Equity-informative methods of health services research

J Health Organ Manag. 2021 Jul 2;ahead-of-print(ahead-of-print). doi: 10.1108/JHOM-07-2020-0275.

Abstract

Purpose: We review quantitative methods for analysing the equity impacts of health care and public health interventions: who benefits most and who bears the largest burdens (opportunity costs)? Mainstream health services research focuses on effectiveness and efficiency but decision makers also need information about equity.

Design/methodology/approach: We review equity-informative methods of quantitative data analysis in three core areas of health services research: effectiveness analysis, cost-effectiveness analysis and performance measurement. An appendix includes further readings and resources.

Findings: Researchers seeking to analyse health equity impacts now have a practical and flexible set of methods at their disposal which builds on the standard health services research toolkit. Some of the more advanced methods require specialised skills, but basic equity-informative methods can be used by any health services researcher with appropriate skills in the three core areas.

Originality/value: We hope that this review will raise awareness of equity-informative methods of health services research and facilitate their entry into the mainstream so that health policymakers are routinely presented with information about who gains and who loses from their decisions.

Keywords: Conditional average treatment effects; Cost/benefit analysis; Distributional cost-effectiveness analysis; Equity; Inequality; Quality improvement; Quality indicators; Quasi experimental designs; Randomised controlled trials; Small-area analysis; Socioeconomic factors; Subgroup analysis.

Publication types

  • Review

MeSH terms

  • Cost-Benefit Analysis
  • Health Equity*
  • Health Services Research