Hospital utilization among urban poor in Indonesia in 2018: is government-run insurance effective? (original) (raw)
Related papers
The purpose of the present research is to study the impact of healthcare and insurance on the health of Indonesian youth. This study uses logistic regression, which is a statistical analysis method that can examine the relationships between variables and predict outcomes. The study was conducted through a national household survey (SUSENAS 2020), which is a data collection method that gathers information from individuals within a household. The study found that children without health insurance were significantly more likely to be hospitalized than those with insurance. Private insurance and employer-sponsored insurance were not found to significantly reduce hospitalization frequency. Other significant factors affecting children's health included age, sex, parent's education, smoking behavior, and house location. The results showed that older children were generally healthier, children of well-educated and non-smoking parents were less likely to be hospitalized, and those li...
Factors Associated with National Health Insurance Coverage in Indonesia
F1000Research
Background: The National Health Insurance (NHI) program is the Indonesian government's national health program. However, health insurance coverage has not been maximized. This study aims to analyze the factors associated with health insurance coverage in Indonesia. Methods: Cross-sectional data were obtained from the Indonesian Demographic and Health Survey 2017. A total of 39,580 respondents were selected using two-stage stratified cluster sampling. The data come from the DHS Questionnaire Phase 7. The variables include age, education level, wealth quintiles, residence, the number of children who are alive, marital status, current employment status, earnings, and health insurance status. The data were analyzed using chi-squared and binary logistic analyses. Results: The prevalence of health insurance coverage in the Indonesian population is 62.3%. Respondent age [AOR=0.875; 95% CI=0.763-0.967], education level [AOR=0.437; 95% CI=0.410-0.466], wealth quintile [AOR=0.762; 95%...
Policy to expand hospital utilization in disadvantaged areas in Indonesia: who should be the target
BMC Public Health, 2023
Background: The disadvantaged areas are one of the government's focuses in accelerating development in Indonesia, including the health sector. The study aims to determine the target for expanding hospital utilization in disadvantaged areas in Indonesia. Methods: The study employed the 2018 Indonesian Basic Health Survey data. This cross-sectional study analyzed 42,644 respondents. The study used nine independent variables: residence, age, gender, marital, education, employment, wealth, insurance, and travel time, in addition to hospital utilization, as a dependent variable. The study employed binary logistic regression to evaluate the data. Results: The results found that average hospital utilization in disadvantaged areas in Indonesia in 2018 was 3.7%. Urban areas are 1.045 times more likely than rural areas to utilize the hospital (95% CI 1.032-1.058). The study also found age has a relationship with hospital utilization. Females are 1.656 times more likely than males to use the hospital (95% CI 1.639-1.673). Moreover, the study found marital status has a relationship with hospital utilization. The higher the education level, the higher the hospital utilization. Employed individuals have a 0.748 possibility to use the hospital compared with those unemployed (95% CI 0.740-0.757). Wealthy individuals have more chances of using the hospital than poor individuals. Individuals with all insurance types are more likely to utilize the hospital than those uninsured. Individuals with travel times of ≤ 1 h are 2.510 more likely to use the hospital than those with > 1 h (95% CI 2.483-2.537). Conclusion: The specific targets to accelerate the increase in hospital utilization in disadvantaged areas in Indonesia are living in a rural area, being male, never in a union, having no education, being employed, being the poorest, uninsured, and having a travel time of > 1 h. The government should make a policy addressing the problem based on the research findings.
National Health Insurance Effects on Inpatient Utilization in Indonesia
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.4\_April2017/IJHSR\_Abstract.016.html, 2017
Introduction: Disparities in geographic access, health facilities, human resources, health, and economic status of the community resulted in disparities in the utilization of inpatient health care. It is a challenge in achieving Universal Health Coverage (UHC) in Indonesia. The National Health Insurance Program (JKN) was an attempt by the Indonesian government to achieve UHC. Since it was first implemented in 2014, the membership of JKN includes 155.4 million people in 2015, rising to 171 million by 2016 from the total target of 254 million people in Indonesia to be achieved by 2019. Aims & Objectives: This study aimed to analyze the effect of JKN on the utilization of inpatient care in government hospitals and private hospitals of the year before (2013) and one year after (2015) the National Health Insurance program (JKN) implemented. Materials & Methods: This study uses a quantitative approach. Quantitative methods implemented through literature and statistical data analysis of Susenas (National Social Economic Survey) in 2013 and 2015. Results: The study found that the program JKN increase the utilization of hospitalization both in the government and private hospitals. Number of percentages, delta values, and odds ratios illustrate that JKN program open wider access to the nationwide inpatient utilization. The increase in inpatient utilization can be influenced by several factors such as the increase in the number of health facilities collaborate with National Health Insurance Agency (BPJS), and the increasing number of JKN participants that got tuition assistance from the government for the poor and underprivileged citizens/Recipient Contribution (PBI). Although all the provinces in Indonesia increased in utilization, there are 17 provinces that are below the national average because of disparities in the availability of facilities and infrastructure, health human resources, and equity in participation of JKN. Conclusion: JKN Program increases the utilization of inpatient care in government and private hospitals despite various disparities between provinces and regions of the major islands in Indonesia are still found.
Medical Clinical Update
The National Health Insurance Program (Jaminan Kesehatan Nasional - JKN) is a social health insurance managed by the National Health Insurance Agency (Badan Penyelenggara Jaminan Sosial Kesehatan – BPJS Kesehatan), aiming to provide health insurance for all Indonesian people. Community groups that receive subsidies from the government are referred to as Contribution Assistance Recipients (Penerima Bantuan Iuran - PBI) participants. One of the issues regarding the JKN program so far is the inaccuracy of PBI targets. Therefore, a study is needed to evaluate the relationship between JKN PBI ownership with their socioeconomic status and history of receiving social aid.
The Role of Health Insurance Membership in Health Service Utilisation in Indonesia
Bulletin of Indonesian Economic Studies, 2014
In 2014, Indonesia implemented a new, nationwide, subsidised universalcoverage health insurance program, under which poor Indonesians do not pay to become members and others pay a relatively low fee. This program has created a national debate about the effectiveness of the ownership of health insurance in increasing the use of health services-particularly among the poor-given the limitations in their quantity and quality. Using membership data on different health insurance programs from the 2007 rounds of Susenas and Riskesdas, this article researches the impact of having health insurance on health service utilisation, by controlling the levels of quality and quantity of health services in the area. We argue that having health insurance increases health service utilisation by approximately eight percentage points when people feel sick (or by approximately five percentage points if we include those who do not feel sick).
Hospital utilization in Indonesia in 2018: do urban–rural disparities exist?
BMC Health Services Research
Background The government must ensure equality in health services access, minimizing existing disparities between urban and rural areas. The referral system in Indonesia is conceptually sound. However, there are still problems of uneven service access, and there is an accumulation of patients in certain hospitals. The study aims to analyze the urban–rural disparities in hospital utilization in Indonesia. Methods The study used secondary data from the 2018 Indonesian Basic Health Survey. This cross-sectional study gathered 629,370 respondents through stratification and multistage random sampling. In addition to the kind of home and hospital utilization, the study looked at age, gender, marital status, education, occupation, wealth, and health insurance as control factors. The research employed multinomial logistic regression to evaluate the data in the final step. Results According to the findings, someone who lives in an urban region has 1.493 times higher odds of using outpatient h...
BMC Public Health, 2023
Background Indonesia has made significant progress in expanding universal health coverage (UHC) through its National Health Insurance (NHI) mechanism. However, in the context of NHI implementation in Indonesia, socioeconomic disparities caused its subpopulations to have different literacy of NHI concepts and procedures, increasing the risk of healthcare access inequities. Hence, the study aimed to analyse the predictors of NHI membership among the poor with different education levels in Indonesia.
SSRN Electronic Journal, 2015
This paper was aimed to investigate the mixed empirical results on the effect of health insurance in reducing the risk of catastrophic health expenditure (CHE). We investigated a wide range of factors affecting the risk of CHE among patients admitted to hospitals in Tehran. We categorized hospitals into five groups from private hospitals to charity ones. The data used herein was extracted from the second round of Urban Health Equity Assessment and Response Tool. Determinants of CHE were identified using logistic regression. We found that the significant effect of insurance on aggregate data was solely determined by its effect on reducing the risk of CHE in social security organization hospitals. Insured people by this organization allocate a higher proportion of their salaries to the health insurance and are admitted to the organizational hospitals free of charge. This finding shows the bias inherited in the aggregation and provides support for full prepayments mechanisms. Our findings suggest that CHE is related to the chosen hospitals by individuals, which, in turn, needs to be based on individuals' health insurance and socioeconomic conditions.
Who gets what? utilization of health services in Indonesia
International Journal of Health Planning and Management, 1988
An evaluation of health service utilization patterns was carried out in five rural districts and a number of urban areas in Indonesia. The study was part of a larger effort to develop economically-related information about the health care services. Utilization levels were then related to such selected population variables as distance from health facilities, insurance status and income. The annual contact rate, curative plus preventive, with all public sector facilities was found to be 0.8 per capita. The geographic catchment areas of the facilities were also found to be very limited. The insured population (civil servants and their families) used services about four times more frequently, on average, than did the rest of the population. In one provincial study, the top 9 per cent of income earners made up one-third of all hospital inpatients, one-half of all hospital outpatients, and one-quarter of all health centre visitors. The implications of these results for equity and efficiency are discussed.