On the measurement of horizontal inequity in the delivery of health care

J Health Econ. 1991 Jul;10(2):169-205; discussion 247-9, 251-6. doi: 10.1016/0167-6296(91)90003-6.


This paper offers a critical appraisal of the various methods used to date to investigate inequity in the delivery of health care. It concludes that none of the methods used to date is particularly well equipped to provide unbiassed estimates of the extent of inequity. It also concludes that Le Grand's (1978) approach is likely to point towards inequity favouring the rich even when none exists. The paper offers an alternative approach, which builds on the approaches to date but seeks to overcome their deficiencies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Chronic Disease
  • Cross-Cultural Comparison
  • Delivery of Health Care / standards*
  • Demography
  • Europe
  • Health Expenditures / statistics & numerical data*
  • Health Services Research / methods*
  • Humans
  • Models, Statistical
  • Regression Analysis
  • Social Justice*
  • Socioeconomic Factors