ECuity Project

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The ECuity Project, now in its third phase, compares inequality and inequity in health and health care across countries.

What is equity? The project has explored how equity is defined by medical and political philosophers, policy makers and academic researchers. It has developed a set of methodologies to provide practical tools for the measurement and explanation of inequality and inequity.

Equity in health care finance

Countries vary in their financing mixes. Some emphasize taxes, others emphasize social insurance, others still emphasize private sources private insurance and out-of-pocket payments. These sources vary in their progressivity: income taxes, for example, are often concentrated amongst the better-off, whilst the poor pay a very large share of out-of-pocket payment payments. Sources also vary in the degree to which they achieve horizontal equity: with private sources there is typically a much larger variation in payments at a given income level.

Equity in health care delivery

Are people in equal need of health care treated the same, irrespective of how well-off they are? And does the degree to which this is true vary from country to country? Are the differences related to features of the health care systems of the countries? Answering these questions requires measures of equity in health care delivery. In addition to developing these, the project has also produced comparable results on equity in health care delivery for several OECD countries. The project is also analysing inequalities in access conditions how, for example, insurance coverage and the liability for out-of-pocket payments varies across income groups and the effects of inequalities in access on utilization.

Inequalities in health

Do the better-off enjoy better health than the poor? Do health inequalities vary across countries? What causes differences in health inequalities between countries? Getting answers to these questions requires measures of health inequality. In addition to developing these, the project has also produced comparable results on health inequalities for several countries, and is also analysing the socioeconomic determinants of health at the individual level.