Abstract
The existence of geographic differences in health resources, health expenditures, the utilization of health services, and health outcomes have been documented by a lot of studies from various countries of the world. In a publicly financed health system, equal access is one of the main objectives of the national health policy. That is why inequalities in the geographic allocation of health resources are an important health policy issue. Measures of inequality express the complexity of variation in the observed variable by a single number, and there is a variety of inequality measures available. The objective of this study is to develop a measure of the geographic inequality in the case of multiple health resources. The measure uses data envelopment analysis (DEA), which is a non-parametric method of production function estimation, to transform multiple resources into a single virtual health resource. The study shows that the DEA originally developed for measuring efficiency can be used successfully to measure inequality. For the illustrative purpose, the inequality measure is calculated for the Czech Republic. The values of separate Robin Hood Indexes (RHIs) are 6.64% for physicians and 3.96% for nurses. In the next step, we use combined RHI for both health resources. Its value 5.06% takes into account that the combinations of two health resources serve regional populations.
Highlights
There is no doubt that in a publicly financed health system, equal access to health services is one of the main objectives of the national health policy [1, 2]
Analyzing the geographic distribution of health resources that are necessary for the provision of health services is about measuring variations
The objective of this study is to develop a measure of the geographic inequality in the case of multiple health resources
Summary
There is no doubt that in a publicly financed health system, equal access to health services is one of the main objectives of the national health policy [1, 2]. The question is whether the observed variations in health resources reflect the variations in the real health needs of the regional population. If it is not the case, the resource variations are a sign of health policy failure provided that equal geographic access was stated as a policy objective. European health systems are mostly publicly funded and highly regulated; the unequal distribution is a consequence of wrong public regulation
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