Measuring equity in access to health care

Area of Science:

• Health Economics
• Public Health Policy
• Econometrics

Background:

• Measuring equity in healthcare access is crucial for public health.
• Health insurance programs significantly influence healthcare utilization and equity.
• Assessing the distributional impact of insurance is key to policy design.

Purpose of the Study:

• To develop and apply methodologies for measuring equity in health service access.
• To quantify the impact of health insurance programs on equity in healthcare distribution.
• To evaluate policy simulations for expanding health insurance eligibility in Ecuador.

Main Methods:

• Utilized egalitarian-based indicators: concentration coefficient and Atkinson measure.
• Employed a weighted Utilitarian social welfare function for overall access.
• Applied microeconomic health care demand models and bivariate probit estimation.

Main Results:

• The General Health Insurance (GHI) program in Ecuador increased overall access but decreased equity.
• GHI benefits exhibited a regressive distribution, with higher earners benefiting more.
• Expanding GHI eligibility to the self-employed or dependents improved equity and social welfare.

Conclusions:

• While health insurance can increase access, its design critically impacts equity.
• Policy interventions like expanding eligibility can mitigate negative equity impacts.
• Methodologies developed offer valuable tools for evaluating health policy and promoting equitable access.