Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-20T05:10:32.371Z Has data issue: false hasContentIssue false

9 - New approaches for understanding inequalities in service use among older people

Published online by Cambridge University Press:  05 August 2011

Sara Allin
Affiliation:
University of Toronto
Jose-Luis Fernandez
Affiliation:
London School of Economics and Political Science
Malcolm Sargeant
Affiliation:
Middlesex University, London
Get access

Summary

Inequalities in publicly funded services have received considerable attention in recent years. On the one hand, policy-makers have placed increased emphasis on ensuring a fair distribution of public services. On the other, researchers have responded by developing new methods to measure and understand inequalities. Inequalities can exist across a number of policy-relevant dimensions. These include, but are not limited to: socio-economic status, where there are concerns that individuals with less income or access to resources may be treated differently by public services such as health and social care; age, where the concern centres around age discrimination or differential access or treatment based on age; geography, where the availability of services or quality of services for a given need vary across regions; and racial/ethnic identity, language and culture. Policy attention has targeted all of these dimensions in recent years, and, in some cases, the policies have recognised the intersections of these factors. Overall, however, the bulk of the empirical research on inequalities in service use has focused on socio-economic inequalities. This chapter pays particular attention to the factors that explain socio-economic inequalities in health and social care service use among older people, and the methodological challenges that their study presents for this segment of the population.

Type
Chapter
Information
Age Discrimination and Diversity
Multiple Discrimination from an Age Perspective
, pp. 183 - 197
Publisher: Cambridge University Press
Print publication year: 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alessie, R.Lusardi, A.Aldershof, T. 1997 Income and wealth over the life cycle: evidence from panel dataReview of Income and Wealth 43 1CrossRefGoogle Scholar
Allin, S.Masseria, C.Mossialos, E. 2009 Measuring socioeconomic differences in use of health care services by wealth versus by incomeAmerican Journal of Public Health 99 1849CrossRefGoogle ScholarPubMed
Allin, S.Masseria, C.Mossialos, E. 2010
Bago d’Uva, T.Jones, A.van Doorslaer, E. 2007
Blakemore, K. 1999 Health and social care needs in minority communities: an over-problematized issue?Health and Social Care in the Community 8 22CrossRefGoogle Scholar
Chui, S.Yu, S. 2001 An excess of culture : the myth of shared care in the Chinese community in BritainAgeing and Society 21 681CrossRefGoogle Scholar
Cookson, R.Dusheiko, M.Hardman, G. 2007 Socioeconomic inequality in small area use of elective total hip replacement in the English National Health Service in 1991 and 2001Journal of Health Services Research and Policy 12 10CrossRefGoogle ScholarPubMed
Cooper, Z. N.McGuire, A.Jones, S.Le Grand, J. 2009 Equity, waiting times and the NHS reformsBMJ 339 b3264CrossRefGoogle ScholarPubMed
Costa-Font, J. 2008 Housing assets and the socio-economic determinants of health and disability in old ageHealth and Place 14 478CrossRefGoogle ScholarPubMed
Crystal, S.Shea, D. 1990 The economic well-being of the elderlyReview of Income and Wealth 36 227CrossRefGoogle Scholar
Culyer, A. J. 1993 Health, health expenditures, and equityvan Doorslaer, E.Wagstaff, A.Rutten, F.Equity in the Finance and Delivery of Health Care: An International PerspectiveOxford University Press299Google Scholar
Culyer, A. J.Wagstaff, A. 1993 Equity and equality in health and health careJournal of Health Economics 12 431CrossRefGoogle ScholarPubMed
Dixon, A.Le Grand, J.Henderson, J.Murray, R.Poteliakhoff, E. 2007 Is the British National Health Service equitable? The evidence on socio-economic differences in utilisationJournal of Health Services Research and Policy 12 104CrossRefGoogle Scholar
Fernandez, J. -L.Forder, J. 2008 Consequences of local variations in social care on the performance of the acute health care sectorApplied Economics 40 1503CrossRefGoogle Scholar
Fernandez, J. -L.Forder, J.Trukeschitz, B.Rokosová, M.McDaid, D. 2009 How Can European States Design Efficient, Equitable and Sustainable Funding Systems for Long-term Care for Older People?CopenhagenWorld Health OrganizationGoogle Scholar
Fernandez, J. L.McDaid, D.Kite, J.Schmidt, A.Park, A.Knapp, M. 2008
Forder, J. 2009 Long-term care and hospital utilisation by older people: an analysis of substitution ratesHealth Economics 18 1322CrossRefGoogle ScholarPubMed
Forder, J.Fernandez, J. -L. 2009 Analysing Costs and Benefits of Social Care Funding Arrangements in England: Technical ReportCanterburyPSSRUGoogle Scholar
Goddard, M.Smith, P. 2001 Equity of access to health care services: theory and evidence from UKSocial Science and Medicine 53 1149CrossRefGoogle ScholarPubMed
Hanratty, B.Drever, F.Jacoby, A.Whitehead, M. 2007 Retirement age caregivers and deprivation of area of residence in England and WalesEuropean Journal of Ageing 4 35CrossRefGoogle ScholarPubMed
Ikegami, N. 2004 Using residential assessment instrument minimum data set care planning instruments in community and institutional care: introduction by chairGeriatrics and Gerontology International 4 S271CrossRefGoogle Scholar
Johnston, D. W.Propper, C.Shields, M. A. 2009 Comparing subjective and objective measures of health: evidence from hypertension for the income/health gradientJournal of Health Economics 28 540CrossRefGoogle ScholarPubMed
Laudicella, M.Cookson, R.Jones, A. M.Rice, N. 2009 Health care deprivation profiles in the measurement of inequality and inequity: an application to GP fundholding in the English NHSJournal of Health Economics 28 1048CrossRefGoogle ScholarPubMed
Lindeboom, M.van Doorslaer, E. 2004 Cut-point shift and index shift in self-reported healthJournal of Health Economics 23 1083CrossRefGoogle ScholarPubMed
Mackenbach, J. P.Bos, V.Andersen, O.Cardano, M.Costa, G.Harding, S.Reid, A.Hemstrom, O.Valkonen, T.Kunst, A. E. 2003 Widening socioeconomic inequalities in mortality in six western European countriesInternational Journal of Epidemiology 32 830CrossRefGoogle ScholarPubMed
Malley, J.Fernandez, J. L. 2010 Measuring quality in social care services: theory and practiceAnnals of Public and Cooperative Economics 81 559CrossRefGoogle Scholar
Marmot, M. G.Shipley, M. J. 1996 Do socioeconomic differences in mortality persist after retirement? 25 year follow up of civil servants from the first Whitehall studyBMJ 313 1177CrossRefGoogle ScholarPubMed
Marmot, M.Wilkinson, R. 1999 The Social Determinants of HealthOxford University PressGoogle Scholar
Mold, F.Fitzpatrick, J. M.Roberts, J. D. 2005 Minority ethnic elders in care homes: a review of the literatureAge and Ageing 34 107CrossRefGoogle ScholarPubMed
Morris, S.Sutton, M.Gravelle, H. 2003 Inequity and Inequality in the Use of Health Care in England: An Empirical InvestigationYorkCentre for Health Economics, University of YorkGoogle Scholar
Munn-Giddings, C.McVicar, A. 2006 Self-help groups as mutual support: what do carers value?Health and Social Care in the Community 15 26Google Scholar
Musgrave, R. A. 1959 The Theory of Public Finance: A Study in Public EconomyNew YorkMcGraw-HillGoogle Scholar
O’Donnell, O.Van Doorsslaer, E.Wagstaff, A.Lindelöw, M. 2008 Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and Their ImplementationWashington, DCWorld Bank PublicationsGoogle Scholar
Reid, R. J.MacWilliam, L.Verhulst, L.Roos, N.Atkinson, M. 2001 Performance of the ACG case-mix system in two Canadian provincesMedical Care 39 86CrossRefGoogle ScholarPubMed
Sen, A. 2002 Health: perception versus observationBMJ 324 860CrossRefGoogle ScholarPubMed
Siciliani, L.Verzulli, R. 2009 Waiting times and socioeconomic status among elderly Europeans: evidence from SHAREHealth Economics 18 1295CrossRefGoogle ScholarPubMed
Spandler, H.Vick, N. 2006 Opportunities for independent living using direct payments in mental healthHealth and Social Care in the Community 14 107CrossRefGoogle ScholarPubMed
Sutton, M.Carr-Hill, R.Gravelle, H.Rice, N. 1999 Do measures of self-reported morbidity bias the estimation of the determinants of health care utilization?Social Science and Medicine 49 867CrossRefGoogle Scholar
van Ourti, T. 2003 Socio-economic inequality in ill-health amongst the elderly: should one use current or permanent income?Journal of Health Economics 22 219CrossRefGoogle ScholarPubMed
Wagstaff, A.van Doorslaer, E. 2000 Equity in health care finance and deliveryCulyer, A. J.Newhouse, J. P.Handbook of Health EconomicsAmsterdamNorth-Holland1803Google Scholar
Wagstaff, A.van Doorslaer, E.Watanabe, N. 2003 On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in VietnamJournal of Econometrics 112 207CrossRefGoogle Scholar
Wanless, D.Forder, J.Fernandez, J. -L.Poole, T.Beesley, L.Henwood, M.Moscone, F. 2006 Securing Good Care for Older People: Taking a Long Term ViewLondonKing’s FundGoogle Scholar
Windmeijer, F. A. G.Santos Silva, J. M. C. 1997 Endogeneity in count data models: an application to demand for health careJournal of Applied Econometrics 12 2813.0.CO;2-1>CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×