Universal health coverage in Indonesia – the forgotten prevention

Widjaja, Felix Firyanto

doi:10.13181/mji.v23i3.1070

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…The exceptionally large inequalities in preventive care utilisation may reflect the low priority given to preventive care in Indonesia’s health policy which to date has strongly focused on curative care. This resulted in low health expenditures on preventive care,42 and the absence of a nationwide preventive programme for the NCDs. As a result, the utilisation of preventive care is relying more on personal resources or potentially motivated or initiated by physicians who have more attention to preventive care 43 44…”

Section: Discussionmentioning

confidence: 99%

“…Until recently, Indonesia did not implement a systematic policy or programmes for the prevention of cardiovascular diseases or other main non-communicable diseases (NCDs) 13. Furthermore, the NHI programme put much emphasis on curative care, which makes the utilisation of preventive care likely depend more on personal resources than on collective efforts 17…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic inequalities in healthcare utilisation in Indonesia: a comprehensive survey-based overview

2019

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ObjectiveMonitoring inequality in healthcare utilisation is essential to reduce persistent inequalities in health in lower-middle income countries. This study aimed to assess socioeconomic inequalities in the utilisation of primary care, secondary care and preventive care in Indonesia.MethodsA cross-sectional study was conducted using data from the 2014 Indonesia Family Life Survey with a total of 42 083 adult participants. Socioeconomic status (SES) was measured by educational level and income. Healthcare utilisation was measured in: (1) primary care, (2) outpatient in secondary care, (3) inpatient care and (4) cardiovascular-related preventive care. The magnitude of inequalities was measured using the relative index of inequality (RII).ResultsSmall educational inequalities were found for primary care utilisation (RII 1.13, 95% CI 1.01 to 1.26). Larger educational inequalities were found for outpatient secondary care (RII 10.35, 95% CI 8.11 to 13.22) and inpatient care (RII 2.78, 95% CI 2.32 to 3.32). The largest educational inequalities were found for preventive care, particularly regarding blood glucose tests (RII 30.31, 95% CI 26.13 to 35.15) and electrocardiography tests (RII 30.90, 95% CI 24.97 to 38.23). Compared with educational inequalities, income inequalities were larger for primary care (RII 1.68, 95% CI 1.52 to 1.85) and inpatient care (RII 3.11, 95% CI 2.63 to 3.66), but not for outpatient secondary care and preventive care.ConclusionsSocioeconomic inequalities in healthcare utilisation in Indonesia are particularly large in secondary and preventive care. Therefore, it is recommended to prioritise policies focused on improving timely, geographical and financial access to secondary and preventive care for lower SES groups.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Socioeconomic inequalities in healthcare utilisation in Indonesia: a comprehensive survey-based overview

2019

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“…Intending to provide comprehensive, fair, and equal health coverage to the entire population, including the poor and vulnerable [ 28 ], the GoI launched JKN ( Jaminan Kesehatan Nasional or the National Health Insurance) in 2014. Not only for free treatment, but JKN also provides the opportunity for people to be healthy by reducing risk and screening those at risk [ 29 ]. To that end, the BPJS ( Badan Penyelenggara Jaminan Sosial or Social Health Insurance Administration Body) has curative and preventive action programs as the managing entity for JKN.…”

Section: National Health Insurance and Household Waste Management: Th...mentioning

confidence: 99%

Is there an ex-ante moral hazard on Indonesia’s health insurance? An impact analysis on household waste management behavior

et al. 2022

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The presence of ex-ante moral hazard could undermine the potential gain from expanding health insurance coverage in developing nations. To test the proposition, this study utilizes a nationally representative longitudinal survey with Indonesia’s health insurance for poor policy in 2014 as the quasi-experimental case study. The country represents developing nations that undergo a massive and rapid expansion of health insurance coverage. The empirical approach combines a matching and difference-in-differences method to obviate potential bias of the selectivity nature of health insurance provision and time-invariant unobserved factors. The findings suggest the presence of ex-ante moral hazard in the form of the less people using trash cans associated with the introduction of the subsidized health insurance premium. The results add empirical findings of a negative side effect of expanding health insurance coverage in developing nations.

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“…1 Since the launch of the Universal Health Coverage (UHC) program in Indonesia, most of the population has been able to access the available health services. 2,3 . In Makassar City, the coverage of National Health Insurance (NHI) membership reached 80 percent.…”

Section: Introductionmentioning

confidence: 99%

A qualitative Study of Accessibility Health Services among Communities on Small Islands in Makassar City

2020

MLU

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This study aims to explore barriers to access in health services among small islands in Makassar City. This research is qualitative research through content analysis by observing phenomena that occur based on the accessibility framework of Levesque, et.al. Data collection was carried out through in-depth interviews with 8 key informants and 9 other informants (n = 17).This study found that geographical factors (distance, travel time, and transportation costs) were the main considerations in utilizing primary health services in the small island communities around Makassar City which were predominantly fishermen. The two closest islands (Barrang Caddi and Bone Tambung), have enjoyed easy access and free service for Universal Health Coverage (UHC) achievements.It is different from the outer islands, especially Langkai and Lanjukang, although most of the residents already have National Health Insurance (NHI) they have difficulty using their cards due to geographical constraints. Moreover, fishermen often go fishing for days, becoming another obstacle in accessing quality health facilities available in Makassar City.Various efforts have been made by the Makassar City Health Office to address the disparity in health services in the islands in Barrang Caddi, such as the use of sea ambulances, and regular visits. The marine ambulance is only one ship on standby between two public health centers in another village office if there is an emergency patient who must be referred to a hospital in Makassar City. This disparity in access to health services triggers injustice among residents of the islands in the Makassar City area. Very contractual with the slogan: "Makassar City of the World".This study revealed a special transportation need in the form of a very simple capacity sea ambulance and managed by island community communities that are not reached by sea ambulances from the public health center.

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Universal health coverage in Indonesia – the forgotten prevention

Abstract: [no abstract available]

Cited by 7 publications

References 5 publications

Socioeconomic inequalities in healthcare utilisation in Indonesia: a comprehensive survey-based overview

Socioeconomic inequalities in healthcare utilisation in Indonesia: a comprehensive survey-based overview

Is there an ex-ante moral hazard on Indonesia’s health insurance? An impact analysis on household waste management behavior

A qualitative Study of Accessibility Health Services among Communities on Small Islands in Makassar City

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