Access Type
Open Access Dissertation
Date of Award
January 2012
Degree Type
Dissertation
Degree Name
Ph.D.
Department
Economics
First Advisor
Allen C. Goodman
Abstract
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.
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.
Recommended Citation
Devkota, Satis Chandra, "Inequality in health care utilization and equity: a cross-country comparision of low and middle income countries" (2012). Wayne State University Dissertations. 537.
https://digitalcommons.wayne.edu/oa_dissertations/537