Health policy and horizontal inequities of health-care utilization in Australia: 1983–2005

Abstract

We used five National Health Surveys (NHSs) in order to measure horizontal inequity (equal health care for equal need) in health-care utilization in Australia over five time points from 1983 to 2005. The direct standardization method was used to estimate the horizontal inequity indices for six measures of health-care utilization. The results suggest that the distributions of General Practitioner (GP) services and any physician visits in Australia were generally pro-poor, whereas the distributions of specialist visits, dentist visits and any ambulatory visits were pro-rich. The computed indices demonstrate that the introduction of Medicare in 1984 had a pro-poor effect on the utilization of GPs, any physician visits and any ambulatory visits. In contrast, the implementation of Private Health Insurance (PHI) policies over the period 1997 to 2000 had a pro-rich effect on the distribution of health-care utilization in recent years, but this finding is based on the assumption that PHI policies affected health-care consumption in the long term.