Inequality in health care utilization and equity: a cross-country comparision of low and middle income countries

<p>This dissertation identifies the sustainable policies that can reduce disparity in health care utilization, education and income from the low and middle income countries represented by Albania, Nepal, Tajikistan and Tanzania. Concentration indices are used to calculate the income related inequality in health care utilization and education, and Gini index is used to calculate the inequality in income. Likewise, horizontal inequity index is used to test whether the principle of equal treatment for equal need and equal schooling for equal need is maintained in all countries under study. Finally, a mechanism is proposed for the first time in the literature to quantify the effect of policy change on disparity. Then this tool is used to quantify the effect of policy change on disparity in health care utilization, education and income. </p> <p>Major findings of this dissertation are: (1) Statistically significant inequality exist in all countries under study and the principle for equal treatment for equal need and equal schooling for equal need are also not fulfilled. (2) Vicious vs. virtuous circle of disparity exist among health care utilization, education and income. For example, an increase in education and income may not always decrease income related inequality in health care utilization. However, if those increases respectively decrease the inequality in education and income first then that could automatically decrease inequality in health care utilization. This fact is equally applicable for the reduction of inequality in education and income. If the changes in policy variable increase the disparity in the same variable that could lead to the vicious circle of disparity among three whereas if that changes reduces disparity in the same variable that could leads to the virtuous circle of disparity among three. (3) Thus, integrated approach of development is sustainable and scalable than single sectoral development policy to eliminate disparity from low and middle income countries represented by Albania, Nepal, Tajikistan and Tanzania.</p>

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Open Access Dissertation

Discipline thesis:degree_discipline

Economics

Year dc:date.available

2012

Author dc:creator

• Devkota, Satis Chandra

Contributors dc:contributor

• Allen C. Goodman

• Africa, Asia and Eastern Europe, Bootstrapping, Concentration index, Horizontal in(equity), Income related inequality, Policy effect of disparity
• Economics

Repository record dc:identifier

https://digitalcommons.wayne.edu/oa_dissertations/537

OAI identifier oai:identifier

oai:digitalcommons.wayne.edu:oa_dissertations-1536