Analysing equity in health care financing: a flow of funds approach

Soc Sci Med. 2009 Aug;69(3):379-86. doi: 10.1016/j.socscimed.2009.05.030. Epub 2009 Jun 18.


There are concerns that existing methods for analysing equity in Irish health care financing, based on progressivity index measures, are not adequately capturing patterns of inequity that occur in practice. This paper follows a new direction in the literature whereby equity in health care financing and delivery are analysed together. A flow of funds for Irish health care resources is developed and applied to data for 2004. The framework traces the flow of public and private health resources from individuals to financial intermediaries, from there to health care providers and functions, and from there to individuals. Individuals are categorised by health care entitlement status. Findings indicate that broad progressive patterns in aggregate resource flows hide less equitable patterns that require further attention and there are complex interactions between public and private resources. The flow of funds approach complements existing analytic methods and generates policy lessons for Irish and international policy makers.

MeSH terms

  • Delivery of Health Care / economics
  • Delivery of Health Care / organization & administration
  • Health Resources / economics*
  • Health Status
  • Health Status Disparities*
  • Humans
  • Ireland
  • National Health Programs / economics*
  • Prejudice*
  • Social Justice / economics*