Inequalities in health care use and expenditures: empirical data from eight developing countries and countries in transition

This paper summarizes eight country studies of inequality in the health sec tor. The analyses use household data to examine the distribution of service use and health expenditures. Each study divides the population into "incom e" quintiles, estimated using consumption expenditures. The studies measure inequality in the use of and spending on health services. Richer groups ar e found to have a higher probability of obtaining care when sick, to be mor e likely to be seen by a doctor, and to have a higher probability of receiv ing medicines when they are ill, than the poorer groups. The richer also sp end more in absolute terms on care. in several instances there are unexpect ed findings. There is no consistent pattern in the use of private providers . Richer households do not devote a consistently higher percentage of their consumption expenditures to health care. The analyses indicate that intuit ion concerning inequalities could result in misguided decisions. It would t hus be worthwhile to measure inequality to inform policy-making. Additional research could be performed using a com mon methodology for the collection of data and applying more sophisticated analytical techniques. These analy ses could be used to measure the impact of health policy changes on inequal ity.