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Health care deprivation profiles in the measurement of inequality and inequity: an application to GP fundholding in the English NHS

Laudicella, M., Cookson, R., Jones, A. M. and Rice, N. (2009). Health care deprivation profiles in the measurement of inequality and inequity: an application to GP fundholding in the English NHS. Journal of Health Economics, 28(6), pp. 1048-1061. doi: 10.1016/j.jhealeco.2009.07.001

Abstract

This paper proposes a new approach to the measurement of inequality and inequity in the delivery of health care based on contributions from the literature on poverty and deprivation. This approach has some appealing characteristics: (1) inequity is additively decomposable by population subgroups; (2) the approach does not rely on socio-economic ranks; (3) it provides a graphical representation of the distribution of inequity; (4) it offers a range of indices consistent with dominance. An empirical application is provided investigating the effect of the GP fundholding reform on equity in English NHS. The results show that the most equitable GP practices self-selected into the scheme in 1991; evidence of an inequity-reducing treatment effect as well as a self-selection effect are found in 1992 and 1993; the self-selection process reduces and no evidence of a treatment effect is present thereafter.

Publication Type: Article
Publisher Keywords: Inequality; Inequity; Health care; Deprivation; GP fundholding
Subjects: R Medicine > RA Public aspects of medicine
Departments: School of Health Sciences
URI: http://openaccess.city.ac.uk/id/eprint/14877
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