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Measuring socioeconomic differences in use of health care services by wealth versus by income

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  • Allin, S.
  • Masseria, C.
  • Mossialos, E.

Abstract

Objectives. We compared the extent of socioeconomic differences in use of health care services based on wealth (i.e., accumulated assets) as the socioeconomic ranking variable with the extent of differences based on income to explore the sensitivity of the estimates of equity to the choice of the socioeconomic indicator. Methods. We used data from the Health and Retirement Study in the United States and the Survey of Health, Ageing, and Retirement in Europe to estimate levels of income- and wealth-related disparity in use of physician and dental services among adults 50 or older in 12 countries. Results. We found socioeconomic differences in use of physician services after standardizing for need in about half of the countries studied. No consistent pattern in levels of disparity measured by wealth versus those measured by income was found. However, the rich were significantly more likely to use dental services in all countries. Wealth-related differences in dental service use were consistently higher than were income-related differences. Conclusions. We found some support for wealth as a more sensitive indicator of socioeconomic status among older adults than was income. Wealth may thus allow more accurate measurements of socioeconomic differences in use of health care services for this population.

Suggested Citation

  • Allin, S. & Masseria, C. & Mossialos, E., 2009. "Measuring socioeconomic differences in use of health care services by wealth versus by income," American Journal of Public Health, American Public Health Association, vol. 99(10), pages 1849-1855.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2008.141499_5
    DOI: 10.2105/AJPH.2008.141499
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    1. Janko Janković & Sladjana Šiljak & Miloš Erić & Jelena Marinković & Slavenka Janković, 2018. "Inequalities in the utilization of health care services in a transition European country: results from the national population health survey," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(2), pages 261-272, March.
    2. Giuliana Luca & Michela Ponzo & Antonio Andrés, 2013. "Health care utilization by immigrants in Italy," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 1-31, March.
    3. Vlastimil Chytrý & Milan Kubiatko & Romana Šindelářová & Janka Medová, 2022. "Socioeconomic Status of University Students as a Limiting Factor for Various Forms of Distance Education during COVID-19 Measures," Sustainability, MDPI, vol. 14(10), pages 1-12, May.
    4. Pawinee Iamtrakul & Sararad Chayphong & Adrian Yat Wai Lo, 2022. "Exploring the Contribution of Social and Economic Status Factors (SES) to the Development of Learning Cities (LC)," Sustainability, MDPI, vol. 14(19), pages 1-20, October.
    5. Johannes G. Jaspersen, 2022. "When full insurance may not be optimal: The case of restricted substitution," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1249-1257, June.
    6. Giorgi Beridze & Alba Ayala & Oscar Ribeiro & Gloria Fernández-Mayoralas & Carmen Rodríguez-Blázquez & Vicente Rodríguez-Rodríguez & Fermina Rojo-Pérez & Maria João Forjaz & Amaia Calderón-Larrañaga, 2020. "Are Loneliness and Social Isolation Associated with Quality of Life in Older Adults? Insights from Northern and Southern Europe," IJERPH, MDPI, vol. 17(22), pages 1-14, November.
    7. Watanabe, Ryo & Hashimoto, Hideki, 2012. "Horizontal inequity in healthcare access under the universal coverage in Japan; 1986–2007," Social Science & Medicine, Elsevier, vol. 75(8), pages 1372-1378.
    8. Kjellsson, Gustav & Clarke, Philip & Gerdtham, Ulf-G., 2014. "Forgetting to remember or remembering to forget: A study of the recall period length in health care survey questions," Journal of Health Economics, Elsevier, vol. 35(C), pages 34-46.
    9. Pulok, Mohammad Habibullah & Hajizadeh, Mohammad, 2022. "Equity in the use of physician services in Canada's universal health system: A longitudinal analysis of older adults," Social Science & Medicine, Elsevier, vol. 307(C).
    10. Sözmen, Kaan & Ünal, Belgin, 2016. "Explaining inequalities in Health Care Utilization among Turkish adults: Findings from Health Survey 2008," Health Policy, Elsevier, vol. 120(1), pages 100-110.
    11. Ricardo Rodrigues & Stefania Ilinca & Maša Filipovič Hrast & Andrej Srakar & Valentina Hlebec, 2022. "Care Task Division in Familialistic Care Regimes: A Comparative Analysis of Gender and Socio-Economic Inequalities in Austria and Slovenia," Sustainability, MDPI, vol. 14(15), pages 1-18, August.
    12. Jasmine L Travers & Catherine C Cohen & Andrew W Dick & Patricia W Stone, 2017. "The Great American Recession and forgone healthcare: Do widened disparities between African-Americans and Whites remain?," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-9, December.
    13. Ricardo Rodrigues & Stefania Ilinca & Andrea E. Schmidt, 2018. "Income‐rich and wealth‐poor? The impact of measures of socio‐economic status in the analysis of the distribution of long‐term care use among older people," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 637-646, March.
    14. Alec Rhodes & Stephanie Moulton & Cäzilia Loibl & Donald Haurin & Joshua Joseph, 2024. "Mortgage Borrowing and Chronic Disease Outcomes in Older Age: Evidence From Biomarker Data in the Health and Retirement Study," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 79(7), pages 1849-1855.
    15. Sveréus, Sofia & Petzold, Max & Rehnberg, Clas, 2024. "Change in avoidable hospitalizations for low-income elders following quasi-market reform in primary care – Evidence from a natural experiment in Sweden," Social Science & Medicine, Elsevier, vol. 346(C).
    16. Silvana Miceli & Laura Maniscalco & Domenica Matranga, 2019. "Social networks and social activities promote cognitive functioning in both concurrent and prospective time: evidence from the SHARE survey," European Journal of Ageing, Springer, vol. 16(2), pages 145-154, June.
    17. Mohammad Habibullah Pulok & Kees Gool & Mohammad Hajizadeh & Sara Allin & Jane Hall, 2020. "Measuring horizontal inequity in healthcare utilisation: a review of methodological developments and debates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 171-180, March.
    18. Šime Smolić & Ivan Čipin & Petra Međimurec, 2022. "Access to healthcare for people aged 50+ in Europe during the COVID-19 outbreak," European Journal of Ageing, Springer, vol. 19(4), pages 793-809, December.
    19. Luiz Vinicius de Alcantara Sousa & Erika da Silva Maciel & Laércio da Silva Paiva & Stefanie de Sousa Antunes Alcantara & Vânia Barbosa do Nascimento & Fernando Luiz Affonso Fonseca & Fernando Adami, 2021. "Inequalities in Mortality and Access to Hospital Care for Cervical Cancer—An Ecological Study," IJERPH, MDPI, vol. 18(20), pages 1-12, October.
    20. Domenica Matranga & Laura Maniscalco, 2022. "Inequality in Healthcare Utilization in Italy: How Important Are Barriers to Access?," IJERPH, MDPI, vol. 19(3), pages 1-14, February.

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