Equity of access to health care services:
Abstract
The pursuit of equity of access to health care is a central objective of many health care systems. This paper first sets out a general theoretical framework within which equity of access can be examined. It then applies the framework by examining the extent to which research evidence has been able to detect systematic inequities of access in UK, where equity of access has been a central focus in the National Health Service since its inception in 1948. Inequity between socio-economic groups is used as an illustrative example, and the extent of inequity of access experienced is explored in each of five service areas: general practitioner consultations; acute hospital care; mental health services; preventative medicine and health promotion; and long-term health care. The paper concludes that there appear to be important inequities in access to some types of health care in the UK, but that the evidence is often methodologically inadequate, making it difficult to draw firm conclusions. In particular, it is difficult to establish the causes of inequities which in turn limits the scope for recommending appropriate policy to reduce inequities of access. The theoretical framework and the lessons learned from the UK are of direct relevance to researchers from other countries seeking to examine equity of access in a wide variety of institutional settings.
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Such variations can exist due to the social gradient in wider determinants of health, differences in local funding and service equity, the make-up of local healthcare systems and regional differences in population composition.
“Such variations can exist due to the social gradient in wider determinants of health, differences in local funding and service equity, the make-up of local healthcare systems and regional differences in population composition [34,35,36,37].”
From The Impact of demographic, socio-economic and geographic factors on mortality risk among people living with dementia in England (2002–2016) (2021) · cites this paper as [35]
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- Authors
- Goddard, M., & Smith, P.
- Affiliations
- University of York (GB)
- Corresponding author
- Smith, Peter
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2001-11
- Volume
- 53
- Issue
- 9
- Pages
- 1149-1162
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W1548648904
- Cited by
- 667
- References
- 76
- Citations by year
- 2026: 19 · 2025: 21 · 2024: 30 · 2023: 24 · 2022: 30 · 2021: 70 · 2020: 21 · 2019: 33 · 2018: 37 · 2017: 21 · 2016: 41 · 2015: 33 · 2014: 33 · 2013: 25 · 2012: 31
- FWCI
- 11.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (submittedVersion)
- Funders
- Goddard Space Flight Center
- Topics
- Social Sciences › Health › Public Health and Social Inequalities
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Economics, Econometrics and Finance › Finance › Healthcare Systems and Reforms
- Keywords
- health disparities, socioeconomic disparities, National Health Service, general practitioner visits, acute hospital care, mental health services, health promotion, long-term care, health policy
- MeSH terms
- United Kingdom, Health Services Accessibility, Health Services Needs and Demand, Health Services Research, Humans, Social Justice, Socioeconomic Factors, State Medicine, Models, Statistical
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