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.
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.
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.
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.
This is independent research by the University of York funded by the Wellcome Trust (Grant No. 205427/Z/16/Z). Work developing some of the methods described was funded by the National Institute for Health Research (SRF-2013-06-015).
The views expressed are those of the authors and not necessarily those of the Wellcome Trust, the UK NHS, National Institute for Health Research or Department of Health and Social Care.
The authors would like to thank Suzanne Robinson and Rachel Morton for helpful comments, Helen Cohen for formatting our references, and Miqdad Asaria and Ana Castro for producing the publicly available indicator data and graphs that we have re-used to create the figures in the section on equity-informative performance measurement.
Cookson, R., Robson, M., Skarda, I. and Doran, T. (2021), "Equity-informative methods of health services research", Journal of Health Organization and Management, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/JHOM-07-2020-0275
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