Socio-economic inequalities in the use of healthcare services of the Montevidean elderly individual

  • Ana Balsa University of Miami
  • Daniel Ferres Universidad de Montevideo
  • Máximo Ross Universidad de la República
  • Patricia Triunfo Universidad de la República
Keywords: healthcare inequities, concentration curves, elderly individuals
JEL Classification: I100, I180, I190


This study uses data from the 1999-2000 SABE survey to analyze socioeconomic inequities in healthcare access, utilization, and quality, for a sample of elderly individuals from Montevideo, Uruguay. We find horizontal inequity favoring the rich in the quality of access to medical visits (lower time spent travelling to the office and waiting in the office), in the probability of medical visits in the past 4 and 12 months, and in the use of preventive services (mamographies, pap scans, and prostate exams). The instrumental variables analysis suggests that inequities are probably underestimated when endogeneity is not taken into consideration.


Bertranou, F. (1999). Are market-oriented health insurance reforms possible in Latin America? The cases of Argentina, Chile and Colombia, Health Policy, 47(1), 19-36.

Bertranou, F. (1998). Health care services utilization and health insurances status. Evidence from Argentina, Revista de Análisis Económico, 13(2), 25-52.

Bertranou, F. (1993). Demanda por consultas preventivas de las salud: aplicación de un modelo logit al caso del gran Mendoza, Reunión Anual, 28, Tucumán, CDI-MECON.

Bound, J. (1991). Self-reported versus objetive measures of health in retirement models. The Journal of Human Resources, 26(1), 106-138.

Culyer, A. J. y J. P. Newhouse (2003). Handbook of Health Economics, vol. 1B, Elsevier North Holland.

De Santis, M. y V. Herrero (2006) Equidad en el acceso, desigualdad y utilización de los servicios de salud. Una aplicación al caso argentino en 2001. Instituto de Economía y Finanzas, Universidad Nacional de Córdoba, Argentina.

García Gómez, P. y N. López (2007). Pubic and Private health insurance and the utilisation of health care in Spain, en P. Lambert (Comp.) Equity, Research on Economic Inequality, vol. 15, 169-195.

Gravelle, H. (2003). Measuring income related inequality in health: standardization and the partial concentration index, Health Economic, 12(10). 803-819.

Idler, E. y Y. Benyamini (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behaviour, 38(1), 21-37.

Instituto Nacional de Estadística (2009). Encuesta continua de hogares, Uruguay,

Juri, M. y S. Cuadrado (2003) Equidad en salud: una base conceptual y medición para Uruguay 1991-2000, monografía 2737, Universidad República de Uruguay.

Leu, R. y M. Schellhorn (2006). The evolution of income-related inequalities in health care utilization in Switzerland over time, CESifo Economic Studies, 52(4), 666-690.

Macinko, J. A. y B. Starfield (2002). Annotated bibliography on equity in health, 1980-2001, International Journal for Equity in Health, 1(1).

Mossey, J. y Shapiro, E. (1982). Self-rated health: a predictor of mortality among the elderly, American Journal of Public Health, 72(8), 800-808.

Noronha, K. y M. Viegas (2005). Desigualdades sociais em saúde e na utilizaçao dos serviços de saúde entre os idosos na América Latina, Revista Panamericana de Salud Pública, 17(5/6), 410-418.

O´Donnell, O., et al. (2008). Analyzing health equity using household survey data. A guide to techniques and their implementation. The World Bank, Washington.

Rao, V. (1969). Two decompositions of the concentration ratio. Journal of the Royal Statistical Society, Series A (General), 132(3), 418-425.

OPS/OMS (2001). Salud, bienestar y envejecimiento en América Latina y el Caribe,

StataCorp (2006). Stata statistical software: Release 9.1, College Station, TX: Stata Corp LP:

Suarez-Berenguela, R. (2000). Health system inequalities and inequities in Latin America and the Caribbean: Findings and policy implications. Working Document, Pan American Health Organization, (

Van Doorslaer, E., C. Masseria y X. Koolman (2006). Inequalities in Access to medical care by income in developed countries, Canadian Medical Association Journal, 174(2), 177-183.

Van Doorslaer, E., X. Koolman y A. Jones (2004). Explaning income-related inequalities in doctor utilization in Europe, Health Economics, 11(4), 389-411.

Wagstaff, A. y E. van Doorslaer (2004). Overall versus socioeconomic health inequality: a measurement framework and two empirical illustrations, Health Economic, 13(3), 297-301.

Wagstaff, A. y E. van Doorslaer (2000). Measuring and testing for inequity in the delivery of health care, Journal of Human Resources, 35(4), 716-733.

Wagstaff, A., E. van Doorslaer y P. Paci (1991). On the measurement of horizontal inequity in the delivery of health care, Journal of Health Economics, 10(2), 169-205.

Wagstaff, A., E. van Doorslaer y N. Watanabe (2003). On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam, Journal of Econometrics, 112(1), 207-223

Wagstaff, A. (2002). Inequality aversion, health inequalities, and health achievement, Journal of Health Economics, 21(4), 627-641.

Wagstaff, A., P. Paci y E. van Doorslaer (1989). Equity in the finances and delivery of health care; some tentative cross-country comparisons, Oxford Review of Economic Policy, 5(1), 89-112.

Wallace, S. P. y V. F. Gutierrez (2005). Equity of access to health care for older adults in tour major Latin American cities, Revista Panamericana de Salud Pública, 17(5/6), 394-409.

Whitehead, M. (1990). The concepts and principles of equity and health. World Health Organization. Reginal Office for Europe, Copenhagen, (mimeo).

Wooldridge, J. (2003). Econometric Analysis of Cross Section and Panel Data, Cambridge, MIT Press

How to Cite
BalsaA., FerresD., RossM., & TriunfoP. (2009). Socio-economic inequalities in the use of healthcare services of the Montevidean elderly individual. Estudios Económicos, 24(1), 35-88.
  • Abstract viewed - 429 times
  • PDF (Spanish) downloaded: 167 times