Hospital utilization among urban poor in Indonesia in 2018: is government-run insurance effective?

Government-run insurance Health insurance Health policy Healthcare evaluation Hospital utilization Public health

Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
12 01 2023
Historique:
received: 18 08 2022
accepted: 10 01 2023
entrez: 12 1 2023
pubmed: 13 1 2023
medline: 17 1 2023
Statut: epublish

Résumé

An urban poor is a vulnerable group that needs government financing support to access health services. Once they are sick, they will fall deeper into poverty. The study aims to analyze the effectiveness of government-run insurance in hospital utilization in urban poor in Indonesia. The research analyzed the 2018 Indonesian Basic Health Survey data. This cross-sectional survey collected 75,970 participants through stratification and multistage random sampling. Meanwhile, the study employed hospital utilization as an outcome variable and health insurance ownership as an exposure variable. Moreover, the study looked at age, gender, marital status, education, and occupation as control factors. The research employed a binary logistic regression to evaluate the data in the final step. The results show that someone with government-run insurance is 4.261 times more likely than the uninsured to utilize the hospital (95% CI 4.238-4.285). Someone with private-run insurance is 4.866 times more likely than the uninsured to use the hospital (95% CI 4.802-4.931). Moreover, someone with government-run and private-run insurance has 11.974 times more likely than the uninsured to utilize the hospital (95% CI 11.752-12.200). The study concluded that government-run insurance is more effective than the uninsured in improving hospital utilization among the urban poor in Indonesia. Meanwhile, private-run is more effective than government-run and uninsured in improving hospital utilization among the urban poor in Indonesia. Moreover, the most effective is to combine the kind of health insurance ownership (government-run and private-run).

Sections du résumé

BACKGROUND
An urban poor is a vulnerable group that needs government financing support to access health services. Once they are sick, they will fall deeper into poverty. The study aims to analyze the effectiveness of government-run insurance in hospital utilization in urban poor in Indonesia.
METHODS
The research analyzed the 2018 Indonesian Basic Health Survey data. This cross-sectional survey collected 75,970 participants through stratification and multistage random sampling. Meanwhile, the study employed hospital utilization as an outcome variable and health insurance ownership as an exposure variable. Moreover, the study looked at age, gender, marital status, education, and occupation as control factors. The research employed a binary logistic regression to evaluate the data in the final step.
RESULTS
The results show that someone with government-run insurance is 4.261 times more likely than the uninsured to utilize the hospital (95% CI 4.238-4.285). Someone with private-run insurance is 4.866 times more likely than the uninsured to use the hospital (95% CI 4.802-4.931). Moreover, someone with government-run and private-run insurance has 11.974 times more likely than the uninsured to utilize the hospital (95% CI 11.752-12.200).
CONCLUSION
The study concluded that government-run insurance is more effective than the uninsured in improving hospital utilization among the urban poor in Indonesia. Meanwhile, private-run is more effective than government-run and uninsured in improving hospital utilization among the urban poor in Indonesia. Moreover, the most effective is to combine the kind of health insurance ownership (government-run and private-run).

Identifiants

pubmed: 36635640
doi: 10.1186/s12889-023-15017-y
pii: 10.1186/s12889-023-15017-y
pmc: PMC9835297
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

92

Informations de copyright

© 2023. The Author(s).

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Auteurs

Ratna Dwi Wulandari (RD)

Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia. ratna-d-w@fkm.unair.ac.id.

Agung Dwi Laksono (AD)

National Research and Innovation Agency, the Republic of Indonesia, Jakarta, Indonesia.

Rofingatul Mubasyiroh (R)

National Research and Innovation Agency, the Republic of Indonesia, Jakarta, Indonesia.

Rika Rachmalina (R)

National Research and Innovation Agency, the Republic of Indonesia, Jakarta, Indonesia.

Mara Ipa (M)

National Research and Innovation Agency, the Republic of Indonesia, Jakarta, Indonesia.

Nikmatur Rohmah (N)

Faculty of Health Science, Muhammadiyah University of Jember, East Java, Indonesia.

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