Measuring health care equity within local health systems: an application to secondary care in England

Abstract: The fair allocation of national health care budgets to local health systems is essential, but not sufficient to guarantee that services and resources reach those who most need them. Whilst there is a growing literature on methods to determine equitable budgets, there is still limited evidence on differences in health care equity between and within systems that receive them. We computed a set of inequality indices for Clinical Commissioning Groups (CCGs) and GP practices in 2015 and 2018 in England. We benchmarked general and acute and mental health care service use with the relative need estimated from the formulae determining the allocation of budgets to Clinical Commissioning Groups. As expected, measured equity varies for the same CCG or GP practice depending on the index used. There is large variation in equity between CCGs and even more between GP practices within the same CCG. Methodological considerations and associations between equity and systems characteristics will be discussed.

Profile: https://research.manchester.ac.uk/en/persons/laura.anselmi