The pursuit of equity is a key objective of many health care systems, including
Australia’s Medicare. Using the Household, Income and Labour Dynamics in
Australia (HILDA) survey, we measured the extent of inequity in the utilisation of
hospital services. We used methodology developed by the ECuity project for
measuring horizontal inequity indices. We examine income-related health care
inequities in both inpatient and day patient access and utilisation, whilst
controlling for morbidity, demographic and socio-economic variables. The
probability of hospital inpatient admission appeared equitable, but the probability
of a day patient visit demonstrated a pro-rich distribution. Even more pronounced
were the findings on the quantity of visits. The positive horizontal inequality
indices indicate a degree of inequity favouring the rich, especially for inpatient
utilisation. The pro-rich distribution of the probability of a day patient visit was
associated with whether individuals held private health insurance. These results
suggest that in Australia, which has a universal and comprehensive health system,
the rich and poor are not treated equally according to need. Further research
should investigate whether the causes of inequities lie in the preferences of
individuals or the preferences of health care providers.