ESS R7 Health Module: Equality in the Access to Health Care

Access to health care is a fundamental determinant of health, particularly in terms of the treatment of pre-exciting conditions. In most advanced capitalist countries, access to health care is universal. However, there are variations in terms of how health care is funded, the role and level of co-payments for treatment, and the extent of provision. This may translate into unequal access for equal need. The main aim of this project was to examine whether access to health care is equal for everyone in European countries using upcoming data from the European Social Survey (ESS). This project developed several of the questions in the new health inequality module together with City University London, which administrates the ESS. The project was able to include several measures of health care utilization into the ESS Health Module. These were: 1) informal care of family members, neighbours, friends and others, 2) consultations of general practitioners and consultations of medical specialists, 3) use of alternative health care and 4) whether access to health care is threatened by elements of affordability and availability. Data from 21 countries (including Norway) become available in May 2016. Around the same time, we published a study presenting the new data: http://esr.oxfordjournals.org/content/early/2016/05/16/esr.jcw019.full We have also published a toplines report, which summarizes some of our main findings: http://www.europeansocialsurvey.org/docs/findings/ESS7_toplines_issue_6_health.pdf This report was presented to Vytenis Andriukaitis, the European Commissioner for Health and Food Safety: http://www.europeansocialsurvey.org/about/news/essnews0021.html At this meeting, Vytenis Andriukaitis, said: "The European Social Survey is a great project of incredible value. The huge amount of scientific data collected on public attitudes and behaviour, enabling comparisons across European nations and also over time, makes it a very useful tool for effective policy-making, including in reducing social inequalities in health." The project has led to many important findings. For example, it has created new knowledge on the linkages between the utilization of various forms of health care services and people`s socio-economic status. We have shown that there are substantial socioeconomic inequalities in access to health care, particularly related to specialist use. We have also discovered that inequalities in unmet need of health care varies between people with less and more resources. Being unable to pay was mentioned as an important reason for unmet needs. Also, the project unveiled hidden forms of health care, such as unpaid care (which is a heavy health burden particularly among women) and alternative care (which is more frequent in countries where there is less trust in the health care system).

Access to health care is a fundamental determinant of health, particularly in terms of the treatment of pre-exciting conditions. In most advanced capitalist countries, access to health care is universal. However, there are variations in terms of how healt h care is funded, the role and level of co-payments for treatment, and the extent of provision. This may translate into unequal access for equal need. The primary objective of the project is to examine whether access to health care (adjusted for need) is equal for everyone in European countries using upcoming data from the European Social Survey (ESS). Recently, the ESS accepted a proposal from NTNU to develop a health module as part of the 7th wave of the European Social Survey. NTNU now faces a histori c opportunity to examine whether the utilization to health care is equal in a broader setting. The module aims to examine the social distribution of (a) hospital admittance, (b) unpaid care, (c) consultations of general practitioners,(d) and consultations of medical specialists in European populations. It will also examine whether (e) access to health care is threatened by elements of affordability and availability. While waiting for the data, the project will focus on the role of health systems in exam ining to what extent - and why - educational inequality in mortality amenable to health care varies across European countries. We argue that the health system is a feature of welfare states that is most directly relevant and linkable to health outcomes, a nd that mortality amenable to health care is a health outcome that is more clearly and strongly connected to state intervention. The evidence obtained from these two sub-studies will be used when policy recommendations are developed. More specifically, i t will address how European welfare states, including Norway best can achieve equal access to health care for equal need.