CosThe methodological contribution of this paper is to introduce
some developments in the literature on poverty and deprivation
to the analysis of inequality and inequity in health care. The HCD
profiles define deprivation in health care as receiving less care than
needed. A common interpretation of equity in health care is that
resources have to be allocated with respect to individuals’ needs
rather than individuals’ preferences. Thus, if some minorities in
the population have inadequate use with respect to their need, this
is generally regarded as an issue of social justice. In this context,
the definition and measurement of need for health care assumes
a crucial role. We have proposed a function of the average utilization
observed in the total population as need estimator, following
the tradition of the literature on health care inequality. In turn,
this has led us to determine a link between horizontal equity and
deprivation allowing us to interpret the HCD approach in terms
of horizontal equity, i.e. equal use for equal need. In this case, the
equity principle embodied by the HCD approach is that an individual
person or group of people should not receive less health care
than the average individual with the same level of need. However,
alternative definitions of need can be specified, and thus alternative
views of equity can be incorporated within the HCD profile
approach. For instance, h* can be exogenously set by a policy maker
as the minimum or target amount of health care that individuals or
communities should receive given their need. This would extend
the approach to take into account vertical as well as horizontal
aspects of equity, requiring appropriately different levels of utilization
for different levels of need as well as equal use for equal need