Inequality in health care use among older people in the United Kingdom: an analysis of panel data

Horizontal equity in health care service use is an area that remains relatively unexamined in the literature on older people. The purpose of this study is to investigate the extent of income-related inequity in the use of GP, inpatient, outpatient and dental services among individuals aged 65 and over in the United Kingdom between 1997 and 2003 using a panel analysis of data from the British Household Panel Survey. The probability of GP, outpatient, dentist or inpatient service use between 1997 and 2003 was predicted using multiple random effects probit panel models, and the estimates used to calculate incomerelated horizontal inequity. The results indicate that individuals on a lower income are significantly less likely to visit a GP, specialist or dentist than the better-off, although they have significantly greater need (the reverse is seen for dental care). However, after adjusting for differences in need, horizontal inequity is found with utilization favouring those on a higher income for all service areas, but not significantly in hospital care.