We propose a method of measuring and decomposing inequity in health care utilisation that allows for heterogeneity in the use-need relationship. This makes explicit inequity that derives from unequal treatment response to variation in need, as well as that due to differential effects of non-need determinants. Under plausible conditions concerning heterogeneity in the use-need relationship and the distribution of need, existing methods that impose homogeneity will underestimate pro-rich inequity. This prediction is confirmed for four low-middle income Asian countries.

decomposition, equity, health care
Equity, Justice, Inequality, and Other Normative Criteria and Measurement (jel D63), Health: General (jel I10), Health and Inequality (jel I14)
Tinbergen Institute
Tinbergen Institute Discussion Paper Series
Discussion paper / Tinbergen Institute
This work was funded by the European Commission 7th Framework Programme; grant id fp7/223166 - Health Equity and Financial Protection in Asia (HEFPA)
Tinbergen Institute

Van de Poel, E, van Doorslaer, E.K.A, & O'Donnell, O.A. (2011). Measurement of Inequity in Health Care with Heterogeneous Response of Use to Need (No. TI 2011-155/3). Discussion paper / Tinbergen Institute (pp. 1–35). Tinbergen Institute. Retrieved from http://hdl.handle.net/1765/26864