The horizontal equity of health care in New Zealand

Objective: Given that 'equal access for equal need' is a clearly articulate d goal of the New Zealand public health system, this study is an attempt to determine if access to public health care services in New Zealand is, for people of equal health need, independent of income. Method: Information on health status, income and health service utilisation for just over 6,000 New Zealanders was obtained from the national Househol d Health Survey 1992-93. Using standardised expenditure concentration curve s and a concentration index, the distribution of health service use by indi viduals in different income groups, as a proxy for access, was illustrated and quantified. Results: The results suggest either appropriate or slightly excess use of s ervices by the poor given their estimated health need. Due to analytical pr oblems caused by data deficiencies, these results must be regarded as tenta tive. Conclusion: For the period under study, no evidence was found to indicate s ignificant access barriers to publicly funded health care for people on dif ferent incomes. This study has served to demonstrate one approach to measur ing inequality and analysing the relationship between inequality and inequi ty. Given the reforms to the health sector since 1993, ongoing monitoring o f equity of access to health care services is essential. Implications: Given the income-related disparities in health that do exist, the public health community should endeavour to develop techniques to moni tor the delivery of publicly funded health care to ensure that further ineq uity is not borne by the poor.