Measuring health care access and its inequality: A decomposition approach

Abstract

We introduce a new method for assessing health care access disparities, focusing on the ‘Access Gap’. This gap represents the difference between the (out-of-pocket) cost of access to adequate health care and available financial resources. Our method quantifies this gap for groups with similar characteristics, using indicators like the Gini coefficient and Entropy for overall inequality analysis. Applied to breast cancer treatment in Italy, we consider geographic location as the primary distinguishing characteristic for individual groups. The analysis covers costs of transportation, accommodation, doctor consultations, diagnostic tests, and non-oncology drugs. Financial resource distribution data comes from the Bank of Italy. Our findings show a pronounced Access Gap in Italy’s southern regions, particularly in Campania. We decompose this gap to understand the influence of supply-side (provider distribution) and demand-side (health spending capacity) factors. The results indicate that disparities in access are mainly driven by demand-side elements, specifically regional spending capacity variations.