[EQ] Measuring Disparities in Health Status and in Access and Use of Health Care

MEASURING DISPARITIES IN HEALTH STATUS AND IN ACCESS AND USE OF HEALTH CARE

IN OECD COUNTRIES

 

Michael de Looper and Gaetan Lafortune

OECD HEALTH WORKING PAPERS NO. 43

Organisation for Economic Co-operation and Development, 2009

 

Available online as PDF file [55p.] at: http://www.olis.oecd.org/olis/2009doc.nsf/LinkTo/NT00000DE2/$FILE/JT03260782.PDF

 

“………Most OECD countries have endorsed as major policy objectives the reduction of inequalities in health status and the principle of adequate or equal access to health care based on need. These policy objectives require an evidence-based approach to measure progress. This paper assesses the availability and comparability of selected indicators of inequality in health status and in health care access and use across OECD countries, focussing on disparities among socioeconomic groups.

 

These indicators are illustrated using national or cross-national data sources to stratify populations by income, education or occupation level. In each case, people in lower socioeconomic groups tend to have a higher rate of disease, disability and death, use less preventive and specialist health services than expected on the basis of their need, and for certain goods and services may be required to pay a proportionately higher share of their income to do so.

 

Options for future OECD work in measuring health inequalities are provided through suggesting a small set of indicators for development and inclusion in the OECD Health Data database. Some indicators appear to be more advanced for international data collection, since comparable data are already being collected in a routine fashion in most OECD countries. These include the indicators of inequalities in self-rated health, self-rated disability, the extent of public health care coverage and private health insurance coverage, and self-reported unmet medical and dental care needs.

 

Increased availability and comparability of data will improve the validity of cross-national comparisons of socioeconomic inequalities in health status and health care access and use. Harmonisation of definitions and collection instruments, and the greater use of data linkages in order to allow disaggregation by socioeconomic status, will determine whether health inequalities can be routinely monitored across OECD countries…..”

 

 

TABLE OF CONTENTS

INTRODUCTION

A FOCUS ON SOCIOECONOMIC INEQUALITIES IN HEALTH

Selection of leading indicators of health inequalities

Classifying social groups

Measures of socioeconomic inequalities in health

Data sources and challenges to improve comparability

1. INDICATORS OF INEQUALITIES IN HEALTH STATUS

1.1 Mortality-based indicators

1.2 Morbidity-based indicators

1.3 Summary measures of population health

 

2. INDICATORS OF INEQUALITIES IN HEALTH CARE ACCESS AND USE

2.1 Health insurance coverage

2.2 Out-of-pocket expenditure

2.3 Health care utilisation

2.4 Unmet care needs

CONCLUSION

GLOSSARY OF TERMS

ANNEX 1: A SUMMARY OF THE “EFFECTIVE COVERAGE” MEASURE

ANNEX 2: QUESTIONS ON SELF-RATED HEALTH AND DISABILITY AND HEALTH CARE ACCESS IN CROSS-NATIONAL SURVEYS

BIBLIOGRAPHY

 

 

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