Policy to expand hospital utilization in disadvantaged areas in Indonesia: who should be the target?

Abstract

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.

Hospital Utilization in Maluku Province, Indonesia

“…The results show that the age group determines hospital utilization among people in Maluku Province, Indonesia. Age is a strong predictor of illness, and the core conditions prevail primarily concerning degenerative diseases in humans (Laksono, Nantabah and Wulandari, 2018;Lee et al, 2021;Rukmini et al, 2022). Different age levels in the aging population have seen significant changes over time around the world.…”

“…The predictor variables examined in the study were age, gender, education level, work type, marital status, health insurance, transportation cost, and time travel. The predictors adopt variables that are known from previous studies (Mahmudiono and Laksono, 2021;Laksono et al, 2023). Age is the respondent's admission of the most recent birthday, which has already passed.…”

“…Among them are age, gender, education level, and type of work. Moreover, other factors are marital status, socioeconomic, transportation cost, and health insurance ownership (Wulandari, Laksono, Nantabah, et al, 2022;Laksono et al, 2023;Wulandari et al, 2023). In addition to the considerations based on these individual assessments, certain other factors influence hospital utilization, notably the disparity in hospital utilization between urban and rural areas, travel cost and time, and geographical disparities between regions are another barrier to hospital access in Indonesia (Li et al, 2018;Dankwah et al, 2019;Mahmudiono and Laksono, 2021;Laksono et al, 2023).…”

Traditional Health Services Utilization in Disadvantage Areas in Indonesia

“…The study examines THS utilization in Indonesia's disadvantaged regions. and Papua Province (Jayawijaya, Nabire, Paniai, Puncak Jaya, Boven Digoel, Mappi, Asmat, Yahukimo, Bintang Mountains, Tolikara, Keerom, Waropen, Supiori, Great Mamberamo, Nduga, Lanny Jaya, Central Mamberamo, Yalimo, Puncak, Dogiyai, Intan Jaya, Deiyai) [15].…”

“…According to this regulation, what is meant by Disadvantaged Regions are districts whose territories and people are less developed compared to other regions on a national scale. This regulation regulates the designation of an area as disadvantaged based on six criteria: the community's economy, human resources, facilities and infrastructure, regional financial capacity, accessibility, and regional characteristics [15]. Based on the background narration, the study aims to analyze the factors related to THS utilization in a disadvantaged area in Indonesia.…”