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Income‐Related Inequity In Healthcare Utilisation Among Individuals With Cardiovascular Disease In England—Accounting For Vertical Inequity

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  • Laura Vallejo‐Torres
  • Stephen Morris

Abstract

Economic analyses of equity which focus solely on horizontal inequity offer a partial assessment of socioeconomic inequity in healthcare use. We analyse income‐related inequity in cardiovascular disease‐related healthcare utilisation by individuals reporting cardiovascular disease in England, including both horizontal and vertical aspects. For the analysis of vertical inequity, we use target groups to estimate the appropriate relationship between healthcare needs and use. We find that including vertical inequity considerations may lead us to draw different conclusions about the nature and extent of income‐related inequity. After accounting for vertical inequity in addition to horizontal inequity, there is no longer evidence of inequity favouring the poor for nurse visits, whereas there is some evidence that doctor visits and inpatient stays are concentrated among richer individuals. The estimates of income‐related inequity for outpatient visits, electrocardiography tests and heart surgery become even more pro‐rich when accounting for vertical inequity. Copyright © 2012 John Wiley & Sons, Ltd.

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  • Laura Vallejo‐Torres & Stephen Morris, 2013. "Income‐Related Inequity In Healthcare Utilisation Among Individuals With Cardiovascular Disease In England—Accounting For Vertical Inequity," Health Economics, John Wiley & Sons, Ltd., vol. 22(5), pages 533-553, May.
    • Handle: RePEc:wly:hlthec:v:22:y:2013:i:5:p:533-553
    DOI: 10.1002/hec.2821
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    2. Sofia Löfvendahl & Anna Jöud & Ingemar F. Petersson & Elke Theander & Åke Svensson & Katarina Steen Carlsson, 2018. "Income disparities in healthcare use remain after controlling for healthcare need: evidence from Swedish register data on psoriasis and psoriatic arthritis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(3), pages 447-462, April.
    3. A. Akhtar & Nadeem Ahmad & Indrani Roy Chowdhury, 2020. "Socio-economic inequality in catastrophic health expenditure among households in India: A decomposition analysis," Indian Economic Review, Springer, vol. 55(2), pages 339-369, December.
    4. Ignacio Abásolo & Miguel Negrín & Jaime Pinilla, 2014. "Utilización y tiempos de espera: dos vertientes inseparables del análisis de la equidad en el acceso al sistema sanitario público," Hacienda Pública Española / Review of Public Economics, IEF, vol. 208(1), pages 11-38, March.
    5. Spitzer, Sonja & Shaikh, Mujaheed, 2022. "Health misperception and healthcare utilisation among older Europeans," The Journal of the Economics of Ageing, Elsevier, vol. 22(C).
    6. Ignacio Abásolo & Miguel Negrín-Hernández & Jaime Pinilla, 2014. "Equity in specialist waiting times by socioeconomic groups: evidence from Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(3), pages 323-334, April.
    7. Kelly, Mark & Kuhn, Michael, 2022. "Congestion in a public health service: A macro approach," Journal of Macroeconomics, Elsevier, vol. 74(C).
    8. Anselmi, Laura & Lagarde, Mylène & Hanson, Kara, 2015. "Going beyond horizontal equity: An analysis of health expenditure allocation across geographic areas in Mozambique," Social Science & Medicine, Elsevier, vol. 130(C), pages 216-224.
    9. Nagano, Hitoshi & Puppim de Oliveira, Jose A. & Barros, Allan Kardec & Costa Junior, Altair da Silva, 2020. "The ‘Heart Kuznets Curve’? Understanding the relations between economic development and cardiac conditions," World Development, Elsevier, vol. 132(C).

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