Access to care and social inequalities in health:An economic analysis

Abstract

The easy integration of individuals into the health care system is the objective of any public health policy. On the other hand, inaccessibility feeds social inequalities in health (Social Health Inequalities ), which reflects the inequality of individuals in access to and consumption of health services. We speak of horizontal equity, when people who are equal in terms of health needs are treated equally regardless of their income. Vertical equity is part of a distributive principle, whereby the more advantaged pay more than the less advantaged. This is a literature review that has exploited what is available in the database. Thus, we selected the most relevant articles. We used the following keywords: access to care, non-use of care, social inequalities in health, concentration curve. The theoretical synthesis showed the existence of two approaches in relation to access to care: the process approach and the dimension approach. The process approach is based on the location of individuals in relation to health care structures and the actual use of this care. With regard to the dimensional approach, it encompasses a set of elements that characterize access to care. Concerning the social health inequalities, the empirical literature has revealed that there are several methods of calculating the social health inequalities, notably the concentration index and standardization methods. Moreover, the social health inequalities are characterized by a measurement problem linked in particular to the objective nature of self-reported health status.

Keywords: access to care, social health inequalities, concentration curve, standardization.

JEL Classification: I12-I14- D63

Paper type: Theoretical Research