The unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach
Abstract Background The Great Recession, starting in 2008, was characterized by an overall reduction in living standards. This pushed several governments across Europe to restrict expenditures, also in the area of healthcare. These austerity measures are known to have affected access to healthcare,...
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ftdoajarticles:oai:doaj.org/article:c210989b0a5744aeb56f8d557048f3ab 2023-05-15T16:48:02+02:00 The unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach Lore Torfs Stef Adriaenssens Susan Lagaert Sara Willems 2021-03-01T00:00:00Z https://doi.org/10.1186/s12939-021-01412-7 https://doaj.org/article/c210989b0a5744aeb56f8d557048f3ab EN eng BMC https://doi.org/10.1186/s12939-021-01412-7 https://doaj.org/toc/1475-9276 doi:10.1186/s12939-021-01412-7 1475-9276 https://doaj.org/article/c210989b0a5744aeb56f8d557048f3ab International Journal for Equity in Health, Vol 20, Iss 1, Pp 1-10 (2021) Economic recession Austerity Access to healthcare Unmet medical needs Inequity in health Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1186/s12939-021-01412-7 2022-12-31T06:30:19Z Abstract Background The Great Recession, starting in 2008, was characterized by an overall reduction in living standards. This pushed several governments across Europe to restrict expenditures, also in the area of healthcare. These austerity measures are known to have affected access to healthcare, probably unevenly among social groups. This study examines the unequal effects of retrenchment in healthcare expenditures on access to medical care for different income groups across European countries. Method Using data of two waves (2008 and 2014) of the European Union Statistics of Income and Living Conditions survey (EU-SILC), a difference-in-differences (DD) approach was used to analyse the overall change in unmet medical needs over time within and between countries. By adding another interaction, the differences in the effects between income quintiles (difference-in-difference-in-differences: DDD) were estimated. To do so, comparisons between two pairs of a treatment and a control case were made: Iceland versus Sweden, and Ireland versus the United Kingdom. These comparisons are made between countries with recessions equal in magnitude, but with different levels of healthcare cuts. This strategy allows isolating the effect of cuts, net of the severity of the recession. Results The DD-estimates show a higher increase of unmet medical needs during the Great Recession in the treatment cases (Iceland vs. Sweden: + 3.24 pp.; Ireland vs. the United Kingdom: + 1.15 pp). The DDD-estimates show different results over the two models. In Iceland, the lowest income groups had a higher increase in unmet medical needs. This was not the case in Ireland, where middle-class groups saw their access to healthcare deteriorate more. Conclusion Restrictions on health expenditures during the Great Recession caused an increase in self-reported unmet medical needs. The burden of these effects is not equally distributed; in some cases, the lower-income groups suffer most. The case of Ireland, nevertheless, shows that certain policy ... Article in Journal/Newspaper Iceland Directory of Open Access Journals: DOAJ Articles International Journal for Equity in Health 20 1 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Economic recession Austerity Access to healthcare Unmet medical needs Inequity in health Public aspects of medicine RA1-1270 |
spellingShingle |
Economic recession Austerity Access to healthcare Unmet medical needs Inequity in health Public aspects of medicine RA1-1270 Lore Torfs Stef Adriaenssens Susan Lagaert Sara Willems The unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach |
topic_facet |
Economic recession Austerity Access to healthcare Unmet medical needs Inequity in health Public aspects of medicine RA1-1270 |
description |
Abstract Background The Great Recession, starting in 2008, was characterized by an overall reduction in living standards. This pushed several governments across Europe to restrict expenditures, also in the area of healthcare. These austerity measures are known to have affected access to healthcare, probably unevenly among social groups. This study examines the unequal effects of retrenchment in healthcare expenditures on access to medical care for different income groups across European countries. Method Using data of two waves (2008 and 2014) of the European Union Statistics of Income and Living Conditions survey (EU-SILC), a difference-in-differences (DD) approach was used to analyse the overall change in unmet medical needs over time within and between countries. By adding another interaction, the differences in the effects between income quintiles (difference-in-difference-in-differences: DDD) were estimated. To do so, comparisons between two pairs of a treatment and a control case were made: Iceland versus Sweden, and Ireland versus the United Kingdom. These comparisons are made between countries with recessions equal in magnitude, but with different levels of healthcare cuts. This strategy allows isolating the effect of cuts, net of the severity of the recession. Results The DD-estimates show a higher increase of unmet medical needs during the Great Recession in the treatment cases (Iceland vs. Sweden: + 3.24 pp.; Ireland vs. the United Kingdom: + 1.15 pp). The DDD-estimates show different results over the two models. In Iceland, the lowest income groups had a higher increase in unmet medical needs. This was not the case in Ireland, where middle-class groups saw their access to healthcare deteriorate more. Conclusion Restrictions on health expenditures during the Great Recession caused an increase in self-reported unmet medical needs. The burden of these effects is not equally distributed; in some cases, the lower-income groups suffer most. The case of Ireland, nevertheless, shows that certain policy ... |
format |
Article in Journal/Newspaper |
author |
Lore Torfs Stef Adriaenssens Susan Lagaert Sara Willems |
author_facet |
Lore Torfs Stef Adriaenssens Susan Lagaert Sara Willems |
author_sort |
Lore Torfs |
title |
The unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach |
title_short |
The unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach |
title_full |
The unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach |
title_fullStr |
The unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach |
title_full_unstemmed |
The unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach |
title_sort |
unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach |
publisher |
BMC |
publishDate |
2021 |
url |
https://doi.org/10.1186/s12939-021-01412-7 https://doaj.org/article/c210989b0a5744aeb56f8d557048f3ab |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
International Journal for Equity in Health, Vol 20, Iss 1, Pp 1-10 (2021) |
op_relation |
https://doi.org/10.1186/s12939-021-01412-7 https://doaj.org/toc/1475-9276 doi:10.1186/s12939-021-01412-7 1475-9276 https://doaj.org/article/c210989b0a5744aeb56f8d557048f3ab |
op_doi |
https://doi.org/10.1186/s12939-021-01412-7 |
container_title |
International Journal for Equity in Health |
container_volume |
20 |
container_issue |
1 |
_version_ |
1766038134191030272 |