Publication: The Concentration Index of a Binary Outcome Revisited
No Thumbnail Available
Date
2011
ISSN
1099-1050 (Electronic)
1057-9230 (Linking)
Published
2011
Author(s)
Editor(s)
Abstract
The binary variable is one of the most common types of variables in the analysis of income-related health inequalities. I argue that while the binary variable has some unusual properties, it shares many of the properties of the ratio-scale variable and hence lends itself to both relative and absolute inequality analyses, albeit with some qualifications. I argue that criticisms of the normalization I proposed in an earlier paper, and of the use of the binary variable for inequality analysis, stem from a misrepresentation of the properties of the binary variable, as well as a switch of focus away from relative inequality to absolute inequality. I concede that my normalization is not uncontentious, but, in a way, that has not previously been noted.
Link to Data Set
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Citations
- Cited 107 times in Scopus (view citations)
Collections
Related items
Showing items related by metadata.
Publication Correcting the Concentration Index : A Comment(2009)In a recent article in this journal, Erreygers [Erreygers, G., 2008. Correcting the concentration index. Journal of Health Economics] has proposed a new measure of income-related health inequality to overcome three shortcomings of the concentration index (CI). I think Erreygers is absolutely right to probe on these issues, and I welcome his generalization of my normalization which was specific to the case of a binary health indicator. However, I have misgivings about his paper. His goal of correcting the CI so as to make it usable with interval-scale variables seems misguided. The CI reflects a commitment on the part of the analyst to measuring relative inequality. Armed only with an interval-scale variable, one simply has to accept that one can meaningfully measure only differences and therefore settle for measuring absolute inequality. Erreygers, index inevitably ends up as a measure of absolute inequality. His objection to my approach to getting round the bounds problem is that my normalization of the CI does not produce a measure of absolute inequality. But that was never my intention! In this comment I also show that--somewhat paradoxically at first glance--my index is also not a pure index of relative inequality. This seems to be an inevitable consequence of tackling the bounds issue.Publication Agglomeration Index : Towards a New Measure of Urban Concentration(Washington, DC: World Bank, 2009)A common challenge in analyzing urbanization is the data. The United Nations compiles information on urbanization (urban population and its share of total national population) that is reported by various countries yet there is no standardized definition of "urban." This situation is particularly troublesome if one wishes to conduct a cross-country analysis or determine the aggregate urbanization status of regions (such as Asia or Latin America) and the world. This paper proposes an alternative measure of urban concentration that we call an agglomeration index. It is based on three factors: population density, the population of a "large" urban center, and travel time to that large urban center. The main objective is to provide a globally consistent definition of settlement concentration to enable cross-country comparative and aggregated analyses. As an accessible measure of economic density, the agglomeration index lends itself to the study of concepts such as agglomeration rents in urban areas, the �thickness� of a market, and the travel distance to such a market with many workers and consumers. With anticipated advances in remote sensing technology and geo-coded data analysis tools, the agglomeration index can be further refined.Publication Measuring Equity in Health Care Financing : Reflections on (and Alternatives to) the World Health Organization's Fairness of Financing Index(World Bank, Washington, DC, 2001-02)In its latest World Health Report, The World Health Organization (WHO) argues that a key dimension of a health system's performance is the fairness of its financing system. The report discusses how policymakers can improve this aspect of performance, proposes an index of fairness, discusses how it should be put into operation, and presents a league table of countries, ranked by fairness with which their health services are financed. The author shows that the WHO index cannot discriminate between health financing systems that are regressive, and those that are progressive - and cannot discriminate between horizontal inequity, and progressiveness, or regressiveness. The index cannot tell policymakers whether it deviates from 1 (complete fairness) because households with similar incomes spend different amounts on health care (horizontal inequity), or because households with different incomes spend different proportions of their income on health care (vertical inequity, given the WHO's interpretation of the ability-to-pay principle) - although the two have different policy implications. With the WHO's index, progressiveness, and regressiveness are both treated as unfair. This makes no sense, because policymakers who may be strongly averse to regressive payments (which worsen income distribution) may in the name of fairness be quite receptive to progressive payments (requiring that the better-off, who may be willing to spend proportionately more on health care, are required to pay proportionately more). The author compares the WHO index with an alternative, and more illuminating approach developed in the income redistribution literature in the early 1990s, and used in the late 1990s, to study the fairness of various OECD health care financing systems. He illustrates the differences between the approaches with an empirical comparison, using data on out-of-pocket payments for health services in Vietnam for 1993 and 1998. This analysis is of some interest in its own right, given the large share of health spending from out-of-pocket payments in Vietnam, and the changes in fees, and drug prices over the 1990s.Publication Public Health Spending, Governance and Child Health Outcomes : Revisiting the Links(Taylor and Francis, 2013-03-21)This paper empirically examines the determinants of child health in developing countries and how public policy may interact with these determinants. It improves on previous empirical studies by conducting a more careful analysis of the determinants controlling for possible endogeneity, and by using a more comprehensive and richer panel dataset, drawing on a health database covering 136 countries over 1960–2005, supplemented by the latest World Development Indicators dataset as well as data on a broad variety of alternative indicators of governance, such as those from the International Country Risk Guide and the Open Budget Index. We find that both public spending on healthcare and the quality of governance matter for the reduction of child mortality rates. However, our mixed results on the interaction of governance with public spending throw some doubt on the conclusiveness of previous empirical studies.Publication Europe and Central Asia's Great Post-communist Social Health Insurance Experiment : Aggregate Impacts on Health Sector Outcomes(2009)The post-Communist transition to social health insurance in many of the Central and Eastern European and Central Asian countries provides a unique opportunity to try to answer some of the unresolved issues in the debate over the relative merits of social health insurance and tax-financed health systems. This paper employs regression-based generalizations of the difference-in-differences method on panel data from 28 countries for the period 1990-2004. We find that, controlling for any concurrent provider payment reforms, adoption of social health insurance increased national health spending and hospital activity rates, but did not lead to better health outcomes.
Users also downloaded
Showing related downloaded files
No results found.