Horizontal equity in the Australian healthcare system

Mohammad Pulok is a PhD candidate from the Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), Australia. The Australian Institute Health and Welfare (AIHW) is the industry partner of his PhD study. Mohammad’s PhD is funded by Capital Markets Cooperative Research Centre’s PhD stipend and UTS international research scholarship. He has completed MSc. in Health Economics and Policy from Barcelona Graduate School of Economics, Spain on top of his MSc. Degree in Economics from Stockholm University, Sweden. Mohammad’s primary research area is equity in health and healthcare. He is currently a visiting PhD student at the Institute of Health Policy, Management and Evaluation, the University of Toronto.

Abstract

Horizontal equity (equal care for equal need irrespective of socioeconomic background) is the cornerstone of Medicare, the tax-funded universal health insurance system of Australia. The aim of my PhD is to assess the fairness of Medicare to deliver healthcare services in an era of greater private healthcare financing in Australia. This presentation will summarise the empirical findings from four papers to provide a comprehensive overview of horizontal inequity in healthcare service delivery in Australia. The first paper uses two latest National Health Surveys to revisit horizontal inequity in eight indicators of healthcare utilization. The second paper examines the role of area level socioeconomic status and private health insurance to explain horizontal inequity of GP and specialist visits. The third study demonstrates the usefulness and importance of using of administrative data to examine inequity in health service use. The extent of area level socioeconomic inequality as well as spatial variation in the observed inequality of specialist services is studied using Medicare Benefit Schedule data. The final paper is specific to study horizontal inequity of healthcare utilization within the Indigenous community of Australia. The general conclusion is that inequity in GP visit has become slightly pro-rich for the first time in Australia while inequity in specialist consultation has continued to be favourable for the better-off people. Additionally, locality of living and private health insurance status matter to explain this pro-rich inequity.