Abstract:
BACKGROUND:Efficiency and equity are both important policy objectives in resource allocation. The discipline of health economics has traditionally focused on maximising efficiency, however addressing inequities in health also requires consideration. Methods to incorporate equity within economic evaluation techniques range from qualitative judgements to quantitative outcomes-based equity weights. Yet, due to definitional uncertainties and other inherent limitations, no method has been universally adopted to date. This paper proposes an alternative cost-based equity weight for use in the economic evaluation of interventions delivered from primary health care services. METHODS:Equity is defined in terms of 'access' to health services, with the vertical equity objective to achieve 'equitable access for unequal need'. Using the Australian Indigenous population as an illustrative case study, the magnitude of the equity weight is constructed using the ratio of the costs of providing specific interventions via Indigenous primary health care services compared with the costs of the same interventions delivered via mainstream services. Applying this weight to the costs of subsequent interventions deflates the costs of provision via Indigenous health services, and thus makes comparisons with mainstream more equitable when applied during economic evaluation. RESULTS:Based on achieving 'equitable access', existing measures of health inequity are suitable for establishing 'need', however the magnitude of health inequity is not necessarily proportional to the magnitude of resources required to redress it. Rather, equitable access may be better measured using appropriate methods of health service delivery for the target group. 'Equity of access' also suggests a focus on the processes of providing equitable health care rather than on outcomes, and therefore supports application of equity weights to the cost side rather than the outcomes side of the economic equation. CONCLUSION:Cost-based weights have the potential to provide a pragmatic method of equity weight construction which is both understandable to policy makers and sensitive to the needs of target groups. It could improve the evidence base for resource allocation decisions, and be generalised to other disadvantaged groups who share similar concepts of equity. Development of this decision-making tool represents a potentially important avenue for further health economics research.
journal_name
Int J Equity Healthjournal_title
International journal for equity in healthauthors
Ong KS,Kelaher M,Anderson I,Carter Rdoi
10.1186/1475-9276-8-34subject
Has Abstractpub_date
2009-10-07 00:00:00pages
34issn
1475-9276pii
1475-9276-8-34journal_volume
8pub_type
杂志文章abstract:BACKGROUND:Chronic diseases are more prevalent and occur at a much younger age in Aboriginal people in Australia compared with non-Aboriginal people. Aboriginal people also have higher rates of unplanned hospital readmissions and emergency department presentations. There is a paucity of research on the effectiveness of...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0776-2
更新日期:2018-05-18 00:00:00
abstract:BACKGROUND:An important health issue in urban areas is how changes arising from the regeneration of city-areas affect social determinants of health and equity. This paper examines the impacts attributable to a new fish market and to delays in the regeneration of a port area in a deteriorated region of the Bay of Pasaia...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0424-7
更新日期:2016-09-15 00:00:00
abstract::Reproductive health services are crucial for maternal and child health, but universal health coverage is still not within reach in most societies. Ethiopia's goal of universal health coverage promises access to all necessary services for everyone while providing protection against financial risk. When moving towards u...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-015-0218-3
更新日期:2015-09-30 00:00:00
abstract:OBJECTIVE:To report the extent of self-reported chronic diseases, self-rated health status (SRH) and healthcare utilization among residents in 1-2 room Housing Development Board (HDB) apartments in Toa Payoh. MATERIALS & METHODS:The study population included a convenience sample of residents from 931 housing developme...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-11-44
更新日期:2012-08-16 00:00:00
abstract:BACKGROUND:Whether smoking accelerates memory recession has been a topic of significant research. However, randomised controlled trials are not easy to carry out, and does not comply with the ethics of research. And observation method which based on the most readily observed data is easy to draw the wrong conclusions w...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0417-6
更新日期:2016-08-22 00:00:00
abstract:INTRODUCTION:Major efforts have been made to improve the health care system in Hunan province, China. The aims of this study were to assess whether and to what extent these efforts have impacted on gender and regional disparities of Tuberculosis (TB) incidence in recent years, especially for less developed areas. METH...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-13-32
更新日期:2014-04-27 00:00:00
abstract:BACKGROUND:Social marginalization and criminalization create health and safety risks for sex workers and reduce their access to health promotion and prevention services compared to the general population. Community empowerment-based interventions that prioritize the engagement of sex workers show promising results. Pee...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-017-0655-2
更新日期:2017-08-30 00:00:00
abstract:BACKGROUND:Despite recent progress in improving access to maternal health services, the utilization of these services remains inequitable among women in developing countries, and rural women are particularly disadvantaged. This study sought to measure i) disparities in the rates of institutional births between rural an...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-1025-z
更新日期:2019-08-09 00:00:00
abstract:INTRODUCTION:Despite the relentless efforts to reduce infant and child mortality with the introduction of the National Expanded Programmes on Immunization (EPI) in 1974, major disparities still exist in immunizations coverage across different population sub-groups. In Kenya, for instance, while the proportion of fully ...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-015-0154-2
更新日期:2015-02-27 00:00:00
abstract:BACKGROUND:Although government has implemented medical-aid policy that provides assistance to the poor with almost free medical services, there are low-income people who do not receive necessary medical services in Korea. The aim of this study is to highlight the characteristics of Medical-Aid enrollees, the poor not e...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-015-0257-9
更新日期:2015-11-14 00:00:00
abstract:OBJECTIVE:This narrative review aimed to identify and categorize the barriers and facilitators to the provision of brief intervention and behavioral change programs that target several risk behaviors among the Indigenous populations of Australia, Canada, and New Zealand. METHODS:A systematic database search was conduc...
journal_title:International journal for equity in health
pub_type: 杂志文章,评审
doi:10.1186/s12939-019-1059-2
更新日期:2019-11-05 00:00:00
abstract:BACKGROUND:Opioid use is a severe problem in Iran. Despite methadone maintenance treatment (MMT) programs being one of the most important treatment strategies for reducing individual and public harms associated with opioid use, a large proportion of Iranian patients refuse to participate in such treatment programs. ME...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0787-z
更新日期:2018-06-11 00:00:00
abstract:OBJECTIVE:Prior to 2007, forced sex with male children in South Africa did not count as rape but as "indecent assault", a much less serious offence. This study sought to document prevalence of male sexual violence among school-going youth. DESIGN:A facilitated self-administered questionnaire in nine of the 11 official...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-7-20
更新日期:2008-07-29 00:00:00
abstract::In the debate on 'Third options' for health care delivery in low- and middle-income countries it is proposed that self-help should play a larger role. Self-help is expected to contribute towards improving population health outcomes and reducing government health care expenditure. We review scope and limitations of sel...
journal_title:International journal for equity in health
pub_type: 社论
doi:10.1186/1475-9276-3-1
更新日期:2004-04-15 00:00:00
abstract:BACKGROUND:With the depth development of health care system reform in China, emergency medical services (EMS) is confronted with challenges as well as opportunities. This study aimed to analyze the equity of China's EMS needs, utilization, and resources distribution, and put forward proposal to improve the equity. MET...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0507-5
更新日期:2017-01-11 00:00:00
abstract:BACKGROUND:Everyone has the right to achieve the standard of health and well-being. Migrants are considered as vulnerable populations due to the lack of access to health services and financial protection in health. Several interventions have been developed to improve migrant population health, but little is known about...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-0970-x
更新日期:2019-05-06 00:00:00
abstract:BACKGROUND:Evidence from low and middle income countries (LMICs) suggests that maternal mortality is more prevalent among the poor whereas access to maternal health services is concentrated among the rich. In Bangladesh substantial inequities exist both in the use of facility-based basic obstetric care and for home bir...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-12-22
更新日期:2013-04-02 00:00:00
abstract:BACKGROUND:Like other African countries, Tanzania has in recent years, been implementing various exemptions and targeting programmes to protect and ensure equitable access to health care by poorer segments of the population. A body of evidence indicates that exemption policies, while potentially effective in principle,...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-12-80
更新日期:2013-09-26 00:00:00
abstract:BACKGROUND:A growing body of literature has demonstrated that higher social capital is associated with improved health conditions. However, some research indicated that the association between social capital and health was substantially attenuated after adjustment for material deprivation. Studies exploring the associa...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-8-2
更新日期:2009-02-15 00:00:00
abstract:BACKGROUND:Latin America (LA) has experienced constant economic and political crises that coincide with periods of greater inequality. Between 1996 and 2007 Ecuador went through one of the greatest political and socio-economic crises in Latin America, a product of neo-liberal economic growth strategies. Between 2007 an...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-020-01359-1
更新日期:2021-01-28 00:00:00
abstract:INTRODUCTION:Literature shows socioeconomic disparities are related to various aspects of diabetes care. However, few studies have explored the relationship between socioeconomics and healthcare outcomes, particularly with regard to preventable hospitalization. This cohort study employed hierarchical modelling to evalu...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-015-0160-4
更新日期:2015-03-21 00:00:00
abstract:BACKGROUND:The strategy of health policy has been changed for improving the performances to meeting the increasing healthcare demands. However, limited evidences were found to prove that the bundled payment was valid for service delivering in public sector. This study was designed to evaluate the effectiveness of a bun...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-016-0334-8
更新日期:2016-03-10 00:00:00
abstract:BACKGROUND:Our research group advanced a health insurance theory to explain Canada's cancer care advantages over America. The late Barbara Starfield theorized that Canada's greater primary care-orientation also plays a critically protective role. We tested the resultant Starfield-Gorey theory by examining the effects o...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-015-0246-z
更新日期:2015-10-29 00:00:00
abstract:INTRODUCTION:Tobacco use in China is disproportionally distributed among rural and urban populations with rural people smoking more. While there is a wealth of evidence on the association between tobacco use among rural people and their lower socio-economic status (SES), how social structural factors contribute to rura...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-13-12
更新日期:2014-02-03 00:00:00
abstract:BACKGROUND:We aimed to determine the extent to which three core variables (school environment, peer group and family affluence) were associated with unhealthy behaviours and health outcomes among Tuscan adolescents. The unhealthy behaviours considered were smoking, alcohol consumption, sedentary lifestyle and irregular...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-014-0083-5
更新日期:2014-09-25 00:00:00
abstract:BACKGROUND:Disparities in prostate cancer (PCa) outcomes and their links to socioeconomic status (SES) have been intensively studied. A relatively low incidence rate and a high proportion of late-stage diagnosis have been documented in studies of Asian populations. For the past 20 years, the trend in the growth of PCa ...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-018-0792-2
更新日期:2018-06-15 00:00:00
abstract:BACKGROUND:Aboriginal and Torres Strait Islander women experience higher rates of obesity, chronic disease, and are less active than non-Indigenous Australian women. Lifestyle programs designed to increase physical activity and encourage healthy eating are needed to ameliorate this disparity. The aim of this study was ...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/1475-9276-12-11
更新日期:2013-01-24 00:00:00
abstract:BACKGROUND:Aboriginal women are frequently called upon to support their families and other community members. At times, such supporting roles can be burdensome for these women. Many Aboriginal women live with chronic conditions. We explored the ways in which the women's caring roles impacted on how they maintained thei...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-1110-3
更新日期:2020-01-13 00:00:00
abstract:BACKGROUND:Health sector priority setting in Low and Middle-Income Countries (LMICs) entails balancing between a high demand and low supply of scarce resources. Human Resources for Health (HRH) consume the largest allocation of health sector resources in LMICs. Health sector decentralization continues to be promoted fo...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-020-01284-3
更新日期:2020-09-21 00:00:00
abstract:BACKGROUND:In 2014 the World Health Organization (WHO) launched the "End TB Strategy", setting new ambitious goals for elimination of tuberculosis (TB). In contrast with previous efforts to control TB, the new strategy adopted the protection and promotion of human rights in TB prevention and care as a core pillar. This...
journal_title:International journal for equity in health
pub_type: 杂志文章
doi:10.1186/s12939-019-0928-z
更新日期:2019-06-03 00:00:00