The horizontal equity of health care in New Zealand

Objective: Given that ‘equal access for equal need’ is a clearly articulated goal of the New Zealand public health system, this study is an attempt to determine if access to public health care services in New Zealand is, for people of equal health need, independent of income. Method: Information on health status, income and health service utilisation for just over 6,000 New Zealanders was obtained from the national Household Health Survey 1992‐93. Using standardised expenditure concentration curves and a concentration index, the distribution of health service use by individuals in different income groups, as a proxy for access, was illustrated and quantified. Results: The results suggest either appropriate or slightly excess use of services by the poor given their estimated health need. Due to analytical problems caused by data deficiencies, these results must be regarded as tentative. Conclusion: For the period under study, no evidence was found to indicate significant access barriers to publicly funded health care for people on different incomes. This study has served to demonstrate one approach to measuring inequality and analysing the relationship between inequality and inequity. Given the reforms to the health sector since 1993, ongoing monitoring of equity of access to health care services is essential. Implications: Given the income‐related disparities in health that do exist, the public health community should endeavour to develop techniques to monitor the delivery of publicly funded health care to ensure that further inequity is not borne by the poor.