Socioeconomic inequalities in health outcomes among Thai older population in the era of Universal Health Coverage: trends and decomposition analysis

Kaikeaw, Sirinya; Punpuing, Sureeporn; Chamchan, Chalermpol; Prasartkul, Pramote

doi:10.1186/s12939-023-01952-0

International Journal for Equity in Health

Table 3 Decomposition of socioeconomic inequality for health outcomes in the Thai older population: 2003 and 2019

From: Socioeconomic inequalities in health outcomes among Thai older population in the era of Universal Health Coverage: trends and decomposition analysis

Determinants	2003						2019
Determinants	Marginal effect(\({\beta }_{k}^{m}\))		Elasticity \(\left({\eta }_{k}\right)\)	\({C}_{k }\)	Con.	% Con.	Marginal effect(\({\beta }_{k}^{m}\))		Elasticity \(\left({\eta }_{k}\right)\)	\({C}_{k }\)	Con.	% Con.
Healthcare accessibility
Health security schemes
CSMBS (ref.)				0.246						0.236
UCS	-0.006		-0.021	-0.273	0.006	9.5	-0.011	***	-0.035	-0.301	0.011	43.8
SSS	0.009		0.001	0.028	0.000	0.0	-0.016	***	-0.004	0.064	0.000	-1.1
	Aggregated contribution				0.006	9.6%	Aggregated contribution				0.010	42.7%
Demographic characteristics
Age-sex interaction
Males age 50–59 (ref.)				0.055						0.053
Males age 60–69	-0.035	***	-0.019	-0.015	0.000	0.5	-0.019	***	-0.010	0.020	0.000	-0.9
Males age 70–79	-0.082	***	-0.022	-0.024	0.001	0.9	-0.045	***	-0.011	-0.034	0.000	1.6
Males age 80+	-0.169	***	-0.015	-0.005	0.000	0.1	-0.068	***	-0.007	-0.016	0.000	0.5
Females age 50–59	-0.017	***	-0.019	0.069	-0.001	-2.1	-0.003		-0.003	0.093	0.000	-1.1
Females age 60–69	-0.061	***	-0.040	-0.031	0.001	2.0	-0.023	***	-0.018	-0.016	0.000	1.2
Females age 70–79	-0.104	***	-0.037	-0.037	0.001	2.3	-0.052	***	-0.019	-0.055	0.001	4.3
Females age 80+	-0.168	***	-0.023	-0.011	0.000	0.4	-0.080	***	-0.011	-0.034	0.000	1.6
	Aggregated contribution				0.003	4.1%	Aggregated contribution				0.002	7.2%
Socioeconomic characteristics
Household wealth quintiles
Q1 (poorest) (ref.)				-0.759						-0.640
Q2	0.009	*	0.010	-0.238	-0.002	-4.0	0.006	**	0.005	-0.326	-0.002	-7.1
Q3	0.012	*	0.008	0.156	0.001	2.1	0.012	***	0.009	0.003	0.000	0.1
Q4	0.039	***	0.024	0.341	0.008	13.5	0.007	**	0.006	0.305	0.002	7.0
Q5 (wealthiest)	0.063	***	0.037	0.500	0.018	30.2	0.015	***	0.013	0.658	0.008	33.8
	Aggregated contribution				0.025	41.7%	Aggregated contribution				0.008	33.8%
Education
No education (ref.)				-0.101						-0.063
Pre and Primary	0.023	***	0.071	-0.146	-0.010	-17.0	0.010	**	0.031	-0.328	-0.010	-41.2
Secondary	0.041	***	0.009	0.122	0.001	1.9	0.014	***	0.007	0.154	0.001	4.5
Post-secondary	0.055	***	0.009	0.120	0.001	1.7	0.022	***	0.008	0.237	0.002	8.0
	Aggregated contribution				-0.008	-13.5%	Aggregated contribution				-0.007	-28.7%
Geographic characteristics
Urban-rural residence
Rural (ref.)				-0.409						-0.244
Urban	0.038	***	0.046	0.409	0.019	31.3	0.022	***	0.036	0.244	0.009	36.4
	Aggregated contribution				0.019	31.3%	Aggregated contribution				0.009	36.4%
Region
BKK (ref.)				0.029						0.016
Central	0.062	***	0.058	0.099	0.006	9.4	0.020	***	0.021	0.102	0.002	8.9
North	0.041	***	0.034	-0.075	-0.003	-4.2	0.031	***	0.027	-0.018	0.000	-1.9
Northeast	0.033	***	0.044	-0.241	-0.011	-17.6	0.018	***	0.022	-0.203	-0.004	-18.4
South	0.060	***	0.026	-0.001	0.000	0.0	0.029	***	0.014	-0.027	0.000	-1.5
	Aggregated contribution				-0.008	-12.4%	Aggregated contribution				-0.003	-13.0%
Health conditions
NCDs morbidity
No morbidity (ref.)				0.029						0.016
Single morbidity	-0.107	***	-0.144	-0.018	0.003	4.2	-0.041	***	-0.040	-0.028	0.001	4.6
Multimorbidity	-0.163	***	-0.066	-0.012	0.001	1.3	-0.060	***	-0.046	0.011	-0.001	-2.1
	Aggregated contribution				0.003	5.4%	Aggregated contribution				0.001	2.5%
Total contribution					0.040	66.2%					0.020	80.8%
Residuals					0.021	33.8%					0.005	19.2%
Overall CIs of EQ-5D					0.061	100.0%					0.024	100.0%

Note: Marginal effects (\({\varvec{\beta }}_{\varvec{k}}^{\varvec{m}}\)) demonstrate associations between determinants and health outcomes (EQ-5D index scores); *** p < 0.001; ** p < 0.01; * p < 0.05; R-squared values of 0.216 (in 2003) and 0.266 (in 2019)
: Elasticity\(({\varvec{\eta }}_{\varvec{k}}={\varvec{\beta }}_{\varvec{k}}^{\varvec{m}}{\stackrel{-}{\varvec{x}}}_{\varvec{k}})\) is the impact of a determinant on health outcomes with respect to the mean of that determinant; \({\varvec{C}}_{\varvec{k} }\) is Erreygers’ concentration index of each determinant; Con. is contributions of each determinant to the overall socioeconomic inequality in health outcomes; %Con. is the percentage contribution; Residual is unexplained component

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ISSN: 1475-9276

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