Inequalities in health care utilization in Spain due to double insurance coverage: An Oaxaca-Ransom decomposition

Soc Sci Med. 2009 Sep;69(5):793-801. doi: 10.1016/j.socscimed.2009.06.037. Epub 2009 Jul 21.


In this article, the analysis of inequalities in health care utilization, produced by the taking out of a private health insurance policy to supplement the care provided by the Spanish National Health System, has been performed by the Oaxaca-Ransom decomposition. Using the European Community Household Panel, this method permits the conclusion that the majority of differences in the number of visits to a general practitioner are explained by the individual characteristics of the publicly insured, while the divergences in the number of consultations with specialists are the result of the overuse of this care by the population with double health insurance coverage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Delivery of Health Care / statistics & numerical data*
  • Female
  • Healthcare Disparities / economics*
  • Humans
  • Insurance Coverage / economics*
  • Insurance, Health / economics*
  • Male
  • Middle Aged
  • Models, Econometric
  • National Health Programs / statistics & numerical data*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Private Sector
  • Socioeconomic Factors
  • Spain
  • Young Adult