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Inequities in health care utilization by people aged 50+: Evidence from 12 European countries

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  • Terraneo, Marco

Abstract

The aim of this study is to describe the magnitude of educational inequities in the use of health care services, by people aged 50+, in 12 European countries, controlling for country-level heterogeneity. We consider four services: having seen or talked to 1) a general practitioner (GP) or 2) specialist, 3) having been hospitalized, and 4) having visited a dentist (only for prevention). Data derived from the SHARE (Survey of Health, Ageing and Retirement in Europe) project, a cross-national panel that collects information from individuals aged 50 and over. A Fixed Effects approach is applied, which is a valuable alternative to the application of conventional multilevel models in country-comparative analysis. The main findings of this study confirm that there is substantial educational inequity in the use of health care, although relevant differences arise between services. A clear pro-educated gradient is found for specialists and dentist visits, whereas no evidence of educational disparities was found for GP use. On the other hand, less clear results emerge regarding hospitalizations. However, the analysis shows that micro-level dimensions, i.e. individual needs and predisposing and enabling population characteristics, and macro level factors, i.e. health care system and welfare regime, interact to determine people's use of health services. It can be concluded that people with more education level have more resources (cognitive, communicative, relational) that allow them to make more informed choices and take more effective actions for their health goals, however, the institutional context may modify this relationship.

Suggested Citation

  • Terraneo, Marco, 2015. "Inequities in health care utilization by people aged 50+: Evidence from 12 European countries," Social Science & Medicine, Elsevier, vol. 126(C), pages 154-163.
    • Handle: RePEc:eee:socmed:v:126:y:2015:i:c:p:154-163
    DOI: 10.1016/j.socscimed.2014.12.028
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    1. L. Bryan, Mark & P. Jenkins, Stephen, 2013. "Regression analysis of country effects using multilevel data: a cautionary tale," ISER Working Paper Series 2013-14, Institute for Social and Economic Research.
    2. Dunlop, Sheryl & Coyte, Peter C. & McIsaac, Warren, 2000. "Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(1), pages 123-133, July.
    3. Marion Devaux & Michael de Looper, 2012. "Income-Related Inequalities in Health Service Utilisation in 19 OECD Countries, 2008-2009," OECD Health Working Papers 58, OECD Publishing.
    4. Keskimäki, Ilmo & Salinto, Marjo & Aro, Seppo, 1995. "Socioeconomic equity in finnish hospital care in relation to need," Social Science & Medicine, Elsevier, vol. 41(3), pages 425-431, August.
    5. Eddy van Doorslaer & Cristina Masseria, 2004. "Income-Related Inequality in the Use of Medical Care in 21 OECD Countries," OECD Health Working Papers 14, OECD Publishing.
    6. Zeynep Or & Florence Jusot & Engin Yilmaz, 2008. "Impact of health care system on socioeconomic inequalities in doctor use," Working Papers DT17, IRDES institut for research and information in health economics, revised Sep 2008.
    7. Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
    8. Chad D. Meyerhoefer & Samuel H. Zuvekas & Richard Manski, 2014. "The Demand For Preventive And Restorative Dental Services," Health Economics, John Wiley & Sons, Ltd., vol. 23(1), pages 14-32, January.
    9. Culyer, A. J., 1995. "Need: The idea won't do--But we still need it," Social Science & Medicine, Elsevier, vol. 40(6), pages 727-730, March.
    10. repec:dau:papers:123456789/7006 is not listed on IDEAS
    11. Edward Kelley & Jeremy Hurst, 2006. "Health Care Quality Indicators Project: Conceptual Framework Paper," OECD Health Working Papers 23, OECD Publishing.
    12. Alberts, Jantina F. & Sanderman, Robbert & Eimers, J. Marietta & Van Den Heuvel, Wim J. A., 1997. "Socioeconomic inequity in health care: A study of services utilization in Curaçao," Social Science & Medicine, Elsevier, vol. 45(2), pages 213-220, July.
    13. Goddard, Maria & Smith, Peter, 2001. "Equity of access to health care services: : Theory and evidence from the UK," Social Science & Medicine, Elsevier, vol. 53(9), pages 1149-1162, November.
    14. Valérie Paris & Marion Devaux & Lihan Wei, 2010. "Health Systems Institutional Characteristics: A Survey of 29 OECD Countries," OECD Health Working Papers 50, OECD Publishing.
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