Horizontal Inequity in Elderly Health Care Utilization: Evidence from India.
Against the backdrop of population aging, this paper presents the analysis of need-standardised health care utilization among elderly in India. Based on nationally representative morbidity and health care survey 2004, we demonstrate that the need for health care utilization is indeed pro-poor in nature. However, the actual health care utilization is concentrated among richer sections of the population. Further, the decomposition analysis reveals that income has a very strong role in shifting the distribution of health care away from the poor elderly. The impact of income on utilization is well-demonstrated even at the ecological-level as states with higher per capita incomes have higher elderly health care utilization even as the levels of need-predicted distribution across these states are similar. We also find that the distribution of elderly across social groups and their educational achievements favours the rich and significantly contributes to overall inequality. Nevertheless, contribution of need-related self-assessed health clearly favours pro-poor inequality. In concluding, we argue that to reduce such inequities in health care utilization it is necessary to increase public investments in health care infrastructure including geriatric care particularly in rural areas and underdeveloped regions to enhance access and quality of health care for the elderly.
['Joe|William|W|', 'Rudra|Shalini|S|', 'Subramanian|S V|SV|']
D000368:Aged D000369:Aged, 80 and over D003466:Cultural Characteristics D019317:Evidence-Based Medicine D005260:Female D015276:Health Care Rationing D000069576:Health Equity D006299:Health Services for the Aged D006801:Humans D007182:Income D007194:India D008297:Male D008875:Middle Aged D012959:Socioeconomic Factors D014600:Utilization Review
Health Care Aged Surveys Delivery of Health Care Socioeconomic Factors