Inequalities in health care use and expenditures: Empirical data from eight developing countries and countries in transition

M. Makinen, H. Waters, M. Rauch, N. Almagambetova, R. Bitran, L. Gilson, D. Mclntyre, S. Pannarunothai, A. L. Prieto, G. Ubilla, S. Ram

Research output: Contribution to journalArticlepeer-review

220 Scopus citations


This paper summarizes eight country studies of inequality in the health sector. The analyses use household data to examine the distribution of service use and health expenditures. Each study divides the population into 'income' quintiles, estimated using consumption expenditures. The studies measure inequality in the use of and spending on health services. Richer groups are found to have a higher probability of obtaining care when sick, to be more likely to be seen by a doctor, and to have a higher probability of receiving medicines when they are ill, than the poorer groups. The richer also spend more in absolute terms on care. In several instances there are unexpected findings. There is no consistent pattern in the use of private providers. Richer households do not devote a consistently higher percentage of their consumption expenditures to health care. The analyses indicate that intuition concerning inequalities could result in misguided decisions. It would thus be worthwhile to measure inequality to inform policy-making. Additional research could be performed using a common methodology for the collection of data and applying more sophisticated analytical techniques. These analyses could be used to measure the impact of health policy changes on inequality.

Original languageEnglish (US)
Pages (from-to)55-65
Number of pages11
JournalBulletin of the World Health Organization
Issue number1
StatePublished - 2000
Externally publishedYes


  • Health expenditures
  • Health policy
  • Health services accessibility
  • Patient acceptance of health care
  • Social justice

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Inequalities in health care use and expenditures: Empirical data from eight developing countries and countries in transition'. Together they form a unique fingerprint.

Cite this