Equity in health and health care in a decentralised context: evidence from Canada.

Abstract:

:The impact of administrative decentralisation on equity in health and health care is an important unresolved issue in the health policy debate. Predictions from the limited theoretical literature and the relevant empirical research are both insufficient to draw any firm conclusions. Many countries are nevertheless experimenting with decentralisation policies in the absence of research evidence. This paper presents an exploratory empirical analysis of decentralisation by investigating the spatial dimensions of health-related equity in Canada, a highly decentralised setting. Using data from the 2001 Canadian Community Health Survey, we apply a decomposition method of the Concentration Index to explore whether income-related inequalities in health and inequities in the use of health care are more likely to be due to gaps between rich and poor Canadian provinces rather than to differences between rich and poor individuals within them. The results show that within area variation is the most important source of income-related health inequality, while income-related inequities in health care use are mostly driven by differences between provinces.

journal_name

Health Econ

journal_title

Health economics

authors

Jiménez-Rubio D,Smith PC,Van Doorslaer E

doi

10.1002/hec.1272

subject

Has Abstract

pub_date

2008-03-01 00:00:00

pages

377-92

issue

3

eissn

1057-9230

issn

1099-1050

journal_volume

17

pub_type

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