Inequity in inpatient healthcare utilisation 10 years after Apartheid

Abstract

This paper provides evidence about socioeconomic inequity in inpatient healthcare utilisation in South Africa after 10 years of reform after Apartheid, and examines which are the contributing determinants. We use the South African sample of the World Health Survey from 2002–03 and estimate horizontal inequity in inpatient healthcare utilisation using the concentration index. We further decompose inequity in inpatient care to explore the contribution of the different determinants of use. We find that inpatient healthcare utilisation is found to be pro-rich distributed in South Africa. The rich are more likely to use inpatient healthcare than the poor, given the same level of need. In addition, race is found to be the most important contributor (42%) to socioeconomic inequity in inpatient healthcare utilisation in South Africa. Gender, education and the consumption level are also found to be important contributors, but to a lesser degree than race. Our findings provide evidence that socioeconomic inequity in inpatient healthcare utilisation still exists in post-Apartheid South Africa and that policies, regulations and research should contribute to a more equitable utilisation. The implementation of National Health Insurance could help to reduce the major problems and large (socioeconomic and racial) inequalities of the South African healthcare system.