Inequity in a market-based health system: evidence from Canada's dental sector

Michel Grignon (), Jeremiah Hurley, Li Wang () and Sara Allin ()
Additional contact information
Li Wang: Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University
Sara Allin: London School of Economics and Political Science, European Observatory on Health Systems and Policies

No 2008-05, Centre for Health Economics and Policy Analysis Working Paper Series from Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada

Abstract: We study the extent and drivers of income-related inequity in utilization of dental services in Canada using the concentration-index approach that has been widely applied to study equity in physician and hospital services. Because dental care is almost wholly privately financed in Canada, our estimates provide a benchmark for income-related inequity of utilization in private health systems. Although a number of studies document a link between income and utilization, our study is one of the few measuring income-related inequity in dental care utilization. A unique feature of our study is that we analyze separately equity in total dental visits and in preventive visits. This is important because the case for equity is much clearer for preventive dental care. We also examine the impact of controlling for need using a wider variety of need indicators than previous analyses. We confirm that most oral health indicators perform poorly as need adjustors because they reflect past dental care use: individuals with higher levels of utilization also are in better oral health. Our most important finding is that access to preventive care is the most pro-rich type of dental care utilization and that income-related inequity in preventive dental care utilization is three times larger than what is measured for specialist services utilization in Canada.

Keywords: Canada; Equity; Dental care; Prevention (search for similar items in EconPapers)
Date: 2008
New Economics Papers: this item is included in nep-hea and nep-ias
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Citations: View citations in EconPapers (1)

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Journal Article: Inequity in a market-based health system: Evidence from Canada's dental sector (2010)
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