Disparity in the Hospitals Utilization among Regions in Indonesia

Authors

  • Trias Mahmudiono Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
  • Agung Dwi Laksono Indonesia Agency for Health Research and Development, Ministry of Health, Jakarta, Indonesia; Doctorate Degree Program in Public Health, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia https://orcid.org/0000-0002-9056-0399

DOI:

https://doi.org/10.3889/oamjms.2021.7304

Keywords:

Disparities, Hospital utilization, Indonesia, Inpatient, Outpatient

Abstract

Abstract: The utilization of hospital services is a benchmark for the success of a health care referral system. Indonesia as the largest archipelago in the world encounters challenging conditions along with lack of infrastructure posed economic and health disparity among its regions. Disparities as a result of this development also have an impact on the accessibility of health care facilities. Regions with good economic movements tend to have good accessibility to health care facilities. For this reason, reducing disparity to achieve universal health services is the goal of health planners and policy makers. Chi Square test was used to test dichotomy variables and t-tests was performed for analysing the difference among continuous variables. These tests were employed to assess the hypothesis that there was significant regional difference in the access of health care in Indonesia. Estimation using multinomial logistic regression test was used to study the disparity between regions in hospital utilization. The results of this study showed that disparities between regions in Indonesia exist in term of hospital utilization. The disparities in hospital utilization among regions in Indonesia were associated with: marital status, socioeconomic status, education level, occupation and insurance ownership. However, the difference in odds ratio for mortality between regions decreased compared to the previous period. Conclusion. Disparities in the hospital utilization among region in Indonesia was associated with complex factors from individual characteristics through geographic barriers.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Laksono AD. Aksesibilitas Pelayanan Kesehatan. Aksesibilitas Pelayanan Kesehatan di Indonesia; 2016. p. 5-20.

Kenea D, Jisha H. Urban-rural disparity and determinants of delivery care utilization in Oromia region, Ethiopia: Communitybased cross-sectional study. Int J Nurs Pract. 2017;23(1):12510. http://doi.org/10.1111/ijn.12510 PMid:28090752 DOI: https://doi.org/10.1111/ijn.12510

Loree JM, Javaheri KR, Lefresne SV, Speers CH, Ruan JY, Chang JT, et al. Impact of travel distance and urban-rural status on the multidisciplinary management of rectal cancer. J Rural Health. 2017;33(4):393-401. http://doi.org/10.1111/jrh.12219 PMid:27717002 DOI: https://doi.org/10.1111/jrh.12219

Dorjdagva J, Batbaatar E, Svensson M, Dorjsuren B, Batmunkh B, Kauhanen J. Free and universal, but unequal utilization of primary health care in the rural and urban areas of Mongolia. Int J Equity Health. 2017;16(1):73. http://doi.org/10.1186/s12939-017-0572-4 DOI: https://doi.org/10.1186/s12939-017-0572-4

Wen PC, Lee C, Chang YH, Ku LJ, Li CY. Demographic and rural-urban variations in dental service utilization in Taiwan. Rural Remote Health. 2017;17(3):4161. http://doi.org/10.22605/RRH4161 PMid:28838246 DOI: https://doi.org/10.22605/RRH4161

Chiang CL, Chen PC, Huang LY, Kuo PH, Tung YC, Liu CC, et al. Impact of universal health coverage on urban-rural inequity in psychiatric service utilisation for patients with first admission for psychosis: A 10-year nationwide population-based study in Taiwan. Br Med J. 2016;6(3):e010802. http://doi.org/10.1136/bmjopen-2015-010802 PMid:26940114 DOI: https://doi.org/10.1136/bmjopen-2015-010802

Gonzales S, Mullen MT, Skolarus L, Thibault DP, Udoeyo U, Willis AW. Progressive rural-urban disparity in acute stroke care. Neurology. 2017;88(5):441-8. http://doi.org/10.1212/WNL.0000000000003562 PMid:28053009 DOI: https://doi.org/10.1212/WNL.0000000000003562

Galal SB, Al-Gamal N. Health problems and the health care provider choices: A comparative study of urban and rural households in Egypt. J Epidemiol Glob Health. 2014;4(2):141-9. https://dx.doi.org/10.1016/j.jegh.2013.12.002 PMid:24857182 DOI: https://doi.org/10.1016/j.jegh.2013.12.002

Sheikh K. Utility of provider volume as an indicator of medical care quality and for policy decisions. Am J Med. 2001;111(9):712-5. http://doi.org/10.1016/s0002-9343(01)00924-x PMid:11747851 DOI: https://doi.org/10.1016/S0002-9343(01)00924-X

Elayyat AH, Sadek A. Hospital utilization pattern in a hepatogastroenterology department of a research institute hospital, from 2004 to 2013. J Egypt Public Health Assoc. 2016;91(2):59-64. http://doi.org/10.1097/01.EPX.0000482537.88140.0c PMid:27455082 DOI: https://doi.org/10.1097/01.EPX.0000482537.88140.0c

Tyler PD, Stone DJ, Geisler BP, McLennan S, Celi LA, Rush B. Racial and geographic disparities in interhospital ICU transfers. Crit Care Med. 2018;46(1):76-80. http://doi.org/10.1097/CCM.0000000000002776 PMid:29068859 DOI: https://doi.org/10.1097/CCM.0000000000002776

Riskesdas. Riset Kesehatan Dasar (RISKESDAS) 2013. Laporan Nasional; 2013. p. 1-384.

O’Donnell TF, Powell C, Deery SE, Darling JD, Hughes K, Giles KA, et al. Regional variation in racial disparities among patients with peripheral artery disease. J Vasc Surg. 2018;68(2):519-26. http://doi.org/10.1016/j.jvs.2017.10.090 PMid:29459014 DOI: https://doi.org/10.1016/j.jvs.2017.10.090

Boatin AA, Schlotheuber A, Betran AP, Moller AB, Barros AJ, Boerma T, et al. Within country inequalities in caesarean section rates: Observational study of 72 low and middle income countries. Br Med J. 2018;360:k55. http://doi.org/10.1136/bmj.k55 PMid:29367432 DOI: https://doi.org/10.1136/bmj.k55

Finucane MM, Stevens GA, Cowan M, Lin JK, Paciorek CJ, Singh GM, et al. HHS Public Access Participants. Vol. 377. 2015. p. 557-67. DOI: https://doi.org/10.1016/S0140-6736(10)62037-5

Gavurová B, Kováč V, Fedačko J. Regional disparities in medical equipment distribution in the Slovak Republic a platform for a health policy regulatory mechanism. Health Econ Rev. 2017;7(1):39. http://doi.org/10.1186/s13561-017-0176-0 PMid:29124432 DOI: https://doi.org/10.1186/s13561-017-0176-0

Laksono AD, Wulandari RD, Soedirham O. Regional disparities of health center utilization in rural Indonesia. Malaysian J Public Health Med. 2019;19(1):158-66. DOI: https://doi.org/10.37268/mjphm/vol.19/no.1/art.48

Laksono AD, Wulandari RD, Soedirham O. Urban and rural disparities in hospital utilization among Indonesian adults. Iran J Public Health. 2019;48(2):247-55. PMid:31205878 DOI: https://doi.org/10.18502/ijph.v48i2.819

National Institute of Health Research and Development of Ministry of Health of the Republic of Indonesia. The 2018 Indonesia Basic Health Survey (Riskesdas). Jakarta: National Report. Available from: https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf

Jaafar G, Darkahi B, Lindhagen L, Persson G, Sandblom G. Disparities in the regional, hospital and individual levels of antibiotic use in gallstone surgery in Sweden. BMC Surg. 2017;17(1):128. http://doi.org/10.1186/s12893-017-0312-0. DOI: https://doi.org/10.1186/s12893-017-0312-0

Ryvicker, M. A conceptual framework for examining healthcare access and navigation: A behavioral-ecological perspective. Soc Theory Health. 2018;16(3):224-40. http://doi.org/10.1057/s41285-017-0053-2 PMid:31007612 DOI: https://doi.org/10.1057/s41285-017-0053-2

Song IG, Shin SH, Kim HS. Improved regional disparities in neonatal care by government-led policies in korea. J Korean Med Sci. 2018;33(6):e43. http://doi.org/10.3346/jkms.2018.33.e43 PMid:29349938 DOI: https://doi.org/10.3346/jkms.2018.33.e43

Chung S, Romanelli RJ, Stults CD, Luf HS. Preventive visit among older adults with medicare’s introduction of annual wellness visit: Closing gaps in underutilization. Prev Med. 2018;115:110-8. http://doi.org/10.1016/j.ypmed.2018.08.018 PMid:30145346 DOI: https://doi.org/10.1016/j.ypmed.2018.08.018

Downloads

Published

2021-11-07

How to Cite

1.
Mahmudiono T, Laksono AD. Disparity in the Hospitals Utilization among Regions in Indonesia. Open Access Maced J Med Sci [Internet]. 2021 Nov. 7 [cited 2024 Apr. 18];9(E):1461-6. Available from: https://oamjms.eu/index.php/mjms/article/view/7304

Issue

Section

Public Health Legislation

Categories

Most read articles by the same author(s)

1 2 > >>