care payment concentration curve and the Lorenz curve.

Kakwani progressivity index(grey):
• positive => progressivity
• negative => regressivity

Question 32

How to assess whether care is equitably distributed (remember: horizontal equity)

Easy way(one indicator for needs):

Answer 32

When the CC of Needs of care is above of the CC of use of care?
Is this equitable(equal people should be treated equal)? You use less then you need. This is inequitable, poor people use less care then they need.