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Socioeconomic equity in amenable mortality in Finland 1992–2008

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  • Lumme, Sonja
  • Sund, Reijo
  • Leyland, Alastair H.
  • Keskimäki, Ilmo

Abstract

This study presents an approach to assess socioeconomic equity in the effectiveness of health services. As an indicator of health system performance we use amenable mortality which captures premature deaths that should not occur in the presence of effective and timely health care. Data on amenable deaths by income groups in Finland in 1992–2008 came from the National Causes of Death Register which was linked to sociodemographic data in population registers. We evaluate the extent of and trends in socioeconomic differences with two widely used inequity indices, the concentration index and the slope index of inequality, and also for different categories of amenable mortality. By categorizing conditions according to the level of intervention associated with the conditions it is possible to evaluate the effect of types of health interventions. Causes of death attributable to specialized and primary care interventions comprise the main groups. By this approach of decomposing equity in amenable mortality in Finland we detected major and increasing socioeconomic inequities and also greater inequity among deaths amenable to specialized health care interventions. Moreover, we saw that inequity increased at a faster pace among deaths amenable to specialized health care interventions yet primary health care interventions made a greater contribution to overall inequity. Although the overall rate of amenable mortality decreased notably during the follow-up, the time trends of socioeconomic differences in amenable health care indicate a substantial increase in inequities in health care in Finland.

Suggested Citation

  • Lumme, Sonja & Sund, Reijo & Leyland, Alastair H. & Keskimäki, Ilmo, 2012. "Socioeconomic equity in amenable mortality in Finland 1992–2008," Social Science & Medicine, Elsevier, vol. 75(5), pages 905-913.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:5:p:905-913
    DOI: 10.1016/j.socscimed.2012.04.007
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    References listed on IDEAS

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    1. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    2. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 5(1), pages 89-112, Spring.
    3. 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.
    4. Keskimäki, Ilmo, 2003. "How did Finland's economic recession in the early 1990s affect socio-economic equity in the use of hospital care?," Social Science & Medicine, Elsevier, vol. 56(7), pages 1517-1530, April.
    5. Philip M. Clarke & Ulf‐G Gerdtham & Luke B. Connelly, 2003. "A note on the decomposition of the health concentration index," Health Economics, John Wiley & Sons, Ltd., vol. 12(6), pages 511-516, June.
    6. Mackenbach, Johan P. & Stronks, Karien & Kunst, Anton E., 1989. "The contribution of medical care to inequalities in health: Differences between socio-economic groups in decline of mortality from conditions amenable to medical intervention," Social Science & Medicine, Elsevier, vol. 29(3), pages 369-376, January.
    7. Wood, Evan & Sallar, Anthony M. & Schechter, Martin T. & Hogg, Robert S., 1999. "Social inequalities in male mortality amenable to medical intervention in British Columbia," Social Science & Medicine, Elsevier, vol. 48(12), pages 1751-1758, June.
    8. Lasser, K.E. & Himmelstein, D.U. & Woolhandler, S., 2006. "Access to care, health status, and health disparities in the United States and Canada: Results of a Cross-National Population Based Survey," American Journal of Public Health, American Public Health Association, vol. 96(7), pages 1300-1307.
    9. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    10. Xander Koolman & Eddy van Doorslaer, 2004. "On the interpretation of a concentration index of inequality," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 649-656, July.
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