Inequity in Health

Question 1

Explain the concepts on equal acess and equitable access in health

Answer 1

Equal access: the same level or type of service is available to all

Equitable acess: services are targeted and provided according to need

Question 2

State three ways inequities in health can arise?

Answer 2

Inequity in access to services (facilities and treatment)

Inequities in utilisation of primary and secondary services

Inequities in availability of responsive of services

Question 3

Describe inequities in primary care in the UK

Answer 3

Usage of some groups is higher than others, however higher usage does not correlate with responsive service or quality (e.g. in chronic conditions)

Marginalised groups may have difficulties accessing primary care e.g. asylum seekers, refugees

Under utilisation of preventative services e.g. screening, immunisations is more likely in socially disadvantaged groups.

Poorest performing practices found in highest areas of deprivation

Question 4

Describe the inequities in secondary care in the UK

Answer 4

Inequities in referral from primary to secondary care. Less referrals from practices in low socio-economic areas

People living in most deprived areas less likely to receive hip or knee replacements

Evidence of gender inequities in inpatients - women less likely to be referred for surgical interventions compared to men

Question 5

Give four ways of tackling supply side barriers to inequities in healthcare

Answer 5

Availability of services
Services not available or useable by certain groups or available according to need. Address biases of clinicians – failure to offer same level of treatment or attention to patients with identical clinical needs from different populations

Quality of care
Reduce variations in quality of services offered to patients with identical needs: eg between areas, age groups, genders

Cost
Reduce costs to individuals; these may vary between populations or people with identical needs

Information
Ensure that information on the availability and type of service is known with equal clarity

Question 6

Give four ways of addressing demand side barriers to inequities in health

Answer 6

Education: making sure patients and populations have appropriate information to understanding treatment options and negotiate access

Take account of preferences for services in particular locations/times, services delivered in particular ways

Take account of community and cultural attitudes and norms: eg some groups of women may prefer women clinicians

Take account of affordability and indirect costs: taking day off work, childcare, prescription and dental costs