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Equity in the utilization of public health care services by regions in Spain: a multinivel analysis

Author

Listed:
  • Ignacio Abásolo

    (Universidad de La Laguna)

  • Jaime Pinilla

    (Universidad de Las Palmas de Gran Canaria)

  • Miguel Negrín

    (Universidad de Las Palmas de Gran Canaria)

Abstract

The aim of this paper is to analyse if there is horizontal equity in the utilisation of public health care services by región (comunidad autónoma) of residence in Spain. Data from the 2006 National Health Survey were considered to undertake a multilevel analysis, using a binary logistic function for each of the public health care services analysed (general practitioner –GP- visits, specialist visits and hospitalisations). Health care need and other socioeconomic and demographic characteristics were controlled at individual level. It can be concluded that, although there is no evidence of territorial inequity in hospitalisations, there is territorial inequity in the case of GP and also of specialist visits, which can not be explained by regional differences in the availability of resources at both health care levels

Suggested Citation

  • Ignacio Abásolo & Jaime Pinilla & Miguel Negrín, 2008. "Equity in the utilization of public health care services by regions in Spain: a multinivel analysis," Hacienda Pública Española / Review of Public Economics, IEF, vol. 187(4), pages 87-106, December.
    • Handle: RePEc:hpe:journl:y:2008:v:187:i:4:p:87-106
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    References listed on IDEAS

    as
    1. Ulf‐ G. Gerdtham, 1997. "Equity in Health Care Utilization: Further Tests Based on Hurdle Models and Swedish Micro Data," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 303-319, May.
    2. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income‐related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628, July.
    3. Tom Van Ourti, 2004. "Measuring horizontal inequity in Belgian health care using a Gaussian random effects two part count data model," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 705-724, July.
    4. O'Donnell, Owen & Propper, Carol, 1991. "Equity and the distribution of UK National Health Service resources," Journal of Health Economics, Elsevier, vol. 10(1), pages 1-19, May.
    5. Derek Bond and Prof. Denis Conniffe, 2002. "Cross-Regional Equity in Health Care Funding," NIRSA Working Paper Series 3, National Institute for Regional and Spatial Analysis (NIRSA), NUI Maynooth, Ireland..
    6. Stephen Birch & John Eyles & K. Bruce Newbold, 1993. "Equitable access to health care: Methodological extensions to the analysis of physician utilization in Canada," Health Economics, John Wiley & Sons, Ltd., vol. 2(2), pages 87-101, July.
    7. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income‐related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647, July.
    8. Marc Saez & Carme Saurina & Germà Coenders & Sònia González‐Raya, 2006. "Use of primary health care services according to the different degrees of obesity in the Girona Health Region, Spain," Health Economics, John Wiley & Sons, Ltd., vol. 15(2), pages 173-193, February.
    9. Windmeijer, F A G & Silva, J M C Santos, 1997. "Endogeneity in Count Data Models: An Application to Demand for Health Care," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 12(3), pages 281-294, May-June.
    10. Carol Propper & Jenny Eachus & Philip Chan & Nicky Pearson & George Davey Smith, 2005. "Access to health care resources in the UK: the case of care for arthritis," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 391-406, April.
    11. 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.
    12. Olsen, Edgar O. & Rogers, Diane Lim, 1991. "The welfare economics of equal access," Journal of Public Economics, Elsevier, vol. 45(1), pages 91-105, June.
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    More about this item

    Keywords

    Equitiy; public health care utilization; multinivel analysis; region.;
    All these keywords.

    JEL classification:

    • C01 - Mathematical and Quantitative Methods - - General - - - Econometrics
    • D39 - Microeconomics - - Distribution - - - Other
    • I19 - Health, Education, and Welfare - - Health - - - Other
    • R53 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Regional Government Analysis - - - Public Facility Location Analysis; Public Investment and Capital Stock

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