Estimates of Healthcare – An Investigation with Probit Model

Abstract

Health systems with universal health care coverage aspire to achieve horizontal equity, commonly defined as equal access to health care services for equal need. While equal access presupposes that individuals are given equal opportunities to access services, the goal of equal utilization for equal need implies a different set of conditions. Although inequity in utilization may not solely reflect inappropriate or unfair differentials in service use, revealing instead different preferences or culture (Oliver and Mossialos 2004), it is the measure of equity most commonly studied to date. In this paper we investigate utilization of health services in the absence of data on access, consistent with other studies. There has been considerable research in the area of equity in utilization of health services in past decades focussing on the general adult population and using cross-sectional data sources. Studies in the India are not conclusive, although they suggest that utilization of primary care and hospital  services, after adjusting for health care need, is  equitable or pro-poor, whereas preventive and specialist care tends to favour the better off. Some empirical studies and reviews of the literature contend that GP and inpatient service use is pro-poor (O'Donnell and Propper 1991; Propper 1998; Goddard and Smith 2001; Dixon et al 2006. Several European studies have investigated socio-economic differences in the use of services among the older population after adjusting for self-reported health status.