A Summary Measure of Health Inequalities for a Pay-for-Population Health Performance System
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A Summary Measure of Health Inequalities for a Pay-for-Population Health Performance System

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  • English
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    • Alternative Title:
      Prev Chronic Dis
    • Personal Author:
      Asada, Yukiko
    • Description:
      A system that rewards population health must be able to measure and track health inequalities. Health inequalities have most commonly been measured in a bivariate fashion, as a joint distribution of health and another attribute such as income, education, or race/ethnicity. I argue this practice gives insufficient information to reduce health inequalities and propose a summary measure of health inequalities, which gives information both on overall health inequality and bivariate health inequalities. I introduce 2 approaches to develop a summary measure of health inequalities. The bottom-up approach defines attributes of interest, measures bivariate health inequalities related to these attributes separately, and then combines these bivariate health inequalities into a summary index. The top-down approach measures overall health inequality and then breaks it down into health inequalities related to different attributes. After describing the 2 approaches in terms of building-block measurement properties, aggregation, value, data and sample size requirements, and communication, I recommend that, when data are available, a summary measure should use the top-down approach. In addition, a strong communication strategy is necessary to allow users of the summary measure to understand how it was calculated and what it means.
    • Subject:
    • Source:
      Prev Chronic Dis. 7(4).
    • Document Type:
      Journal Article
    • Genre:
      Special Topic
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