Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries

Eur J Health Econ. 2015 Jan;16(1):21-33. doi: 10.1007/s10198-013-0546-4. Epub 2013 Dec 14.

Abstract

A key policy objective in OECD countries is to achieve adequate access to health care for all people on the basis of need. Previous studies have shown that there are inequities in health care services utilisation (HCSU) in the OECD area. In recent years, measures have been taken to enhance health care access. This paper re-examines income-related inequities in doctor visits among 18 selected OECD countries, updating previous results for 12 countries with 2006-2009 data, and including six new countries. Inequalities in preventive care services are also considered for the first time. The indirect standardisation procedure is used to estimate the need-adjusted HCSU and concentration indexes are derived to gauge inequalities and inequities. Overall, inequities in HCSU remain present in OECD countries. In most countries, for the same health care needs, people with higher incomes are more likely to consult a doctor than those with lower incomes. Pro-rich inequalities in dental visits and cancer screening uptake are also found in nearly all countries, although the magnitude of these varies among countries. These findings suggest that further monitoring of inequalities is essential in order to assess whether country policy objectives are achieved on a regular basis.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Breast Neoplasms / diagnosis
  • Dental Care / statistics & numerical data
  • Developed Countries / statistics & numerical data*
  • Early Detection of Cancer / statistics & numerical data
  • Female
  • Health Services / statistics & numerical data*
  • Health Services Accessibility / economics
  • Health Status
  • Healthcare Disparities*
  • Humans
  • Income / statistics & numerical data*
  • Male
  • Middle Aged
  • Office Visits / statistics & numerical data
  • Organisation for Economic Co-Operation and Development
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Physicians / statistics & numerical data
  • Sex Factors
  • Socioeconomic Factors
  • Uterine Cervical Neoplasms / diagnosis
  • Young Adult