© 2000 by European Journal of Public Health
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EQUITY |
Equity of a health system
ALAIN JOURDAIN**Correspondence: Alain Jourdain, PhD, Prof., Ecole Nationale de la Santé Publique, Laboratoire d'Analyse des Politiques Sociales et Sanitaires (LAPSS), Avenue du Professeur Léon Bernard, 35043 Rennes-Cedex, France
Background: This study of the equity of the French health system is based on the principles which led to its creation from 1945 onwards. Efforts have been concentrated on the general implementation of health insurance for the whole population and the construction of a network of public hospitals to cover the territory. Methods: As far as equality of access to care is concerned, the results obtained during the 1990s show some positive effects of increased supply of hospital and community health care. However, inequalities between income groups with regard to community health care have increased and the choice of better performing hospitals by certain population groups favours the more privileged. Furthermore, interregional inequalities in the distribution of sickness benefits are considerable and did not decrease during the early 1990s. Results: These results indicate that the emphasis placed on accessibility over the past 50 years is not sufficient to ensure equity in the use of care and all the more so in health. Conclusion: The lack of connection in public policies between the priorities of health care and the distribution of resources remain among the major challenges that the 1996 reform is attempting to meet.
Keywords: equity, health systems, regions, social classes