socio-economic disparities in health and health care Flashcards
1
Q
Equity as a policy objective in health care
A
- distribution of health and health care is important
- may conflict with pursuit of efficiency - health gain versus distribution of health
- focus varies across countries in response to attitudes of policy-makers
2
Q
equity as a concept
A
- normative concept - what the distribution should be
- positive concept - measurement and comparison of what is
3
Q
equity and social justice
A
- distributional objectives in health care focused on notions of social justice
- derives from principles about what a person ought to have as of right
- need set of rules that can be justified on an impartial basis e.g. Rawls’ veil of ignorance - rules of justice agreed upon when individuals are ignorant of the position they occupy in society
- distributional principles of social justice are not influenced by costs
4
Q
theories of social justice
A
- utilitarian - social welfare is the sum of individual utilities
CRITIQUE - utilitarian social welfare function is not egalitarian enough - welfare can increase by a policy that increases utility of wealthy individuals and reduces utility of the poor, so long as the rich gain more than the poor - weighted utilitarian - society might consider giving more weight to the poor or to people with disabilities - inequality aversion
- rawlsian - social welfare increases only if the utility of the person with the lowest utility increases
5
Q
equity and healthcare systems - Europe
A
- access to healthcare based on need or ability to benefit
- financing healthcare related to ability of pay
- promotion of a reduction in health inequalities
6
Q
equity and health care systems - US
A
- less agreement to link healthcare payments to ability to pay
- health care rationed according to willingness to pay
- role of state limited to providing a minimum standard of care for the poor
7
Q
What is access?
A
- ‘receipt of treatment’ - GP appointments, hospital appointments
- ‘opportunity to receive treatment’ (both monetary and non-monetary costs’
- distinction between access and receipt of treatment
8
Q
what is need?
A
- ill health
- ill individuals held to have high need for medical care
- can only be in need if there is medical care available to improve health
9
Q
capacity to benefit from health care
A
tries to deal with criticisms of access and need
10
Q
equity in health care finance - concepts, measurement and empirical evidence
A
- equity concepts - vertical and horizontal
- sources of financing
- kakwani’s progressivity index
- wagstaff and van doorslaer (2000)
11
Q
inequality and equity in health care utilization - testing and measuring inequity, empirical evidence
A
- main concern
- empirical evidence - martin et al (2020) - waiting times, data, measurements, findings
- horizontal equity
- how to quantify inequality in health care utilisation - concentration curve for health care utilisation
- indirect standardisation
- empirical evidence - van doorslaer and masseria (2004)
12
Q
inequality in health - measuring health inequalities, socioeconomic inequalities in health
A
- pure inequality vs socio-economic related inequality in health
- method of measuring pure inequality in health
- method of measuring socio-economic inequality in health
- empirical evidence - van doorslaer (1997)
- challenges and limitations of socio-economic inequality in health
- measure of relative inequality
- decomposition of CI
- empirical example - Wagstaff et al 2003
13
Q
inequality of opportunity in health - the responsibility cut
A
- principles of inequality of opportunity
- Roemer’s solution to measuring IOp
- Ex-ante approach
- empirical example - davillas et al (2020)
