ArticleInternational journal for equity in health2021
The unequal effects of austerity measures between income-groups on the access to healthcare: a quasi-experimental approach.
Article in International journal for equity in health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Healthy Ageing without Health Equity? Capability, Justice, and Ageing Governance in the UN Decade.Journal of bioethical inquiry · 2026Article
- The impact of socioeconomic crisis on cancer patient outcomes in Lebanon, 2018-2020.Journal of comparative effectiveness research · 2026Article
- Income-related inequality and horizontal inequity in healthcare utilization under population aging and labor market changes in Japan.International journal for equity in health · 2025Article
- Utilization of Health Care Services and Accessibility Challenges among Adults Aged 50+ before and after Austerity Measures across 27 European Countries: Secular Trends in the SHARE Study from 2004/05 to 2019/20.Healthcare (Basel, Switzerland) · 2024Article
- A scoping review on the impact of austerity on healthcare access in the European Union: rethinking austerity for the most vulnerable.International journal for equity in health · 2023Article
- How International Health System Austerity Responses to the 2008 Financial Crisis Impacted Health System and Workforce Resilience - A Realist Review.International journal of health policy and management · 2023Review
- Mortality and life expectancy trends in Spain by pension income level for male pensioners in the general regime retiring at the statutory age, 2005-2018.International journal for equity in health · 2022Article
- The healthcare inequality among middle-aged and older adults in China: a comparative analysis between the full samples and the homogeneous population.Health economics review · 2022Article
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4 authors.
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Abstract
backgroundThe Great Recession, starting in 2008, was characterized by an overall reduction in living standards. This pushed several governments across Europe to restrict expenditures, also in the area of healthcare. These austerity measures are known to have affected access to healthcare, probably unevenly among social groups. This study examines the unequal effects of retrenchment in healthcare expenditures on access to medical care for different income groups across European countries.
methodUsing data of two waves (2008 and 2014) of the European Union Statistics of Income and Living Conditions survey (EU-SILC), a difference-in-differences (DD) approach was used to analyse the overall change in unmet medical needs over time within and between countries. By adding another interaction, the differences in the effects between income quintiles (difference-in-difference-in-differences: DDD) were estimated. To do so, comparisons between two pairs of a treatment and a control case were made: Iceland versus Sweden, and Ireland versus the United Kingdom. These comparisons are made between countries with recessions equal in magnitude, but with different levels of healthcare cuts. This strategy allows isolating the effect of cuts, net of the severity of the recession.
resultsThe DD-estimates show a higher increase of unmet medical needs during the Great Recession in the treatment cases (Iceland vs. Sweden: + 3.24 pp.; Ireland vs. the United Kingdom: + 1.15 pp). The DDD-estimates show different results over the two models. In Iceland, the lowest income groups had a higher increase in unmet medical needs. This was not the case in Ireland, where middle-class groups saw their access to healthcare deteriorate more.
conclusionRestrictions on health expenditures during the Great Recession caused an increase in self-reported unmet medical needs. The burden of these effects is not equally distributed; in some cases, the lower-income groups suffer most. The case of Ireland, nevertheless, shows that certain policy measures may relatively spare lower-income groups while affecting middle-class income groups more. These results bring in evidence that policies can reduce and even overshoot the general effect of income inequalities on access to healthcare.
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