The Palestinian Economy. Theoretical and Practical Challenges

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Proceedings “The Palestinian Economy: Theoretical and Practical Challenges” 375 As shown above, although the distributions of need serve to push the distribution of utilisation of the three levels of health care in a pro-poor direction, the divergence between overall use-inequality index (I y ) and the distributions of need (I N ) is, however, remarkable. The discrepancies between the “actual” and the “need-expected” distributions of utilisation indicate, therefore, the direction and magnitude of Horizontal Inequity (HI) index – defined as inequality not due to income-related differences in need, and computed as in Eq. (22) – i.e., by subtracting the contribution of need factors from the total inequality. Results on the HI index, which are also presented in Figure 4.1 with the corresponding 95% BTS confidence intervals, show that in all the cases, the values of HI index appear to be positive, in the range of [0.039; 0.213], and statistically significantly different than zero at p < 0.05. For all levels of health care, the WB region of the OPT shows significantly higher HI index values than GS. However, in the two regions, the magnitudes of HI index across the three levels of health care show generally similar patterns: the HI values are greater (i.e., very pro-rich) in the case of tertiary-care [HI = 0.2126 and 0.1945, for the WB and GS, respectively] and secondary-inpatient case [HI = 0.0954 and 0.0484, for the WB and GS, respectively], while they appear to be smaller (i.e., less pro-rich) in the case of primary-care [HI = 0.0398 and 0.0357 for the WB and GS, respectively], and secondary-outpatient case [HI = 0.0789 and 0.0413 for the WB and GS, respectively]. The above suggest that, for a given level of need, the better-off make greater use of, and receive in proportion more, health care than the “poor”. Results, which hold true for all levels of health care, clearly indicate significant contributions of “other” non-need factors (I NN ) in generating the total level of inequality in utilisation. As illustrated above, the observed non-zero values of HI index can be mechanically disentangled in terms of two parts, I V and I B , reflecting, respectively, two distinct channels of influence: the effects (on ŷ) operating through the inter-personal variations in the x k ’s across income (the I V ), and the effects operating through the inter-group variations in the estimated parameters across income range (the I B ). Detailed results on each part of the decomposition are also presented in Table 4.1. Broadly interpreted, the I V would tell us – for all x k combined (or for each x k in turn) – the extent to which the observed inequality (in ŷ) is due to socioeconomic inequalities, whereas, the I B show – for a given level of need – the extent to which inequalities in ŷ are due to heterogeneity in behaviour (or practice) of the socioeconomic groups.
376 Abu-Zaineh – Mataria Figure 4.1: Horizontal Inequity Indices by Levels of Health Care and Regions, with 95% BTS Confidence Intervals 0.32 0.28 Horizontal Inequity (HI) 0.24 0.20 0.16 0.12 0.08 0.04 0.00 -0.04 WB GS WB GS WB GS WB GS Primray-care Secondary-care (outpatient) Secondary-care (inpatient) Tertiary-care Overall, in the two regions and for all levels of health care, the estimated values of I V index – i.e., the aggregation or the combined effects of all socio-economic variables – appear to be invariably significantly positive [I V > 0 at p < 0.05], and account for a significant and sizeable contribution: between 63% and 70% of all measured HI. This suggests that the measured income-related inequity – defined as inequality not due to need – in the utilisation of the three levels of health care in the OPT are mainly driven by omnipresent socio-economic inequalities. In effect, the (aggregate) positive contribution of I V indicates that some (or all) of the significant socio-economic regressors included in our model do have a “pro-rich bias” in their distributions by income, and consequently, act to push the distribution of utilisation in a “pro-rich” direction. It may be of interest, therefore, to consider the (partial) contribution of each x k in turn. However, before going through these contributions, it is worth bearing in mind their interpretations. As explained above, these are computed by the CI of several simulated-distributions through going from a distribution, one in which the relevant explanatory variable in whose the effect and distribution by income we are interested is neutralised (i.e., assumed be equally distributed across income by setting it
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The Palestinian Economy Theoretical
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© Gianni Vaggi - Marco Missaglia -
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VOLUME II
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246 Zagha 1. Introduction The local
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248 Zagha and groups in political d
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250 Zagha drawbacks in the politica
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252 Zagha it is not surprising that
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254 Zagha economy (including expend
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256 Zagha social norms sharply dist
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258 Zagha Bird (1995) puts it, info
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260 Zagha intergovernmental fiscal
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262 Zagha low rate flat tax levied
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264 Zagha need to be given access t
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266 Zagha Such failures are found i
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268 Zagha 4.1.3. The Relationship b
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270 Zagha a final account report of
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272 Zagha 4.1.6. Functions of LGUs
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274 Zagha • Management of LGU ass
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276 Zagha Figure 2: Local Governmen
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278 Zagha In summary, what the data
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280 Zagha on the cash basis. Almost
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282 Zagha Figure 7: Business Opinio
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284 Zagha within the Palestinian na
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286 Zagha Table 5: Number of NGOs i
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288 Zagha Fiscal decentralisation i
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290 Zagha Burki, J., Perry, G., Dil
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292 Zagha Palestinian Legislative C
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Issues, Performance and Trajectorie
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Proceedings “The Palestinian Econ
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The Effect of the Israeli-Palestini
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426 Olivera Figure 1: Economic Grow
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428 Olivera 3. Traditional economic
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430 Olivera costs and lower market
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The Palestinian Economy. Theoretical and Practical Challenges

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