Documents Asaria, Miqdad 3 results

"Background There are substantial socioeconomic inequalities in both life expectancy and healthcare use in England. In this study, we describe how these two sets of inequalities interact by estimating the social gradient in hospital costs across the life course.Methods Hospital episode statistics, population and index of multiple deprivation data were combined at lower-layer super output area level to estimate inpatient hospital costs for 2011/2012 by age, sex and deprivation quintile. Survival curves were estimated for each of the deprivation groups and used to estimate expected annual costs and cumulative lifetime costs.Results A steep social gradient was observed in overall inpatient hospital admissions, with rates ranging from 31?298/100?000 population in the most affluent fifth of areas to 43?385 in the most deprived fifth. This gradient was steeper for emergency than for elective admissions. The total cost associated with this inequality in 2011/2012 was

Background Provision of universal coverage is essential for achieving equity in healthcare, but inequalities still exist in universal healthcare systems. Between 2004/2005 and 2011/2012, the National Health Service (NHS) in England, which has provided universal coverage since 1948, made sustained efforts to reduce health inequalities by strengthening primary care. We provide the first comprehensive assessment of trends in socioeconomic inequalities of primary care access, quality and outcomes during this period.Methods Whole-population small area longitudinal study based on 32?482 neighbourhoods of approximately 1500 people in England from 2004/2005 to 2011/2012. We measured slope indices of inequality in four indicators: (1) patients per family doctor, (2) primary care quality, (3) preventable emergency hospital admissions and (4) mortality from conditions considered amenable to healthcare.Results Between 2004/2005 and 2011/2012, there were larger absolute improvements on all indicators in more-deprived neighbourhoods. The modelled gap between the most-deprived and least-deprived neighbourhoods in England decreased by: 193 patients per family doctor (95% CI 173 to 213), 3.29 percentage points of primary care quality (3.13 to 3.45), 0.42 preventable hospitalisations per 1000 people (0.29 to 0.55) and 0.23 amenable deaths per 1000 people (0.15 to 0.31). By 2011/2012, inequalities in primary care supply and quality were almost eliminated, but socioeconomic inequality was still associated with 158?396 preventable hospitalisations and 37?983 deaths amenable to healthcare.Conclusions Between 2004/2005 and 2011/2012, the NHS succeeded in substantially reducing socioeconomic inequalities in primary care access and quality, but made only modest reductions in healthcare outcome inequalities.

"We study whether exposure to COVID-19 has affected individual aversion to health and income inequality in the UK, Italy, and Germany, as well as the effect of personal shocks on employment (redundancies, government replacement salary and unemployment), income and health directly linked to COVID-19. We find that conditioned on risk aversion and relevant covariates (income, education, demographics), individuals who have experienced either a health or an financial shock during the COVID-19 pandemic, exhibit lower inequality aversion in terms of health and income, compared to those who have not experienced these shocks. Comparing levels of health and income inequality aversion in the UK between the years 2016 and 2020 we find a significant increase in inequality aversion from 2016 to 2020 in both health (17.3%) and income domains (8.8%). However, our difference-in-differences (DiD) for treatment (risk) groups defined in terms of age, region and personal exposure to health and income shocks in 2020 compared to 2016, does not indicate any additional difference in inequality aversion. The exception being individuals who are both in a high-risk age group and at the same time also experienced a health shock in 2020 compared to 2016, which are significantly more inequality averse in both health and income domains."