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Need, equity and equality in health and health care

By Tony J Culyer and Adam Wagstaff

Abstract

Four distributional principles for the allocation of health care resources are discussed: equal expenditures per capita, proportionality to need, proportionality to endowment health status, and proportionality to capacity to benefit. They are compared with another process, concept of equity, equality of access and an end-state concept, equality of health. Each, save the last, is shown to create anomalies and inequity.equity, expenditure, access

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