Conindex: Estimation of Concentration Indices

O’Donnell, Owen; O’Neill, Stephen; Ourti, Tom Van; Walsh, Brendan M.

doi:10.1177/1536867x1601600112

Cited by 346 publications

(302 citation statements)

References 39 publications

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“…In order to keep the relative inequality variance property of concentration index intact, for bounded variables Wagstaff proposed a modified concentration index by rescaling the standard index [18]. We estimated the corrected concentration index for our study using conindex command of STATA [19]. …”

Section: Methodsmentioning

confidence: 99%

Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh

et al. 2017

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BackgroundDespite remarkable progress in maternal and child health, inequity persists in maternal care utilization in Bangladesh. Government of Bangladesh (GOB) with technical assistance from United Nation Population Fund (UNFPA), United Nation Children’s Fund (UNICEF) and World Health Organization (WHO) started implementing Maternal and Neonatal Health Initiatives in selected districts of Bangladesh (MNHIB) in 2007 with an aim to reduce inequity in healthcare utilization. This study examines the effect of MNHIB on inequity in maternal care utilization.MethodTwo surveys were carried out in four districts in Bangladesh- baseline in 2008 and end-line in 2013. The baseline survey collected data from 13,206 women giving birth in the preceding year and in end-line 7,177 women were interviewed. Inequity in maternal healthcare utilization was calculated pre and post-MNHIB using rich-to-poor ratio and concentration index.ResultsMean age of respondents were 23.9 and 24.6 years in 2008 and 2013 respectively. Utilization of pregnancy-related care increased for all socioeconomic strata between these two surveys. The concentration indices (CI) for various maternal health service utilization in 2013 were found to be lower than the indices in 2008. However, in comparison to contemporary BDHS data in nearby districts, MNHIB was successful in reducing inequity in receiving ANC from a trained provider (CI: 0.337 and 0.272), institutional delivery (CI: 0.435 in 2008 to 0.362 in 2013), and delivery by skilled personnel (CI: 0.396 and 0.370).ConclusionsOverall use of maternal health care services increased in post-MNHIB year compared to pre-MNHIB year and inequity in maternal service utilization declined for three indicators out of six considered in the paper. The reductions in CI values for select maternal care indicators imply that the program has been successful not only in improving utilization of maternal health services but also in lowering inequality of service utilization across socioeconomic groups. Maternal health programs, if properly designed and implemented, can improve access, partially overcoming the negative effects of socioeconomic disparities.

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Section: Methodsmentioning

confidence: 99%

Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh

et al. 2017

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“…The computation of the budget share is also straightforward, the only complication being what to do if the denominator is negative, which is possible if it is household income. Progressivity is easily computed as the difference between the Gini coefficient (for income or consumption) and the concentration index for out-of-pocket expenditures, both of which can be computed straightforwardly in Stata using any user-developed section that computes inequality measures such as CONINDEX for Stata (O'Donnell et al 2015) and INEQ for R (Zeileis and Kleiber 2014). The incidence of and inequality in catastrophic expenditures can both be computed using the Stata module FPRO (Eozenou and Wagstaff 2018), as can the headcountand poverty gap-based measures of impoverishment.…”

Section: Computationmentioning

confidence: 99%

Out-of-Pocket Expenditures on Health: A Global Stocktake

Wagstaff¹,

Smitz²

2019

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This paper provides an overview of research on out-ofpocket health expenditures, reviewing the various summary measures and the results of multi-country studies using these measures. The paper presents estimates for 146 countries from all World Bank income groups for all summary measures, along with correlations between the summary measures and macroeconomic and health system indicators. Large differences emerge across countries in per capita outof-pocket expenditures in 2011 international dollars, driven in large part by differences in per capita income and the share of gross domestic product spent on health. The two measures of dispersion or risk-the coefficient of variation and Q90/Q50-are only weakly correlated across countries and not explained by the macroeconomic and health system indicators. Considerable variation emerges in the out-ofpocket health expenditure budget share, which is highly correlated with the incidence of "catastrophic" expenditures. Out-of-pocket expenditures tend to be regressive and catastrophic expenditures tend to be concentrated among the poor when expenditures are assessed relative to income, while expenditures tend to be progressive and catastrophic expenditures tend to be concentrated among the rich when expenditures are assessed relative to consumption. At the extreme poverty line of $1.90-a-day, most impoverishment due to out-of-pocket expenditures occurs among low-income countries.

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“…The Gini coefficient is a commonly used measure of inequality in frequency distributions of variables such as income expressed as a value between 0.00 and 1.00, with 1.00 representing the maximum possible inequality in a significantly skewed distribution. CI is a calculation of the inequality of a health variable attributable to socioeconomic factors, and has previously been used in health economic analyses to evaluate whether the socioeconomic contributions to health inequalities vary over time or by geography . Inequality was also analysed in groups according to income using the World Bank Atlas method, after adjusting for the difference between the rate of inflation in the country and that in a number of developed countries using a weighted average of GDP deflators.…”

Section: Methodsmentioning

confidence: 99%

“…CI is a calculation of the inequality of a health variable attributable to socioeconomic factors, and has previously been used in health economic analyses to evaluate whether the socioeconomic contributions to health inequalities vary over time or by geography. 18,19 Inequality was also analysed in groups according to income using the World Bank Atlas method, after adjusting for the difference between the rate of inflation in the country and that in a number of developed countries using a weighted average of GDP deflators.…”

Section: Variablesmentioning

confidence: 99%

Longitudinal changes in global cataract surgery rate inequality and associations with socioeconomic indices

Yan

Wang

Wijngaarden

et al. 2018

Clinical Exper Ophthalmology

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Importance Cataract is the leading cause of blindness and the second leading cause of vision impairment. The majority of people with vision impairment reside in low‐resource settings with limited access to cataract surgery and services. Background Cataract surgery rate (CSR) is a proxy measure for eye care service delivery and estimating the burden of cataract disease. This research aims to evaluate the longitudinal changes of CSR inequality globally and by income groups. Design Systematic review. Participants Studies published from January 2000 to December 2015 were considered for inclusion into the review. Methods CSR data were retrieved from a systematic review of published literature (OVID Medline, Embase, PubMed, ISI, Web of Science), unpublished reports and data repositories. Main Outcome Measures Inequality of CSR was measured on a global scale and between countries grouped by income levels using the Gini coefficient and concentration index, with respect to the human development index (HDI). Results Overall, correlations between HDI and gross domestic product (GDP) per capita vs CSRs were observed with R2 values of 49.2% (β = 5.01, P < 0.001) and 38.9% (β = 0.56, P < 0.001), respectively. Analysis of longitudinal CSR data using generalized estimation equation models revealed strong associations between CSR and HDI (P < 0.001), GDP (P < 0.001) and the proportion of people aged ≥50 (P = 0.001). Overall, the trend of inequality in worldwide CSR remained relatively stable. Conclusions and Relevance Inequalities in cataract service provision were found between countries grouped by income and associated with socioeconomic indicators.

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Conindex: Estimation of Concentration Indices

Cited by 346 publications

References 39 publications

Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh

Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh

Out-of-Pocket Expenditures on Health: A Global Stocktake

Longitudinal changes in global cataract surgery rate inequality and associations with socioeconomic indices

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