Health policies and data

OECD Study on Measuring Equity of Access to Health Care


1) To provide up-to-date comparative information on income-related equity of access to health care among OECD countries.

2) To examine causes of variations by looking at selected health system characteristics (eg., insurance coverage and geographic variations in the availability/use of resources) and other socio-economic factors (eg., education).


This study was conducted under the direction of Professor Eddy van Doorslaer (Erasmus University, Rotterdam). It followed generally the method that Professor van Doorslaer developed in the paper "Explaining income-related inequalities in doctor utilisation in Europe: a decomposition approach" (a paper prepared under the ECuity II project funded by the European Community).

The study measured access to selected health care services by the actual use of these services (self-reported). The focus is on variations in utilisation across income groups (eg., income quintiles). Health status measures (eg., self-rated general health, self-reported activity limitations) were used to adjust for differences in morbidity or "need" across income groups. The health care utilisation variables that considered in this study are: 1) consultations with doctors, breaking down visits to general practitioners and to specialists where possible; 2) hospital utilisation; and 3) consultations with dentists.

The main data source were national population household surveys (for European Union countries, the European Community Household Panel will be used, except for France). More than 20 OECD countries will be covered in this study (the 15 European Union countries, Australia, Canada, Hungary, Mexico, Norway, Switzerland and the United States).

The final report from this study has been released as Health Working Paper No. 14, titled "Income-related inequality in the use of medical care in 21 OECD countries".


Mr. Gaetan Lafortune, OECD Health Division.


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