URBAN-RURAL DISPARITY: THE UTILIZATION OF PRIMARY HEALTHCARE CENTERS AMONG ELDERLY IN EAST JAVA, INDONESIA
Downloads
Background: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output.
Aim: This study analyzed the urban-rural disparity in the utilization of primary healthcare center by the elderly.
Method: This study used in the 2013 Basic Health Research raw data. The 2013 Basic Health Research was designed as a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province participated. Data were analyzed using Multinomial Logistic Regression tests.
Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). The elderly who have a primary school and under education have the possibility of 1.558 times more utilizing outpatients in primary healthcare centersthan the elderly who have college education levels (OR 1.558; 95% CI 1.001-2.424).
Conclusion: There was a disparity between urban and rural areas in the utilization of outpatient primary healthcare centers in East Java by the elderly. Policymakers in East Java are recommended to improve facilities and infrastructure of the primary healthcare centersin rural areas by paying attention to the results of this study.
Keywords: elderly, urban-rural disparities, primary healthcare center, healthcare utilization, inpatient-outpatient.
Brydsten, A., Hammarström, A. and San Sebastian, M. (2018) ‘Health inequalities between employed and unemployed in northern Sweden: A decomposition analysis of social determinants for mental health', International Journal for Equity in Health, 17(1). doi: 10.1186/s12939-018-0773-5.
Carrillo, J. E. et al. (2011) ‘Defining and targeting health care access barriers.', Journal of health care for teh poor and underserved, 22(2), pp. 562–575. doi: 10.1353/hpu.2011.0037.
Chiapella, L. C., Menna, J. M. and Mamprin, M. E. (2018) ‘Potentially Inappropriate Medications in Elderly Ambulatory Patients: A Comparative Study between a Primary Health Care Center and a Community Pharmacy', Value in Health Regional Issues, 17, pp. 119–125. doi: 10.1016/j.vhri.2017.12.009.
Chuah, F. L. H. et al. (2018) ‘Teh health needs and access barriers among refugees and asylum-seekers in Malaysia: A qualitative study', International Journal for Equity in Health, 17(120), pp. 1–15. doi: 10.1186/s12939-018-0833-x.
Dehbarez, N. T. et al. (2018) ‘Does free choice of hospital conflict wif equity of access to highly specialized hospitals? A case study from teh Danish health care system', Health Policy, 122(7). doi: 10.1016/j.healthpol.2018.04.006.
Dhruve, S., Badgaiyan, Y. D. and Pandey, S. (2016) ‘A Study of Socio Economic Factors Effecting Family Planning Services in An Urban Area', International Journal of Scientific Research, 5(6), pp. 618–620.
East Java Central Bureau (2019) Persentase Penduduk Lansia Hasil Proyeksi Penduduk Menurut Kabupaten/Kota di Jawa Timur, 2010-2020, East Java Central Bureau. Available at: https://jatim.bps.go.id/dynamictable/2018/02/06/328/persentase-penduduk-lansia-hasil-proyeksi-penduduk-menurut-kabupaten-kota-di-jawa-timur-2010-2020.html (Accessed: 20 February 2019).
East Java Provincial Health Office (2018) Rencana Kerja Dinas Kesehatan Provinsi Jawa Timur Tahun 2018. Available at: https://e-renggar.kemkes.go.id/file2018/e-performance/2-059010-2tahunan-623.pdf.
El-Sayed, A. M., Vail, D. and Kruk, M. E. (2018) ‘Ineffective insurance in lower and middle income countries is an obstacle to universal health coverage', Journal of global health, 8(2), pp. 1–10. doi: 10.7189/jogh.08.020402.
Fu, X. et al. (2018) ‘Influencing factors of inequity in health services utilization among teh elderly in China 14 Economics 1402 Applied Economics 11 Medical and Health Sciences 1117 Public Health and Health Services', International Journal for Equity in Health, 17(1). doi: 10.1186/s12939-018-0861-6.
González, M. J. (2005) ‘Access to mental health services: Teh struggle of poverty effected urban children of color', Child and Adolescent Social Work Journal, 22(3–4), pp. 245–256. doi: 10.1007/s10560-005-0036-3.
Hahn, R. ., Truman, B. . and Williams, D. . (2018) ‘Civil rights as determinants of public health and racial and ethnic health equity: Health care, education, employment, and housing in teh United States', SSM - Population Health, 4, pp. 17–24. doi: 10.1016/j.ssmph.2017.10.006.
Hamzah, O. S. and Tamba, L. (2018) ‘Determinants of Implementation of Bureaucracy Behavior in Health Service in Community Health Center', Indian Journal of Public Health Research & Development, 9(3), pp. 292–296. doi: 10.5958/0976-5506.2018.00225.5.
Holliday, T. L. et al. (2017) ‘Disparities in rural breast cancer care: Factors effecting choice of breast reconstruction in a West Virginia Tertiary Care Hospital', American Surgeon, 83(7), pp. 717–721.
Johar, M. et al. (2018) ‘Inequality in access to health care, health insurance and teh role of supply factors', Social Science and Medicine, 213, pp. 134–145. doi: 10.1016/j.socscimed.2018.07.044.
Karuaihe, S. T. and Wandschneider, P. R. (2018) ‘Limited access to services for teh urban poor in Windhoek, Namibia', Development Southern Africa, 35(4), pp. 466–479. doi: 10.1080/0376835X.2018.1475219.
Kusumawardani, N. et al. (2018) ‘Socio-economic, demographic and geographic correlates of cigarette smoking among Indonesian adolescents: results from teh 2013 Indonesian Basic Health Research (RISKESDAS) survey', Global Health Action, 11, pp. 54–62. doi: 10.1080/16549716.2018.1467605.
Laksono, A. D., Nantabah, Z. K. and Wulandari, R. D. (2018) ‘Access Barriers to Health Center for Elderly in Indonesia', Buletin Penelitian Sistem Kesehatan, 21(4), pp. 228–235. doi: 10.22435/hsr.v2Ii4.887.
Laksono, A. D. and Rachmawaty, T. (2013) ‘Akseptabilitas Bidan terhadap Implementasi Kebijakan Jaminan Persalinan di Kabupaten Mojokerto', Buletin Penelitian Sistem Kesehatan, 16(4), pp. 341–349.
Langley, E. L., Wootton, B. M. and Grieve, R. (2018) ‘Teh Utility of teh Health Belief Model Variables in Predicting Help-Seeking Intention for Anxiety Disorders', Australian Psychologist, 53, pp. 291–301. doi: 10.1111/ap.12334.
Lee, Y.-H. et al. (2018) ‘Growing concerns and controversies to Taiwan's National Health Insurance”what are teh lessons from mainland China, South Korea and Singapore?', International Journal of Health Planning and Management, 33(1), pp. e357–e366. doi: 10.1002/hpm.2387.
Li, C., Yao, N. (Aaron) and Aitian Yin (2018) ‘Disparities in dental healthcare utilization in China', Community Dentistry and Oral Epidemiology, 46(6), pp. 576–585. doi: 10.1111/cdoe.12394.
Li, J. et al. (2018) ‘Urban-rural disparities in health care utilization among Chinese adults from 1993 to 2011', BMC health services research, 18(102), pp. 1–9. doi: 10.1186/s12913-018-2905-4.
Lungu, E. A. et al. (2018) ‘What influences where they seek care? Caregivers' preferences for under-five child healthcare services in urban slums of Malawi: A discrete choice experiment', PLoS ONE, 13(1). doi: 10.1371/journal.pone.0189940.
Megatsari, H. et al. (2018) ‘Community Perspective about Health Services Access', Buletin Penelitian Sistem Kesehatan, 21(4), pp. 247–253. doi: 10.22435/hsr.v2Ii4.231.
Mubasyiroh, R., Nurhotimah, E. and Laksono, A. D. (2016) ‘Indeks Aksesibilitas Pelayanan Kesehatan di Indonesia', in Supriyanto, S., Chalidyanto, D., and Wulandari, R. D. (eds) Aksesibilitas Pelayanan Kesehatan di Indonesia. Jogjakarta: PT Kanisius, pp. 21–58.
National Institute of Health Research and Development (2013) Riset Kesehatan Dasar 2013. Jakarta: Ministry of Health of teh Republic of Indonesia.
Pratiwi, N. L. et al. (2014) ‘Kajian Kebijakan Penyaluran Dana Bantuan Operasional Kesehatan dalam Mendukung Pencapaian Kesehatan Ibu dan Anak (MDG's 4,5) di Tiga Kabupaten, Kota di Provinsi Jawa Timur Indonesia', Buletin Penelitian Sistem Kesehatan, 17(4), pp. 395–405.
Putri, Y. S. E. and Riasmini, N. M. (2013) ‘Teh Predictors of Caregiver's Burden and Depression Level in Caring Elderly People wif Dementia at Community', Jurnal Ners, 8(1), pp. 88–97. doi: 10.20473/jn.v8i1.3882.
Rinaldi, G., Kiadaliri, A. A. and Haghparast-Bidgoli, H. (2018) ‘Cost effectiveness of HIV and sexual reproductive health interventions targeting sex workers: A systematic review', Cost Effectiveness and Resource Allocation, 16(63). doi: 10.1186/s12962-018-0165-0.
Sari Rochman, E. M. et al. (2018) ‘Method Extreme Learning Machine for Forecasting Number of Patients' Visits in Dental Poli (A Case Study: Community Health Centers Kamal Madura Indonesia)', Journal of Physics: Conference Series, 953. doi: 10.1088/1742-6596/953/1/012133.
Song, me. G., Shin, S. H. and Kim, H.-S. (2018) ‘Improved regional disparities in neonatal care by government-led policies in Korea', Journal of Korean Medical Science, 33(6). doi: 10.3346/jkms.2018.33.e43.
Song, Y. et al. (2018) ‘Spatial and temporal variations of spatial population accessibility to public hospitals: a case study of rural–urban comparison', GIScience and Remote Sensing, 55(5), pp. 718–744. doi: 10.1080/15481603.2018.1446713.
Suharmiati, Laksono, A. D. and Astuti, W. D. (2013) ‘Policy Review on Health Services in Primary Health Center in teh Border and Remote Area', Buletin Penelitian Sistem Kesehatan, 16(2), pp. 109–116.
Tebay, V. (2018) ‘Teh strategy in improving quality of health services for patient satisfaction in community health clinic (Puskesmas) North Jayapura, Jayapura City', Indian Journal of Public Health Research and Development, 9(4), pp. 189–193. doi: 10.5958/0976-5506.2018.00281.4.
Telleen, S. et al. (2012) ‘Access to oral health services for urban low-income Latino children: Social ecological influences', Journal of Public Health Dentistry, 72(1), pp. 8–18. doi: 10.1111/j.1752-7325.2011.00275.x.
Wong, R. C. P. and Szeto, W. Y. (2018) ‘An alternative methodology for evaluating teh service quality of urban taxis', Transport Policy, 69, pp. 132–140. doi: 10.1016/j.tranpol.2018.05.016.
World Health Organization (2018) Vulnerable groups, Environmental health in emergencies. Available at: http://www.who.int/environmental_health_emergencies/vulnerable_groups/en/ (Accessed: 10 July 2018).
Wulandari, R. D. et al. (2019) ‘Socioeconomic Disparities in Hospital Utilization among Elderly People in Indonesia', Researchgate. doi: 10.13140/RG.2.2.11898.54721.
Xu, Y. et al. (2018) ‘Catastrophic health expenditure in households wif chronic disease patients: A pre-post comparison of teh New Health Care Reform in Shaanxi Province, China', PLOS ONE. Edited by U. Simeoni, 13(3), pp. 1–13. doi: 10.1371/journal.pone.0194539.
Yildiz, M. S., Heboyan, V. and Khan, M. M. (2018) ‘Estimating technical efficiency of Turkish hospitals: Implications for hospital reform initiatives', BMC Health Services Research, 18(401), pp. 1–16. doi: 10.1186/s12913-018-3239-y.
Yu, T.-H., Matthes, N. and Wei, C.-J. (2018) ‘Can urban-rural patterns of hospital selection be changed using a report card program? A nationwide observational study', International Journal of Environmental Research and Public Health, 15(9), pp. 1–12. doi: 10.3390/ijerph15091827.
Yuan, Y. et al. (2018) ‘Socioeconomic and Geographic Disparities in Accessing Nursing Homes Wif High Star Ratings', Journal of teh American Medical Directors Association, 19(10), pp. 1–8. doi: 10.1016/j.jamda.2018.05.017.
1. As an author you (or your employer or institution) may do the following:
- make copies (print or electronic) of the article for your own personal use, including for your own classroom teaching use;
- make copies and distribute such copies (including through e-mail) of the article to research colleagues, for the personal use by such colleagues (but not commercially or systematically, e.g. via an e-mail list or list server);
- present the article at a meeting or conference and to distribute copies of the article to the delegates attending such meeting;
- for your employer, if the article is a ‘work for hire', made within the scope of your employment, your employer may use all or part of the information in the article for other intra-company use (e.g. training);
- retain patent and trademark rights and rights to any process, procedure, or article of manufacture described in the article;
- include the article in full or in part in a thesis or dissertation (provided that this is not to be published commercially);
- use the article or any part thereof in a printed compilation of your works, such as collected writings or lecture notes (subsequent to publication of the article in the journal); and prepare other derivative works, to extend the article into book-length form, or to otherwise re-use portions or excerpts in other works, with full acknowledgement of its original publication in the journal;
- may reproduce or authorize others to reproduce the article, material extracted from the article, or derivative works for the author's personal use or for company use, provided that the source and the copyright notice are indicated.
All copies, print or electronic, or other use of the paper or article must include the appropriate bibliographic citation for the article's publication in the journal.
2. Requests from third parties
Although authors are permitted to re-use all or portions of the article in other works, this does not include granting third-party requests for reprinting, republishing, or other types of re-use.
3. Author Online Use
- Personal Servers. Authors and/or their employers shall have the right to post the accepted version of articles pre-print version of the article, or revised personal version of the final text of the article (to reflect changes made in the peer review and editing process) on their own personal servers or the servers of their institutions or employers without permission from JAKI;
- Classroom or Internal Training Use. An author is expressly permitted to post any portion of the accepted version of his/her own articles on the author's personal web site or the servers of the author's institution or company in connection with the author's teaching, training, or work responsibilities, provided that the appropriate copyright, credit, and reuse notices appear prominently with the posted material. Examples of permitted uses are lecture materials, course packs, e-reserves, conference presentations, or in-house training courses;