Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-25T09:01:47.102Z Has data issue: false hasContentIssue false
  • English
  • Français

Equity in Health and Social Care*

Published online by Cambridge University Press:  20 January 2009

Maria Evandrou ,
Jane Falkingham ,
Julian Le Grand  and
David Winter
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper studies equity in the distribution of primary health care and domiciliary care for elderly people. The main data source is the 1980 GHS which has been linked to local authority data. An equitably distributed service is defined as one in which only variables which measure respondent's need for the service provide a significant explanation of whether the respondent receives the service. In the case of primary health care we find that for a number of groups defined by gender and age, economic and demographic variables have significant explanatory power. For two groups (males under 41 and females between 40 and 60), need was the only significant variable. For domiciliary care not only are variables which relate to the respondent's demographic and economic status significant but also variables which are concerned with local authorities' policies concerning supply. In general neither service is distributed equitably in the sense defined.

Type
Articles
Information
Journal of Social Policy , Volume 21 , Issue 4 , October 1992 , pp. 489 - 523
Copyright
Copyright © Cambridge University Press 1992

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

REFERENCES

Association of Directors of Social Services (ADSS) (1980), Report of the Second Survey of the Extent and Effect of Cuts/Savings in Expenditure on the Personal Social Services, Newcastle-upon-Tyne.Google Scholar
Bebbington, A.C. and Davies, B. (1983), ‘Equity and efficiency in the allocation of personal social services’, Journal of Social Policy, 12, 309–30.Google Scholar
Bramley, G., Grand, J. Le and Low, W. (1990), ‘How far is the poll tax a “community charge”? The implications of service usage evidence’, Policy and Politics, 17, 187–205.Google Scholar
Cartwright, A. (1967), Patients and their Doctors: A Study of General Practice, Routledge and Kegan Paul, London.Google Scholar
Chesher, A.D. (1984), ‘Testing for neglected heterogeneity’, Econometrica, 52:4, 865–72.Google Scholar
Chartered Institute of Public Finance and Accounting (CIPFA) (1980a), Rate Collection Statistics 1979/80 (Actuals), CIPFA, London.Google Scholar
CIPFA (1980b), Personal Social Services Statistics 1979/80 (Actuals), CIPFA, London.Google Scholar
CIPFA (1981a), Rate Collection Statistics 1980/81 (Actuals), CIPFA, London.Google Scholar
CIPFA (1981b), Personal Social Services Statistics 1980/81 (Actuals), CIPFA, London.Google Scholar
Collins, E. and Klein, R. (1980), ‘Equity and the NHS’, British Medical Journal, 281, 1111–15.Google Scholar
Cooper, M.H. (1975), Rationing Health Care, Croom Helm, London.Google Scholar
Culyer, A.J. (1976), Need and the National Health Service, Martin Robertson, Oxford.Google Scholar
Deacon, R.T. and Sonstelie, J. (1985), ‘Rationing by waiting and the value of time: results from a natural experiment’, Journal of Political Economy, 93, 627–47.CrossRefGoogle Scholar
Department of Health and Social Security (DHSS) (1976), Sharing Resources for Health in England, HMSO, London.Google Scholar
Evandrou, M. (1987), ‘The use of domiciliary services by the elderly: a survey’, Welfare State Programme Discussion Paper WSP/49, London School of Economics.Google Scholar
Evandrou, M. (1992), ‘Challenging invisibility of carers: mapping informal care nationally’, in Laczko, F. and Victor, C.R. (eds), Social Policy and Elderly People: The Role of Community Care, Avebury, Aldershot.Google Scholar
Evandrou, M., Arber, S., Dale, A. and Gilbert, G.N. (1985), ‘Who cares for the elderly?: family care provision and receipt of statutory services’, paper presented at the Annual Conference of the British Society of Gerontology, September 1985, Keele University, published in part in C. Phillipson, M. Bernard and P. Strang (eds) (1986), Dependency and Interdependence in Old Age: Theoretical Perspectives and Policy Alternatives, Croom Helm, London.Google Scholar
Evandrou, M. and Falkingham, J. (1987), ‘Linking local authority information to the General Household Survey’, Welfare State Programme Research Note WSP/RN/9, London School of Economics.Google Scholar
Evandrou, M. and Victor, C.R. (1989), ‘Differentiation in later life: social class and housing tenure cleavages’, in Bytheway, B., Keil, T., Allatt, P. and Bryman, A. (eds), Becoming and Being Old: Sociological Approaches to Later Life, Sage, London.Google Scholar
Evandrou, M., Falkingham, J., Grand, J. Le, Winter, D. (1990), ‘Equity in health and social care’, Welfare State Programme Discussion Paper WSP/52, London School of Economics.Google Scholar
Forster, D.P. (1976), ‘Social class differences in sickness and general practitioner consultations’, Health Trends, 8, 29–32.Google Scholar
Goodin, R. and Grand, J. Le (1987), Not Only the Poor, Allen and Unwin, London.Google Scholar
Hunt, A. (1978), The Elderly at Home, HMSO, London.Google Scholar
Hyman, M. (1980), The Home-help Service: A Case History Study in the London Borough of Redbridge, Redbridge Social Services Department, Ilford.Google Scholar
Judge, K. (1978), Rationing Social Care, Heinemann, London.Google Scholar
Judge, K. and Matthews, J. (1980), Charging for Social Care: A Study of Consumer Charges, Allen and Unwin, London.Google Scholar
Grand, J. Le (1978), ‘The distribution of public expenditure: the case of health care’, Economica, 45, 125–42.Google Scholar
Grand, J. Le (1982), The Strategy of Equality, Allen and Unwin, London.Google Scholar
Midwinter, E. (1986), Caring for Cash: The Issue of Private Domiciliary Care, Centre for Policy on Ageing.Google Scholar
Morris, V. (1986), ‘Local authority review: some questions of distribution and allocation’, working paper submitted to the Joseph Rowntree Memorial Trust.Google Scholar
O'Donnell, O. and Propper, C. (1991), ‘Equity and distribution of UK National Health Service resources’, Journal of Health Economics, 10, 1–20.CrossRefGoogle ScholarPubMed
OPCS (1984), General Household Survey 1982, HMSO, London.Google Scholar
Orme, O. (1989), ‘The calculation of the information matrix test for binary data models’, The Manchester School, LVI:4, 370–76.Google Scholar
Parkin, D. (1979), ‘Distance as an influence on demand in general practice’, Journal of Epidemiology and Community Health, 33, 96–99.CrossRefGoogle ScholarPubMed
Puffer, F. (1986), ‘Access to primary health care: a comparison of the U.S. and the U.K.’, Journal of Social Policy, 15:3, 293–314.CrossRefGoogle Scholar
Puffer, F. (1987), ‘The effect of regional and class difference in the UK on access to health care’, paper presented to the Health Economist's Study Group, University of Warwick.Google Scholar
Ritchie, J., Jacoby, A. and Bone, M. (1981), Access to Primary Health Care, OPCS, Social Survey Division, HMSO, London.Google Scholar
Royal Commission on the Distribution of Income and Wealth (1978), Lower Incomes, Report No.6, Cmnd.7175, HMSO, London.Google Scholar
Townsend, P. and Wedderburn, D. (1965), The Aged in the Welfare State, G. Bell and Sons, London.Google Scholar
Victor, C.R. and Evandrou, M. (1987), ‘Does social class matter in later life?’, in di Gregorio, S. (ed.), Social Gerontology: New Directions, Croom Helm, London.Google Scholar
Walters, V. (1980), Class, Inequality and Health Care, Croom Helm, London.Google Scholar
Wenger, C. O. (1985), ‘Care in the community. Changes in dependency and use of domiciliary services: a longitudinal perspective’, Ageing and Society, 5, 143–59.Google Scholar
White, H. (1982), ‘Maximum likelihood estimation for misspecified models’, Econometrica, 50:1, 1–25.Google Scholar
Whitehouse, C.R. (1985), ‘Effect of distance from surgery on consultation rates in an urban practice’, British Medical Journal, 290, 359–62.Google Scholar
Wright, F. (1983), ‘Single carers: employment, housework and caring’, in Finch, J. and Groves, D. (eds), A Labour of Love: Women, Work and Caring, Routledge and Kegan Paul, London.Google Scholar