Equity as a goal for health care: an operational inquiry.

Difference in health status, allocation of resources, provision of services and development of basic health infrastructure, both within and between countries raise questions of fairness. The means for assessing this differential, developing strategies to overcome them and documenting changes become crucial. This paper will explore the concepts of equity and justice from an operational perspective, present a number of scenarios in dealing with the health of populations and assess the impact of using equity as a goal for health care in those cases. The objective is to present an analysis of how the same goal in health care may result in different actions with variable results. An evaluation of the potential conflict between equity and utility is presented. Implications for further work on the means of assessing inequities, use of indicators and measuring the result of interventions is discussed.