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 hospital services than someone in a rural area (AOR 1.493; 95% CI 1.489–1.498). Meanwhile, someone who lives in an urban region has 1.075 times higher odds of using an inpatient facility hospital than someone who lives in a rural one (AOR 1.075; 95% CI 1.073–1.077). Furthermore, someone living in an urban region has 1.208 times higher odds than someone who lives in a rural area using outpatient and inpatient hospital services simultaneously (AOR 1.208; 95% CI 1.204–1.212). Conclusion The study concluded there were urban–rural disparities in hospital utilization in Indonesia.
Background: The Indonesian government initiated National Health Insurance (NHI) to reduce health service barriers. The study aimed to analyze specific targets for expanding the NHI’s membership in Indonesia. Methods: The study population was all populations in Indonesia. Meanwhile, the study involved a 47 644 weighted sample. The analyzed variables included NHI’s membership, residence, age, gender, education, employment, marital status, and wealth. The study employed binary logistic regression in the final step. Results: The urban population was 0.608 times less likely than the rural population to become a non-member of NHI. Aging younger was one of the barriers to becoming an NHI member, and the male gender is one of the barriers to becoming an NHI member. Meanwhile, the lower the education level, the greater the obstacles to becoming an NHI member in Indonesia. Besides, the unemployed population was 1.002 more likely than the employed population to become a non-member of NHI. The result shows that never married or married have a higher chance of becoming a non-member of NHI. Finally, all wealth status categories are more likely to become barriers to the most prosperous population becoming an NHI member. Conclusions: The study concluded that 7 population characteristics become specific targets for expanding NHI membership in Indonesia. The 7 characteristics are the population who live in rural areas, are young, male, poor education, unemployed, never married or married, and poor.
Nowadays, Traditional Health Services increasingly in demand by the Indonesian Community. According to the National Basic Health Research data of 2018, 31.4% of the population utilized THS. Moreover, the practice of traditional medicine has widely provided in several places. Traditional health services at public hospitals are known as integrated traditional health services (ITHS). This study aims at analyzing the utilization of integrated traditional health services at public hospitals by the community in fi ve provinces. This study, a descriptive with a cross-sectional design, involved ten public hospitals. It selected according to the availability of traditional health services, which is before or since 2014. The number of patients (called respondents) interviewed was determined purposively as many as fi ve patients per hospital; therefore, there were fi fty people. The results of this study indicated that Integrated Traditional Health Services has utilized by most patients aged 20 to 50 years. Information sources regarding the availability of Traditional Health Services mainly from physicians or health professionals. Most respondents lived not far from hospitals so that access to the hospitals can be reachable. Most respondents are satisfi ed with the services accepted. Manager of Traditional Health Services is a physician. Even though most respondents said that not only the cost of treatment for Traditional Health Services is expensive, but also is not covered in benefi t packages of the National Health Insurance Scheme (JKN). Therefore, they remain seeking Traditional Health Services practicing out of pocket payment method. It is recommended that the financing of Traditional Health Services should be covered by Social Security Administration Body (BPJSK) through
ABSTRAK Anak balita merupakan periode masa yang disebut golden age. Akses pelayanan kesehatan untuk kelompok ini menjadi perhatian karena kesinambungan hidup pada kelompok tersebut menjadi salah satu tolok ukur pembangunan kesehatan. Penelitian ini merupakan analisis lanjut data Riskesdas 2013, yang disajikan secara deskriptif kuantitatif. Analisis dilakukan pada variabel-variabel cakupan kunjungan balita ke pelayanan kesehatan. Pelayanan kesehatan dimaksud adalah Rumah Sakit, Puskesmas/Pustu, Praktik Dokter/Klinik, dan Polindes/Praktik Bidan. Hasil penelitian menunjukkan bahwa balita yang tinggal di perkotaan dan pada kelompok kaya dan sangat kaya memiliki akses yang lebih baik di Rumah Sakit dan praktik dokter/klinik pada akses rawat jalan dan rawat inap. Sementara mereka yang tinggal di perdesaan dan pada kelompok miskin memiliki akses yang lebih baik ke Puskesmas/Pustu dan Polindes/praktik bidan baik di rawat jalan maupun rawat inap. Berdasarkan hasil penelitian dapat disimpulkan bahwa balita yang tinggal di perkotaan dan pada kelompok kaya memiliki akses yang lebih baik pada pelayanan kesehatan rujukan, sementara mereka yang tinggal di perdesaan dan pada kelompok miskin memiliki akses yang lebih baik di fasilitas pelayanan kesehatan dasar. Kata kunci: akses, pelayanan kesehatan, balita ABSTRACT Toddler is a period of time called golden age. Access to health services for this group is a concern because the continuity of life in the group is one of the benchmarks for health development. This research is an advance analysis of the Riskesdas 2013, which is presented in quantitative descriptive manner. Analysis was carried out on the variables of coverage of toddler visits to health services. The intended health services are hospitals, health center/Pustu, doctor/clinic, and Polindes/midwife, both on outpatient visits and inpatients. The results showed that toddlers who lived in urban areas and in the rich and very rich groups had better access in hospitals and doctor/clinic practices on access to outpatient and inpatient care. While those who live in rural areas and the poor have better access to health center/Pustu and Polindes/ midwives both in outpatient and inpatient care. Based on the results of the study it can be concluded that toddlers who live in urban areas and in rich groups have better access to referral health services, while those who live in rural areas and in poor groups have better access to basic health care facilities. Keyword: access, health services, toddler
The elderly are one of the most vulnerable groups with very high dependency rates. This condition has the potential to cause other problems for the caregiver or his family. The elderly also has the potential to suffer from catastrophic diseases that have costly consequences. This research is a further analysis of Riskesdas 2013 data, that presented in descriptive quantitative. The results showed that elderly people living in urban as well as rural areas have a tendency of moderate access barrier to Puskesmas. There are still 15% of very poor elderly people who have major access barrier to Puskesmas. This study concludes that although elderly access to Puskesmas is quite good, but the access of very poor elderly is still need more attention. The government needs to provide basic health care facilities in more rural areas. The government also needs to realize a National Health Insurance with tax-based funding, to ensure universal coverage regardless of the ability to pay the community. Abstrak Lansia adalah salah satu kelompok rentan yang memiliki angka ketergantungan sangat tinggi. Kondisi ini berpotensi menimbulkan masalah lain bagi yang merawat atau keluarganya. Lansia juga berpotensi menderita penyakit katastropik yang menimbulkan konsekuensi biaya yang mahal. Penelitian ini merupakan analisis lanjut data Riskesdas 2013, yang disajikan secara deskriptif kuantitatif. Hasil penelitian menunjukkan bahwa lansia yang tinggal di perkotaan maupun perdesaan mempunyai kecenderungan hambatan akses sedang untuk ke Puskesmas. Masih ada 15% lansia sangat miskin yang memiliki hambatan besar ke Puskesmas. Penelitian ini menyimpulkan bahwa meski akses lansia ke Puskesmas sudah cukup baik, tetapi akses lansia yang sangat miskin masih perlu mendapat perhatian lebih. Pemerintah perlu menyediakan fasilitas pelayanan kesehatan dasar di wilayah perdesaan yang lebih banyak. Pemerintah juga perlu mewujudkan sebuah Jaminan Kesehatan Nasional dengan pendanaan berbasis pajak, untuk memastikan cakupan secara universal dengan tanpa menghiraukan kemampuan membayar masyarakat.
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