Background: Health care utilization is one of the key indicators in measuring performance of health care services. Strong brand equity suggests positive correlation with great attraction for consumers to use a product. Design and Methods: A cross-sectional study was conducted to identify the effects of brand equity to health care utilization. 381 students were selected by simple random sampling. Multiple logistic regression tests were used to analyze the influence between variables. Results: Findings showed that there was an influence between brand equity and health care utilization (P=0.001). In the three attributes, brand equity was known to have an influence to the utilization of health care. The highest influence of the three attributes was brand association (Exp (B) = 2.501). Conclusions: It can be concluded that brand equity affects patient visits to AHCC showing that the brand equity significantly influence patient visits. Promotion to create familiarity and good impression was required to enhance brand equity and increase health care utilization.

PurposeThe purpose of this paper is to investigate whether justice, trust in healthcare services, the confidence level of the health system and institutions, political party support and evaluation of healthcare services post-Jaminan Kesehatan Nasional (JKN) affected policy acceptability (PA) in the health workers (n=95) and laypeople (n=308) sample.Design/methodology/approachThe authors performed a two-level, linear mixed-effects model to test the hypothesis that trust, perceived justice, confidence in healthcare services and national health system evaluation could impact PA in the health workers and laypeople sample. The authors calculated the effect sizes by comparing Level 2 variances and residuals of the null model and the random intercept model.FindingsThe findings suggested that healthcare workers with high concern for justice would be more likely to hold negative acceptability to JKN. The findings implied that health workers tend to associate JKN with unfairness. Also, JKN acceptability in laypeople sample was found to be positively associated with the evaluation of healthcare service post-JKN, whereas justice or political party support did not affect JKN acceptability. It might indicate that laypeople motives for joining JKN scheme could be essentially pragmatic.Research limitations/implicationsThe authors administered the questionnaire using an online platform and circulated it through social media and IMS, so that this research poses a problem of self-selection bias, which potentially leads to biased estimates. The authors also oversampled female participants, especially in laypeople sample.Originality/valueAiming at universal health coverage in 2019, JKN will cover almost 300m Indonesians and be one of the biggest single-payer national health insurance scheme in the world. The research might offer insight into how health workers and laypeople respond to the policy.

Background Several large-scale reforms, including policies aimed at achieving universal health coverage, have been implemented to overcome health disparities in Indonesia. However, access to health services remains unequal. Many people ‘bypass’ health services in their home district to access health services in neighbouring districts, even though their health insurance does not cover such services. This study aims to identify the factors that are associated with this out-of-district bypassing behaviour. Methods We surveyed 500 respondents living in the outermost districts of East Java province. We used data on education, income, district, age, gender, household size, district accessibility, insurance coverage status and satisfaction with health facilities in the home district and logistic regression analysis to model the predictors of out-of-district health facility bypassing. Results The most important predictors of the bypassing behaviour were education and poor access to health facilities in the home district. Open-ended data also found that the most important reason for seeking care in another district was mostly geographic. In contrast, health insurance coverage does not appear to be a significant predictor. Conclusions Education and geographic factors are the main predictors of out-of-district bypassing behaviour, which appears to be how border communities express their health facility preferences. Local and central governments should continue their work to reduce inequality in access to health facilities in Indonesia's geographically challenged districts.

The Government of Indonesian implemented maternal health service programs to minimize at-home childbirth services and increase mothers' utilization of its services. There is not enough evidence these policies are effectively decreasing the maternal mortality rate. Hence, this study aimed to analyze the predictors of each specific childbirth services in Indonesia. This study used the secondary dataset of the 2012 Indonesian demographic data survey (IDHS). The sample was 17,769 women ages 15 to 49 years old. We performed logistic regression for the multivariate case to identify the predictors of childbirth service. Geographical, education, and economic condition significantly predict childbirth services. Women who are not residents tend to use a community-based facility than institutionalized health. Women with higher parity, inadequate knowledge on pregnancy danger signs, lower antenatal care visits, and never had any discussion with their husbands about the planned place of giving birth tend to prefer giving birth at home than health facilities. Women's decision to use a safe childbirth service is hindered by demanding access to reach institutionalized healthcare. Our findings highlighted the importance of women empowerment to enable women to utilize safe labor in a health facility.

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