A Monte Carlo method to estimate the confidence intervals for the concentration index using aggregated population register data

Sonja Lumme, Reijo Sund, Alastair H. Leyland, Ilmo Keskimäki
2015 Health Services & Outcomes Research Methodology  
In this paper, we introduce several statistical methods to evaluate the uncertainty in the concentration index (C) for measuring socioeconomic equality in health and health care using aggregated total population register data. The C is a widely used index when measuring socioeconomic inequality, but previous studies have mainly focused on developing statistical inference for sampled data from population surveys. While data from large population-based or national registers provide complete
more » ... ge, registration comprises several sources of error. We simulate confidence intervals for the C with different Monte Carlo approaches, which take into account the nature of the population data. As an empirical example, we have an extensive dataset from the Finnish cause-of-death register on mortality amenable to health care interventions between 1996 and 2008. Amenable mortality has been often used as a tool to capture the effectiveness of health care. Thus, inequality in amenable mortality provides evidence on weaknesses in health care performance between socioeconomic groups. Our study shows using several approaches with different parametric assumptions that previously introduced methods to
doi:10.1007/s10742-015-0137-1 pmid:25983615 pmcid:PMC4426159 fatcat:564on2eefjggtfjo7ouqbjty3u