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Article: Horizontal equity in health care utilization evidence from three high-income Asian economies

TitleHorizontal equity in health care utilization evidence from three high-income Asian economies
Authors
Issue Date2007
PublisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/socscimed
Citation
Social Science And Medicine, 2007, v. 64 n. 1, p. 199-212 How to Cite?
AbstractThis paper compares the extent to which the principle of "equal treatment for equal need"(ETEN) is maintained in the health care delivery systems of Hong Kong, South Korea and Taiwan. Deviations in the degree to which health care is distributed according to need are measured by an index of horizontal inequity. Income-related inequality in utilization is split into four major sources: (i) direct effect of income; (ii) need indicators (self-assessed health status, activity limitation, and age and gender interaction terms); (iii) non-need variables (education, work status, private health insurance coverage, employer-provided medical benefits, Medicaid status (low-income medical assistance), geographic region and urban/rural residency and (iv) a residual term. Service types studied include western doctor, licensed traditional medicine practitioner (LTMP), dental and emergency room (ER) visits, as well as inpatient admissions. Violations of the ETEN principle are observed for physician and dental services in Hong Kong . There is pro-rich inequity in western doctor visits. Unusually, this inequity exists for general practitioner but not specialist care. In contrast, South Korea appears to have almost comprehensively maintained ETEN although the better-off have preferential access to higher levels of outpatient care. Taiwan shows intermediate results in that the rich are marginally more likely to use outpatient services, but quantities of western doctor and dental visits are evenly distributed while there is modest pro-rich bias in the number of LTMP episodes. ER visits and inpatient admissions in Taiwan are either proportional or slightly pro-poor. Future work should focus on the evaluation of policy interventions aimed at reducing the observed unequal distributions. © 2006 Elsevier Ltd. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/86928
ISSN
2015 Impact Factor: 2.814
2015 SCImago Journal Rankings: 1.894
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLu, JRen_HK
dc.contributor.authorLeung, GMen_HK
dc.contributor.authorKwon, Sen_HK
dc.contributor.authorTin, KYKen_HK
dc.contributor.authorVan Doorslaer, Een_HK
dc.contributor.authorO'Donnell, Oen_HK
dc.date.accessioned2010-09-06T09:23:03Z-
dc.date.available2010-09-06T09:23:03Z-
dc.date.issued2007en_HK
dc.identifier.citationSocial Science And Medicine, 2007, v. 64 n. 1, p. 199-212en_HK
dc.identifier.issn0277-9536en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86928-
dc.description.abstractThis paper compares the extent to which the principle of "equal treatment for equal need"(ETEN) is maintained in the health care delivery systems of Hong Kong, South Korea and Taiwan. Deviations in the degree to which health care is distributed according to need are measured by an index of horizontal inequity. Income-related inequality in utilization is split into four major sources: (i) direct effect of income; (ii) need indicators (self-assessed health status, activity limitation, and age and gender interaction terms); (iii) non-need variables (education, work status, private health insurance coverage, employer-provided medical benefits, Medicaid status (low-income medical assistance), geographic region and urban/rural residency and (iv) a residual term. Service types studied include western doctor, licensed traditional medicine practitioner (LTMP), dental and emergency room (ER) visits, as well as inpatient admissions. Violations of the ETEN principle are observed for physician and dental services in Hong Kong . There is pro-rich inequity in western doctor visits. Unusually, this inequity exists for general practitioner but not specialist care. In contrast, South Korea appears to have almost comprehensively maintained ETEN although the better-off have preferential access to higher levels of outpatient care. Taiwan shows intermediate results in that the rich are marginally more likely to use outpatient services, but quantities of western doctor and dental visits are evenly distributed while there is modest pro-rich bias in the number of LTMP episodes. ER visits and inpatient admissions in Taiwan are either proportional or slightly pro-poor. Future work should focus on the evaluation of policy interventions aimed at reducing the observed unequal distributions. © 2006 Elsevier Ltd. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/socscimeden_HK
dc.relation.ispartofSocial Science and Medicineen_HK
dc.subject.meshAsiaen_HK
dc.subject.meshDelivery of Health Care - economics - statistics & numerical dataen_HK
dc.subject.meshHealth Surveysen_HK
dc.subject.meshHumansen_HK
dc.subject.meshNational Health Programs - economicsen_HK
dc.subject.meshPatient Acceptance of Health Care - statistics & numerical dataen_HK
dc.subject.meshSocioeconomic Factorsen_HK
dc.titleHorizontal equity in health care utilization evidence from three high-income Asian economiesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0277-9536&volume=64&spage=199&epage=212&date=2007&atitle=Horizontal+equity+in+health+care+utilization+evidence+from+three+high-income+Asian+economiesen_HK
dc.identifier.emailLeung, GM:gmleung@hku.hken_HK
dc.identifier.emailTin, KYK:tinyiuke@hku.hken_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.identifier.authorityTin, KYK=rp00494en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.socscimed.2006.08.033en_HK
dc.identifier.pmid17014944-
dc.identifier.scopuseid_2-s2.0-33751017107en_HK
dc.identifier.hkuros125063en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33751017107&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume64en_HK
dc.identifier.issue1en_HK
dc.identifier.spage199en_HK
dc.identifier.epage212en_HK
dc.identifier.isiWOS:000242922600016-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLu, JR=8957442200en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.scopusauthoridKwon, S=23100199700en_HK
dc.identifier.scopusauthoridTin, KYK=7003796897en_HK
dc.identifier.scopusauthoridVan Doorslaer, E=7006272913en_HK
dc.identifier.scopusauthoridO'Donnell, O=6601988937en_HK

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