Now showing 1 - 10 of 11
  • Publication
    Poverty dynamics : an analysis of the 1994 and 1995 waves of the European Community Household Panel Survey
    (Economic and Social Research Institute, 2000-07) ; ; ;
    Recent poverty research internationally based on analysis of panel data has highlighted the importance of income dynamics. In this paper, we study mobility into and out of relative income poverty from one year to the next using data for twelve countries from the European Community Household Panel Survey (ECHP). The ECHP has unique potential as a harmonised data set to serve as the basis for comparisons of income and poverty dynamics across EU countries, and here we begin exploiting this potential by analysing income poverty transitions from Wave 1 to Wave 2. As well as describing the extent of these transitions, we analyse the pattern by fitting log-linear and linear by linear models commonly employed in the analysis of social mobility. Moving from general to specific models we show the relative impact of hierarchy, immobility and affinity effects. Our analysis shows that cross-national variation in short-term poverty dynamics is predominantly a consequence of "shift" rather than "association effects". Variation across countries in patterns of poverty persistence is extremely modest. Models that assume that the processes underlying poverty dynamics are constant across countries perform almost as well as those that allow for cross-national variability.
      469
  • Publication
    Equity in the utilisation of health care in Ireland
    (Economic and Social Research Institute, 2004) ;
    This paper analyses the extent of equity of health service delivery across the income distribution in Ireland – that is the extent to which there is equal treatment for equal need irrespective of income. We find that almost all services, apart from dental and optician services, are used more by those at the lower end of the income distribution, but that this group also have the greatest need for health care. The comparison of health need to health care delivery across the income distribution without standardising for confounding factors suggests that those in higher income groups receive more health care for a given health status indicating inequity. However, need for health care is highest among the elderly and this group also tend to be at the bottom of the income distribution. Once we standardise for age, sex and location we find that hospital services are distributed equitably across the income distribution, whereas GP and prescription services tend to be pro-poor (used more by those with lower incomes for a given health status) and dental and optician services tend to be pro-rich (used more by those with higher incomes for a given health status).
      415
  • Publication
    Persistent and consistent poverty in the 1994 and 1995 waves of the European Community Household Panel Study
    (Economic and Social Research Institute, 2000-07) ; ; ;
    In this paper we attempt to contribute to the growing literature on the mismatch observed when comparing income and deprivation measures of poverty through an analysis of the first two waves of the European Community Household Panel Study. We do so by developing for each country measures of point in time income poverty, persistent income poverty and consistent poverty involving both low income and a corresponding level of deprivation. Our analysis shows that the mismatch between income and deprivation measures is greatest at the least generously defined poverty lines. A similar relationship was found for persistence. But, while consistency was related to the overall level of poverty in a country, this was not true for persistence. To develop further our understanding of different poverty measures the relationship of these variables to economic strain is considered. While deprivation has a substantially stronger impact than income a significant interaction between the two factors is found to exist. As a prelude to a systematic multivariate analysis of the determinants of different types of poverty, the final section illustrates the manner in which conclusions about the impact of social class on poverty are affected by the choice of poverty measure and the country under consideration. It proceeds to place these findings in the context of the recent debate on the "democratisation" of poverty.
      443
  • Publication
    Differences in Nulliparous Caesarean Section Rates across Models of Care: A Decomposition Analysis
    To evaluate the extent of the difference in elective (ELCS) and emergency (EMCS) caesarean section (CS) rates between nulliparous women in public maternity hospitals in Ireland by model of care, and to quantify the contribution of maternal, clinical, and hospital characteristics in explaining the difference in the rates. Cross-sectional analysis using a combination of two routinely collected administrative databases was performed. A non-linear extension of the Oaxaca-Blinder method is used to decompose the difference between public and private ELCS and EMCS rates into the proportion explained by the differences in observable maternal, clinical, and hospital characteristics and the proportion that remains unexplained. Of the 29,870 babies delivered to nulliparous women, 7,792 were delivered via CS (26.1 %), 79.6 % of which were coded as EMCS. Higher prevalence of ELCS was associated with breech presentation, other malpresentation, and the mother being over 40 years old. Higher prevalence of EMCS was associated with placenta praevia or placental abruption, diabetes (pre-existing and gestational), and being over 40 years old. The private model of care is associated with ELCS and EMCS rates 6 percentage points higher compared than the public model of care but this differential is insignificant in the fully adjusted models for EMCS. Just over half (53 %) of the 6 percentage point difference in ELCS rates between the two models of care can be accounted for by maternal, clinical and hospital characteristics. Almost 80 % of the difference for EMCS can be accounted for.CONCLUSIONS: The majority of the difference in EMCS rates across models of care can be explained by differing characteristics between the two groups of women. The main contributor to the difference was advancing maternal age. The unexplained component of the difference for ELCS is larger; an excess private effect remains after accounting for maternal, clinical, and hospital characteristics. This requires further investigation and may be mitigated in future with the introduction of clinical guidelines related to CS.
      289Scopus© Citations 12
  • Publication
    Targeting poverty : lessons from monitoring Ireland’s National Anti-Poverty Strategy
    (Economic and Social Research Institute, 1999-07-14) ; ;
    In 1997 the Irish Government adopted the National Anti-Poverty Strategy (NAPS), a global target for the reduction of poverty which illuminates a range of issues relating to official poverty targets. The Irish target is framed in terms of a relative poverty measure incorporating both relative income and direct measures of deprivation based on data on the extent of poverty from 1994. Since 1994 Ireland has experienced an unprecedented period of economic growth that makes it particularly important to assess whether the target has been achieved, but in doing so we cannot avoid asking some underlying questions about how poverty should be measured and monitored over time. After briefly outlining the nature of the NAPS measure, this article examines trends in poverty in Ireland between 1987 and 1997. Results show that the relative income and deprivation components of the NAPS measure reveal differential trends with increasing relative income poverty, but decreasing deprivation. However, this differential could be due to the fact that the direct measures of deprivation upon which NAPS is based have not been updated to take account of changes in real living standards and increasing expectations. To test whether this is so, we examine the extent to which expectations about living standards and the structure of deprivation have changed over time using confirmatory factor analysis and tests of criterion validity using different definitions of deprivation. Results show that the combined income and deprivation measure, as originally constituted continues to identify a set of households experiencing generalised deprivation resulting from a lack of resources.
      420
  • Publication
      446
  • Publication
    Targeting poverty : lessons from monitoring Ireland's National Anti-Poverty Strategy
    (Cambridge University Press, 2000-10) ; ;
    In 1997 the Irish government adopted the National Anti-Poverty Strategy (NAPS), a global target for the reduction of poverty which illuminates a range of issues relating to official poverty targets. The Irish target is framed in terms of a relative poverty measure incorporating both relative income and direct measures of deprivation based on data on the extent of poverty from 1994. Since 1994 Ireland has experienced an unprecedented period of economic growth that makes it particularly important to assess whether the target has been achieved, but in doing so we cannot avoid asking some underlying questions about how poverty should be measured and monitored over time. After briefly outlining the nature of the NAPS measure, this article examines trends in poverty in Ireland between 1987 and 1997. Results show that the relative income and deprivation components of the NAPS measure reveal differential trends with increasing relative income poverty, but decreasing deprivation. However, this differential could be due to the fact that the direct measures of deprivation upon which NAPS is based have not been updated to take account of changes in real living standards and increasing expectations. To test whether this is so, we examine the extent to which expectations about living standards and the structure of deprivation have changed over time using confirmatory factor analysis and tests of criterion validity using different definitions of deprivation. Results show that the combined income and deprivation measure, as originally constituted, continues to identify a set of households experiencing generalised deprivation resulting from a lack of resources.
      1217
  • Publication
    National Variation in Caesarean Section Rates: A Cross Sectional Study in Ireland
    Objective: Internationally, caesarean section (CS) rates are rising. However, mean rates of CS across providers obscure extremes of CS provision. We aimed to quantify variation between all maternity units in Ireland. Methods: Two national databases, the National Perinatal Reporting System and the Hospital Inpatient Enquiry Scheme, were used to analyse data for all women delivering singleton births weighing ≥500g. We used multilevel models to examine variation between hospitals in Ireland for elective and emergency CS, adjusted for individual level sociodemographic, clinical and organisational variables. Analyses were subsequently stratified for nullipara and multipara with and without prior CS. Results: The national CS rate was 25.6% (range 18.2% ─ 35.1%). This was highest in multipara with prior CS at 86.1% (range 6.9% ─ 100%). The proportion of variation in CS that was attributable to the hospital of birth was 11.1% (95% CI, 6.0 ─ 19.4) for elective CS and 2.9% (95% CI, 1.4 ─ 5.6) for emergency CS, after adjustment. Stratifying across parity group, variation between hospitals was greatest for multipara with prior CS. Both types of CS were predicted by increasing age, prior history of miscarriage or stillbirth, prior CS, antenatal complications and private model of care. Conclusion: The proportion of variation attributable to the hospital was higher for elective CS than emergency CS suggesting that variation is more likely influenced by antenatal decision making than intrapartum decision making. Multipara with prior CS were particularly subject to variability, highlighting a need for consensus on appropriate care in this group.                        
      374Scopus© Citations 30