Pre- and Pro-Crises Financing and Inequalities in Mortality Amenable to Health Care between Small Areas of Hungary: The Last 12 Years

Katalin Kovács , Hungarian Demographic Research Institute
Lajos Bálint, Hungarian Central Statistical Office (HCSO)

The study investigates the evolution of NUTS4 level territorial inequalities in mortality amenable to health care in Hungary and the role of income in this process. Hungarian amenable mortality 95% higher than the EU average and its within-country inequalities are traditionally high. By statistical data health care in Hungary suffers from lack of adequate financing making an appearance especially in accessibility of out-patient services and diagnostic procedures. These services are becoming increasingly private bringing up the question of accessibility of these services in poorer areas and the role of income in general. On the other hand, several projects targeted poor areas aiming to improve outpatient services. Standardized death rates of amenable mortality for NUTS4 areas were calculated for three markedly different time periods: the pre-crises period of 2005-08, the crises period of 2009-12 and the post-crises period of 2013-16. These periods differ by level of health care spending, the rate of out-of-pocket spending and magnitude of investment into health care. We found growing inequalities for the crises period compared to pre-crises period and father growing inequalities in the post-crises period. In an OLS regression we examined the role of area-level income. Between the period 2009-12 and 2013-16 mortality inequalities measured by ß-convergence had slightly but significantly diminished but role of income was negligible. A likely explanation of these finding is that major investments into local health and inequalities in health care provision are important factors shaping inequalities. Their role will be examined next in our investigation.

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 Presented in Session 47. Linking Policies, Health and Mortality