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A short note revisiting the concentration index: Does the normalization of the concentration index matter?
The concentration index, including its normalization, is prominently used to assess socioeconomic inequalities in health and health care. Wagstaff's and Erreygers' normalizations or corrections of the standard concentration index are the most suggested approaches when analyzing binary heal...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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John Wiley and Sons Inc.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324972/ https://www.ncbi.nlm.nih.gov/pubmed/35426194 http://dx.doi.org/10.1002/hec.4515 |
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author | Ataguba, John E. |
author_facet | Ataguba, John E. |
author_sort | Ataguba, John E. |
collection | PubMed |
description | The concentration index, including its normalization, is prominently used to assess socioeconomic inequalities in health and health care. Wagstaff's and Erreygers' normalizations or corrections of the standard concentration index are the most suggested approaches when analyzing binary health variables encountered in many health economics and health services research. In empirical applications of the corrected or normalized concentration indices, researchers interpret them similarly to the standard concentration index, which may be problematic as this ignores their underlying behaviors. This paper shows that the empirical bounds of the standard concentration index, including the corrected indices, depend not only on the sample size directly but also on the sampling weight. Notably, the paper highlights critical challenges for assessing and interpreting the popular Wagstaff's and Erreygers' corrected concentration indices with binary health variables. Specifically, it shows that it might be misleading, for example, to assess socioeconomic health inequalities using the magnitude of the “symmetric” Erreygers' corrected concentration index in the face of progressive improvements in the binary health variable. Also, Wagstaff's normalized concentration index may give a spurious “concentration” of the binary health variable among the rich or the poor in certain rare instances. |
format | Online Article Text |
id | pubmed-9324972 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93249722022-07-30 A short note revisiting the concentration index: Does the normalization of the concentration index matter? Ataguba, John E. Health Econ SHORT RESEARCH ARTICLES The concentration index, including its normalization, is prominently used to assess socioeconomic inequalities in health and health care. Wagstaff's and Erreygers' normalizations or corrections of the standard concentration index are the most suggested approaches when analyzing binary health variables encountered in many health economics and health services research. In empirical applications of the corrected or normalized concentration indices, researchers interpret them similarly to the standard concentration index, which may be problematic as this ignores their underlying behaviors. This paper shows that the empirical bounds of the standard concentration index, including the corrected indices, depend not only on the sample size directly but also on the sampling weight. Notably, the paper highlights critical challenges for assessing and interpreting the popular Wagstaff's and Erreygers' corrected concentration indices with binary health variables. Specifically, it shows that it might be misleading, for example, to assess socioeconomic health inequalities using the magnitude of the “symmetric” Erreygers' corrected concentration index in the face of progressive improvements in the binary health variable. Also, Wagstaff's normalized concentration index may give a spurious “concentration” of the binary health variable among the rich or the poor in certain rare instances. John Wiley and Sons Inc. 2022-04-14 2022-07 /pmc/articles/PMC9324972/ /pubmed/35426194 http://dx.doi.org/10.1002/hec.4515 Text en © 2022 The Authors. Health Economics published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | SHORT RESEARCH ARTICLES Ataguba, John E. A short note revisiting the concentration index: Does the normalization of the concentration index matter? |
title | A short note revisiting the concentration index: Does the normalization of the concentration index matter? |
title_full | A short note revisiting the concentration index: Does the normalization of the concentration index matter? |
title_fullStr | A short note revisiting the concentration index: Does the normalization of the concentration index matter? |
title_full_unstemmed | A short note revisiting the concentration index: Does the normalization of the concentration index matter? |
title_short | A short note revisiting the concentration index: Does the normalization of the concentration index matter? |
title_sort | short note revisiting the concentration index: does the normalization of the concentration index matter? |
topic | SHORT RESEARCH ARTICLES |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324972/ https://www.ncbi.nlm.nih.gov/pubmed/35426194 http://dx.doi.org/10.1002/hec.4515 |
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