IDEAS home Printed from https://ideas.repec.org/p/ehl/lserod/101244.html
   My bibliography  Save this paper

The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation

Author

Listed:
  • Asaria, Miqdad
  • Doran, Tim
  • Cookson, Richard

Abstract

Background There are substantial socioeconomic inequalities in both life expectancy and healthcare use in England. In this study, we describe how these two sets of inequalities interact by estimating the social gradient in hospital costs across the life course.Methods Hospital episode statistics, population and index of multiple deprivation data were combined at lower-layer super output area level to estimate inpatient hospital costs for 2011/2012 by age, sex and deprivation quintile. Survival curves were estimated for each of the deprivation groups and used to estimate expected annual costs and cumulative lifetime costs.Results A steep social gradient was observed in overall inpatient hospital admissions, with rates ranging from 31 298/100 000 population in the most affluent fifth of areas to 43 385 in the most deprived fifth. This gradient was steeper for emergency than for elective admissions. The total cost associated with this inequality in 2011/2012 was £4.8 billion. A social gradient was also observed in the modelled lifetime costs where the lower life expectancy was not sufficient to outweigh the higher average costs in the more deprived populations. Lifetime costs for women were 14% greater than for men, due to higher costs in the reproductive years and greater life expectancy.Conclusions Socioeconomic inequalities result in increased morbidity and decreased life expectancy. Interventions to reduce inequality and improve health in more deprived neighbourhoods have the potential to save money for health systems not only within years but across peoples’ entire lifetimes, despite increased costs due to longer life expectancies.

Suggested Citation

  • Asaria, Miqdad & Doran, Tim & Cookson, Richard, 2016. "The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation," LSE Research Online Documents on Economics 101244, London School of Economics and Political Science, LSE Library.
  • Handle: RePEc:ehl:lserod:101244
    as

    Download full text from publisher

    File URL: http://eprints.lse.ac.uk/101244/
    File Function: Open access version.
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Heckman, James J. & Moon, Seong Hyeok & Pinto, Rodrigo & Savelyev, Peter A. & Yavitz, Adam, 2010. "The rate of return to the HighScope Perry Preschool Program," Journal of Public Economics, Elsevier, vol. 94(1-2), pages 114-128, February.
    2. 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.
    3. Maureen Mackintosh, 2007. "Planning and Market Regulation: Strengths, Weaknesses and Interactions in the Provision of Less Inequitable and Better Quality Health Care," Open Discussion Papers in Economics 64, The Open University, Faculty of Social Sciences, Department of Economics.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    2. Peter Smith, 2019. "Can a Strong Economic Case Be Made for Investing in the NHS?," Monograph 002090, Office of Health Economics.
    3. Cookson, R. & Asaria, M. & Ali, S. & Shaw, R. & Doran, T. & Goldblatt, P., 2018. "Health equity monitoring for healthcare quality assurance," Social Science & Medicine, Elsevier, vol. 198(C), pages 148-156.
    4. Miqdad Asaria, 2017. "Health care costs in the English NHS: reference tables for average annual NHS spend by age, sex and deprivation group," Working Papers 147cherp, Centre for Health Economics, University of York.
    5. Thomas Leoni & Martin Spielauer & Peter Reschenhofer, 2020. "Soziale Unterschiede, Lebenserwartung und Gesundheitsausgaben im Lebensverlauf," WIFO Studies, WIFO, number 66626.
    6. Enkai Guo & Huamei Zhong & Yang Gao & Jing Li & Zhaohong Wang, 2022. "Socioeconomic Disparities in Health Care Consumption: Using the 2018-China Family Panel Studies," IJERPH, MDPI, vol. 19(12), pages 1-14, June.
    7. Demir, Eren & Yakutcan, Usame & Page, Stephen, 2024. "Using simulation modelling to transform hospital planning and management to address health inequalities," Social Science & Medicine, Elsevier, vol. 347(C).
    8. Hazewinkel, Audinga-Dea & Richmond, Rebecca C. & Wade, Kaitlin H. & Dixon, Padraig, 2022. "Mendelian randomization analysis of the causal impact of body mass index and waist-hip ratio on rates of hospital admission," Economics & Human Biology, Elsevier, vol. 44(C).
    9. Laura Bojke & Andrea Manca & Miqdad Asaria & Ronan Mahon & Shijie Ren & Stephen Palmer, 2017. "How to Appropriately Extrapolate Costs and Utilities in Cost-Effectiveness Analysis," PharmacoEconomics, Springer, vol. 35(8), pages 767-776, August.
    10. Smith, Samantha & Walsh, Brendan & Wren, Maev-Ann & Barron, Steve & Morgenroth, Edgar & Eighan, James & Lyons, Seán, 2019. "Geographic profile of healthcare needs and non-acute healthcare supply in Ireland," Research Series, Economic and Social Research Institute (ESRI), number RS90.
    11. Sarah Gibney & Lucy Bruton & Catherine Ryan & Gerardine Doyle & Gillian Rowlands, 2020. "Increasing Health Literacy May Reduce Health Inequalities: Evidence from a National Population Survey in Ireland," IJERPH, MDPI, vol. 17(16), pages 1-17, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    2. Elizabeth M. Caucutt & Lance Lochner & Youngmin Park, 2017. "Correlation, Consumption, Confusion, or Constraints: Why Do Poor Children Perform so Poorly?," Scandinavian Journal of Economics, Wiley Blackwell, vol. 119(1), pages 102-147, January.
    3. repec:spo:wpmain:info:hdl:2441/6s39gt704s95upu27ma7s3p6q8 is not listed on IDEAS
    4. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    5. Holla,Alaka & Bendini,Maria Magdalena & Dinarte Diaz,Lelys Ileana & Trako,Iva, 2021. "Is Investment in Preprimary Education Too Low ? Lessons from (Quasi) ExperimentalEvidence across Countries," Policy Research Working Paper Series 9723, The World Bank.
    6. Henning Hermes & Philipp Lergetporer & Fabian Mierisch & Frauke Peter & Simon Wiederhold, 2023. "Discrimination on the Child Care Market: A Nationwide Field Experiment," Working Papers 225, Bavarian Graduate Program in Economics (BGPE).
    7. Orazio Attanasio & Helen Baker-Henningham & Raquel Bernal & Costas Meghir & Diana Pineda & Marta Rubio-Codina, 2022. "Early Stimulation and Nutrition: The Impacts of a Scalable Intervention," Journal of the European Economic Association, European Economic Association, vol. 20(4), pages 1395-1432.
    8. Emma Tominey, 2010. "The Timing of Parental Income and Child Outcomes: The Role of Permanent and Transitory Shocks," CEE Discussion Papers 0120, Centre for the Economics of Education, LSE.
    9. Martin, Will, 2021. "Tools for measuring the full impacts of agricultural interventions," IFPRI-MCC technical papers 2, International Food Policy Research Institute (IFPRI).
    10. Lauber, Verena & Thomas, Lampert, 2014. "The Effect of Early Universal Daycare on Child Weight Problems," VfS Annual Conference 2014 (Hamburg): Evidence-based Economic Policy 100399, Verein für Socialpolitik / German Economic Association.
    11. Jo Blanden & Emilia Del Bono & Sandra McNally & Birgitta Rabe, 2016. "Universal Pre‐school Education: The Case of Public Funding with Private Provision," Economic Journal, Royal Economic Society, vol. 0(592), pages 682-723, May.
    12. Ralph Hippe & Luisa De Sousa Lobo Borges de Araujo & Patricia Dinis Mota da Costa, 2016. "Equity in Education in Europe," JRC Research Reports JRC104595, Joint Research Centre.
    13. Clément de Chaisemartin & Quentin Daviot & Marc Gurgand & Sophie Kern, 2021. "Lutter contre les inégalités dès la petite enfance : évaluation à grande échelle du programme Parler Bambin," Post-Print halshs-03288700, HAL.
    14. Randall Akee & Leah R. Clark, 2023. "Universal Preschool Lottery Admissions and Its Effects on Long-Run Earnings and Outcomes," Working Papers 23-09, Center for Economic Studies, U.S. Census Bureau.
    15. Kerstin Grosch & Simone Haeckl & Martin G. Kocher, 2022. "Closing the Gender STEM Gap - A Large-Scale Randomized-Controlled Trial in Elementary Schools," CESifo Working Paper Series 9907, CESifo.
    16. Arnaud Chevalier & Olivier Marie, 2013. "Economic Uncertainty, Parental Selection, and the Criminal Activity of the "Children of the Wall"," SOEPpapers on Multidisciplinary Panel Data Research 605, DIW Berlin, The German Socio-Economic Panel (SOEP).
    17. Lara Loewenstein, 2023. "Increasing the (Female) Labor Supply," Economic Commentary, Federal Reserve Bank of Cleveland, vol. 2023(05), March.
    18. Marcela Arrivillaga, 2021. "Assesing Health Services in Colombia: Development of a Conceptual Framework and Measurement tools based on primary data," SAGE Open, , vol. 11(2), pages 21582440211, May.
    19. Agostinelli, Francesco & Avitabile, Ciro & Bobba, Matteo, 2021. "Enhancing Human Capital in Children: A Case Study on Scaling," TSE Working Papers 21-1196, Toulouse School of Economics (TSE), revised Oct 2023.
    20. Flèche, Sarah & Lekfuangfu, Warn N. & Clark, Andrew E., 2021. "The long-lasting effects of family and childhood on adult wellbeing: Evidence from British cohort data," Journal of Economic Behavior & Organization, Elsevier, vol. 181(C), pages 290-311.
    21. Vittadini, Giorgio & Sturaro, Caterina & Folloni, Giuseppe, 2022. "Non-Cognitive Skills and Cognitive Skills to measure school efficiency," Socio-Economic Planning Sciences, Elsevier, vol. 81(C).

    More about this item

    JEL classification:

    • E6 - Macroeconomics and Monetary Economics - - Macroeconomic Policy, Macroeconomic Aspects of Public Finance, and General Outlook

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ehl:lserod:101244. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: LSERO Manager (email available below). General contact details of provider: https://edirc.repec.org/data/lsepsuk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.