INPATIENT CARE UTILIZATION AFTER JKN: A STUDY CASE IN EAST NUSA TENGGARA
Background: Healthcare utilization is a predictor of health status among the population. The issues of its accessibility and equity have been raised, particularly after the government launched JKN (Jaminan Kesehatan Nasional)
Aim: This study aims to analyze the determinants of inpatient care utilization in East Nusa Tenggara.
Method: We used SUSENAS 2019 dataset and carried out descriptive and econometrics analysis to covariates including age, gender, educational level, type of health insurance, employment status, and type of residence.
Result: We found that all covariates analyzed were statistically significant in affecting the probability of inpatient care utilization (p-value<0.005). Different patterns of sociodemographic factors among people in East Nusa Tenggara will affect their rate of inpatient care utilization.
Conclusion: Inpatient care utilization rate is crucial to measure health accessibility and prevent any aggravated morbidity due to delayed treatment. Strategies to increase inpatient care utilization are needed to provide accessible treatment for all and increasing population health status.
Keywords: East Nusa Tenggara, health utilization, hospitalization, inpatient care
Alkhawaldeh, A. et al. (2023) ‘Application and Use of Andersen's Behavioral Model as Theoretical Framework: A Systematic Literature Review from 2012–2021', Iranian Journal of Public Health [Preprint]. Available at: https://doi.org/10.18502/ijph.v52i7.13236.
Anwar, M.N. and Pujiyanto, P. (2022) ‘Analysis of Socioeconomic Factors on Healthcare Facilities Utilization for Inpatient Care in Indonesia', PREPOTIF : Jurnal Kesehatan Masyarakat, 6(1), pp. 696–709. Available at: https://doi.org/10.31004/prepotif.v6i1.3265.
Azimzadeh, S. et al. (2019) ‘Effective Factors of Utilization of Inpatient, Outpatient, Diagnostic, and Pharmaceutical Health Services: A Systematic Review', Galen Medical Journal, 8, p. e1236. Available at: https://doi.org/10.22086/gmj.v8i0.1236.
Bland, J.S. (2018) ‘Age as a Modifiable Risk Factor for Chronic Disease', Integrative Medicine: A Clinician's Journal, 17(4), pp. 16–19. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469457/.
Erlangga, D. et al. (2019) ‘The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review', PLOS ONE, 14(8), p. e0219731. Available at: https://doi.org/10.1371/journal.pone.0219731.
Farrell, C.M. and Gottlieb, A. (2020) ‘The Effect of Health Insurance on Health Care Utilization in the Justice-Involved Population: United States, 2014–2016', American Journal of Public Health, 110(Suppl 1), pp. S78–S84. Available at: https://doi.org/10.2105/AJPH.2019.305399.
Feng, G. et al. (2019) ‘Disease spectrum analysis of hospitalized children in China: A study of 18 tertiary children's hospitals', Pediatric Investigation, 3(3), pp. 159–164. Available at: https://doi.org/10.1002/ped4.12144.
Idris, I.B. et al. (2023) ‘Women's autonomy in healthcare decision making: a systematic review', BMC Women's Health, 23, p. 643. Available at: https://doi.org/10.1186/s12905-023-02792-4.
Johar, M. et al. (2019) ‘"Tahukah kamu?”: Analisis Set Data Survei Sosial Ekonomi Nasional (Susenas):', Jurnal Ekonomi dan Pembangunan Indonesia, 19(2), pp. 191–208. Available at: https://doi.org/10.21002/jepi.v19i2.843.
Laksono, A.D., Wulandari, R.D. and Soedirham, O. (2019) ‘Urban and Rural Disparities in Hospital Utilization among Indonesian Adults', Iranian Journal of Public Health, 48(2), pp. 247–255. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556184/.
Lee, J. and Di Ruggiero, E. (2022) ‘How does informal employment affect health and health equity? Emerging gaps in research from a scoping review and modified e-Delphi survey', International Journal for Equity in Health, 21(1), p. 87. Available at: https://doi.org/10.1186/s12939-022-01684-7.
Manafe, A., Sinurat, D. and Sukin, M. (2021) Statistik Kesehatan Provinsi Nusa Tenggara Timur 2021. 53000.2210.
Maulana, N. et al. (2022) ‘How Jaminan Kesehatan Nasional (JKN) coverage influences out-of-pocket (OOP) payments by vulnerable populations in Indonesia', PLOS Global Public Health. Edited by H.H. Farooqui and H.H. Farooqui, 2(7), p. e0000203. Available at: https://doi.org/10.1371/journal.pgph.0000203.
Ministry of Health (2021) Indikator Kinerja Program PPSDMK 1 Periode Tahun 2021 Berdasarkan Aplikasi SISDMK Kemenkes, Tableau Software. Available at: https://public.tableau.com/views/IndikatorKinerjaProgramPPSDMK1-2021/Dashboard1?:embed=y&:showVizHome=no&:host_url=https%3A%2F%2Fpublic.tableau.com%2F&:embed_code_version=3&:tabs=no&:toolbar=yes&:animate_transition=yes&:display_static_image=yes&:display_spinner=no&:display_overlay=yes&:display_count=yes&:language=en-US&publish=yes&:loadOrderID=0 (Accessed: 2 March 2023).
Hassan, N.Z.A.M. et al. (2022) ‘The inequalities and determinants of Households' Distress Financing on Out-off-Pocket Health expenditure in Malaysia', BMC Public Health, 22(1), p. 449. Available at: https://doi.org/10.1186/s12889-022-12834-5.
Mulyanto, J., Kringos, D.S. and Kunst, A.E. (2019) ‘Socioeconomic inequalities in healthcare utilisation in Indonesia: a comprehensive survey-based overview', BMJ Open, 9(7), p. e026164. Available at: https://doi.org/10.1136/bmjopen-2018-026164.
Muttaqien, M. et al. (2021) ‘Why did informal sector workers stop paying for health insurance in Indonesia? Exploring enrollees' ability and willingness to pay', PLOS ONE, 16(6), p. e0252708. Available at: https://doi.org/10.1371/journal.pone.0252708.
Naicker, N. et al. (2021) ‘Health Services Use and Health Outcomes among Informal Economy Workers Compared with Formal Economy Workers: A Systematic Review and Meta-Analysis', International Journal of Environmental Research and Public Health, 18(6), p. 3189. Available at: https://doi.org/10.3390/ijerph18063189.
National Academies of Sciences, E. et al. (2018) ‘Factors That Affect Health-Care Utilization', in Health-Care Utilization as a Proxy in Disability Determination. Available at: https://www.ncbi.nlm.nih.gov/books/NBK500097/ (Accessed: 18 April 2024).
OECD (2008) OECD Glossary of Statistical Terms. OECD. Available at: https://doi.org/10.1787/9789264055087-en.
Osamor, P. and Grady, C. (2018) ‘Factors Associated with Women's Health Care Decision-Making Autonomy: Empirical Evidence from Nigeria', Journal of Biosocial Science, 50(1), pp. 70–85. Available at: https://doi.org/10.1017/S0021932017000037.
Pratiwi, A.B. et al. (2021) ‘Is Indonesia achieving universal health coverage? Secondary analysis of national data on insurance coverage, health spending and service availability', BMJ Open, 11(10), p. e050565. Available at: https://doi.org/10.1136/bmjopen-2021-050565.
Pullyblank, K. et al. (2023) ‘Exploring Multiple Dimensions of Access to and Preferences for Telehealth Use', Telemedicine Reports, 4(1), pp. 348–358. Available at: https://doi.org/10.1089/tmr.2023.0049.
Ramadani, R. et al. (2021) Statistik JKN 2015-2019 Fakta dan Data Capaian Program Jaminan Kesehatan Nasional. (1).
Siswoyo, B.E., Prabandari, Y.S. and Hendrartini, Y. (2019) ‘Kesadaran Pekerja Sektor Informal terhadap Program Jaminan Kesehatan Nasional di Provinsi Daerah Istimewa Yogyakarta', Jurnal Kebijakan Kesehatan Indonesia : JKKI, 4(4), pp. 118–125. Available at: https://jurnal.ugm.ac.id/jkki/article/view/36116.
Tesfaye, G. et al. (2019) ‘Predisposing, enabling and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia', Reproductive Health, 16(1), p. 167. Available at: https://doi.org/10.1186/s12978-019-0829-z.
Wulandari, R.D. et al. (2022) ‘Hospital utilization in Indonesia in 2018: do urban–rural disparities exist?', BMC Health Services Research, 22(1), p. 491. Available at: https://doi.org/10.1186/s12913-022-07896-5.
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