Equality and Equity in Utilization of Health Services in Iran; Indirect Standardization Approach

The achievement of equitable system in the form of “equal health services for equal needs” are important goals of policy makers. Therefore, measurement of inequity in utilization of services and distinguishing it from equality is very important.

In this study, equity and equality in health care utilization are estimated by using a survey of health services utilization data set in 2008, which is done by the Ministry of Health and Education Medical and applying indirect standardization method. This is performed in Stata software suite.

Inequality index before standardization indicates that there are slight inequalities between different income groups except health care services for general practitioner, health center, dental services, and services which are offered at private clinics. However, the expected need index indicates that more needs are concentrated among the poor. Thus, it is expected that they utilized more services. However, results of estimation after standardization of inequality and measuring inequity indicates that distribution of health services utilization, particularly outpatient services, is pro-rich and there is horizontal inequity in favor of high income groups.

The concept of inequality is according to the principle that individuals have different needs and different demands in using health services. However, the concept of inequity was achieved according to equal needs. In this case, the difference in utilization is considered as inequity. As a result, the index of inequality cannot be applied for the study of inequity.