ArticleBMC health services research2021
Socioeconomic differences in healthcare expenditure and utilization in The Netherlands.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Pooled it
- Contributions of prior health and vaccination to inequality in COVID-19 mortality by income: analysis of administrative microdata for the non-institutionalized Dutch population.International journal of epidemiology · 2026Article
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- Broad perspective on socio-economic disadvantages in youth with mild to borderline intellectual disabilities in mental health care.European child & adolescent psychiatry · 2026Article
- Health care utilization up to 11 years after diagnosis among patients with a hematologic malignancy and its association with socioeconomic position.Journal of cancer survivorship : research and practice · 2026Article
- Incidence and spatial variation of Parkinson's disease in the Netherlands (2017-2022): a population-based study.The Lancet regional health. Europe · 2026Article
- Endometriosis healthcare access in Indonesia based on the Indonesian national health insurance data in 2020-2023.Reproduction & fertility · 2026Article
- Sociodemographic variations in healthcare service use among people with HIV in the UK.PloS one · 2026Article
- Socioeconomic disparities in the trends of inpatient utilization for middle-aged and older adults in China: the perspective of international comparison from four cohorts.Global health research and policy · 2025Article
- Trajectories of health and social care expenditure in the last year of life among people 70 years and older in Region Stockholm: a population-based cohort study.BMC geriatrics · 2025Article
- The burden of somatic comorbidities in patients surviving a traumatic brain injury.Acta neurochirurgica · 2025Article
- The impact of ageing, socio-economic differences and the evolution of morbidity on future health expenditure - a dynamic microsimulation.BMC health services research · 2025Article
- Decomposing socioeconomic differences in self-rated health and healthcare expenditure by chronic conditions and social determinants.International journal for equity in health · 2025Article
- More or less equal? Trends in horizontal equity in mental health care utilization in Stockholm county, Sweden (2006-2022). Repeated survey-registry linked studies.International journal for equity in health · 2025Article
- Socioeconomic disparities in health-related quality of life and healthcare use in the last year of life of patients with advanced cancer: longitudinal results from the eQuiPe study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Observational
- Risk Models to Predict Screen-Detected and Interval Breast Cancers in Population Mammography Screening Participants.Cancers · 2025Article
- Exploring socio-economic inequalities in mental healthcare utilization in adults with self-reported psychological distress: a survey-registry linked cohort design.Epidemiology and psychiatric sciences · 2025Article
- Differences in eHealth Access, Use, and Perceived Benefit Between Different Socioeconomic Groups in the Dutch Context: Secondary Cross-Sectional Study.JMIR formative research · 2025Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWorldwide, socioeconomic differences in health and use of healthcare resources have been reported, even in countries providing universal healthcare coverage. However, it is unclear how large these socioeconomic differences are for different types of care and to what extent health status plays a role. Therefore, our aim was to examine to what extent healthcare expenditure and utilization differ according to educational level and income, and whether these differences can be explained by health inequalities.
methodsData from 18,936 participants aged 25-79 years of the Dutch Health Interview Survey were linked at the individual level to nationwide claims data that included healthcare expenditure covered in 2017. For healthcare utilization, participants reported use of different types of healthcare in the past 12 months. The association of education/income with healthcare expenditure/utilization was studied separately for different types of healthcare such as GP and hospital care. Subsequently, analyses were adjusted for general health, physical limitations, and mental health.
resultsFor most types of healthcare, participants with lower educational and income levels had higher healthcare expenditure and used more healthcare compared to participants with the highest educational and income levels. Total healthcare expenditure was approximately between 50 and 150 % higher (depending on age group) among people in the lowest educational and income levels. These differences generally disappeared or decreased after including health covariates in the analyses. After adjustment for health, socioeconomic differences in total healthcare expenditure were reduced by 74-91 %.
conclusionsIn this study among Dutch adults, lower socioeconomic status was associated with increased healthcare expenditure and utilization. These socioeconomic differences largely disappeared after taking into account health status, which implies that, within the universal Dutch healthcare system, resources are being spent where they are most needed. Improving health among lower socioeconomic groups may contribute to decreasing health inequalities and healthcare spending.
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