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Exploring the pathways of inequality in health, health care access and financing in decentralized Spain.
- Source :
- Journal of European Social Policy; Dec2009, Vol. 19 Issue 5, p446-458, 13p, 2 Charts, 4 Graphs
- Publication Year :
- 2009
-
Abstract
- The regional organization of the Spanish national health system offers a 'unique field' for exploring the sources of health inequalities as well as for testing the effects of political decentralization on health and healthcare inequalities. Drawing from the results of an empirical analysis where inequalities in three dimensions of health (outcome), healthcare (access) and healthcare payments (financing) are estimated, this article first explores the association between three such inequality dimensions alongside other system and socio-economic controls. Second, we examine whether the first wave of asymmetric healthcare devolution which took place in Spain between (1980-2001) -- whereby health policy responsibilities were transferred to a few region states (autonomous communities [ACs]) -- correlates with higher inequalities in health, healthcare and health financing. Our findings suggest that inequalities in health and healthcare appear to be driven by income inequalities and inequalities in use but not by inequalities in financing and health expenditure. Region states politically responsible for the organization of healthcare did not exhibit significant differences in health and healthcare inequalities and tend to exhibit a better equity performance. [ABSTRACT FROM AUTHOR]
- Subjects :
- MEDICAL care
EQUALITY
SOCIOECONOMICS
HEALTH policy
ORGANIZATION
Subjects
Details
- Language :
- English
- ISSN :
- 09589287
- Volume :
- 19
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Journal of European Social Policy
- Publication Type :
- Academic Journal
- Accession number :
- 45142745
- Full Text :
- https://doi.org/10.1177/0958928709344289