The evolution of income-related inequalities in healthcare utilisation in Indonesia, 1993-2014.
<h4>Objective</h4>While the major policy changes in the Indonesian healthcare system over the last 25 years have been well documented, less is known about the accompanying changes in inequalities in healthcare utilisation during this period. Our study aimed to describe the trends in inco...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0218519 |
| _version_ | 1819142306816589824 |
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| author | Joko Mulyanto Dionne S Kringos Anton E Kunst |
| author_facet | Joko Mulyanto Dionne S Kringos Anton E Kunst |
| author_sort | Joko Mulyanto |
| collection | DOAJ |
| description | <h4>Objective</h4>While the major policy changes in the Indonesian healthcare system over the last 25 years have been well documented, less is known about the accompanying changes in inequalities in healthcare utilisation during this period. Our study aimed to describe the trends in income-related inequalities in healthcare utilisation in Indonesia during the period 1993-2014.<h4>Methods</h4>A repeated cross-sectional study was conducted using data from the Indonesian Family Life Surveys from 1993, 2000, 2007, and 2014. We measured outpatient and inpatient healthcare utilisation in public and private provider as well as the overall utilisation. Standardised prevalence rate and relative index of inequality (RII) were used to measure the extent of inequalities in healthcare utilisation by income level (income-related inequalities).<h4>Results</h4>Relatively large income-related inequalities were observed in the utilisation of private outpatient care and public and private inpatient care in 1993. Income-related inequalities in public and private outpatient care utilisation decreased between 1993 and 2007 but increased in 2014. Income-related inequalities in public and private inpatient care utilisation continued to decrease between 1993 and 2014. The largest decrease was observed in private inpatient care utilisation.<h4>Conclusion</h4>Income-related inequalities in all types of healthcare utilisation decreased until 2007. This trend continued until 2014 only for public and private inpatient care utilisation. This phenomenon may be explained by the changes to the healthcare system (e.g. expansion of the government health insurance programme and health sector decentralisation), which coincided with the changes in inequalities in healthcare utilisation in Indonesia. |
| first_indexed | 2024-12-22T12:08:15Z |
| format | Article |
| id | doaj.art-1c8fe13fd60b44f4b3ff0b36a5580893 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-22T12:08:15Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-1c8fe13fd60b44f4b3ff0b36a55808932022-12-21T18:26:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01146e021851910.1371/journal.pone.0218519The evolution of income-related inequalities in healthcare utilisation in Indonesia, 1993-2014.Joko MulyantoDionne S KringosAnton E Kunst<h4>Objective</h4>While the major policy changes in the Indonesian healthcare system over the last 25 years have been well documented, less is known about the accompanying changes in inequalities in healthcare utilisation during this period. Our study aimed to describe the trends in income-related inequalities in healthcare utilisation in Indonesia during the period 1993-2014.<h4>Methods</h4>A repeated cross-sectional study was conducted using data from the Indonesian Family Life Surveys from 1993, 2000, 2007, and 2014. We measured outpatient and inpatient healthcare utilisation in public and private provider as well as the overall utilisation. Standardised prevalence rate and relative index of inequality (RII) were used to measure the extent of inequalities in healthcare utilisation by income level (income-related inequalities).<h4>Results</h4>Relatively large income-related inequalities were observed in the utilisation of private outpatient care and public and private inpatient care in 1993. Income-related inequalities in public and private outpatient care utilisation decreased between 1993 and 2007 but increased in 2014. Income-related inequalities in public and private inpatient care utilisation continued to decrease between 1993 and 2014. The largest decrease was observed in private inpatient care utilisation.<h4>Conclusion</h4>Income-related inequalities in all types of healthcare utilisation decreased until 2007. This trend continued until 2014 only for public and private inpatient care utilisation. This phenomenon may be explained by the changes to the healthcare system (e.g. expansion of the government health insurance programme and health sector decentralisation), which coincided with the changes in inequalities in healthcare utilisation in Indonesia.https://doi.org/10.1371/journal.pone.0218519 |
| spellingShingle | Joko Mulyanto Dionne S Kringos Anton E Kunst The evolution of income-related inequalities in healthcare utilisation in Indonesia, 1993-2014. PLoS ONE |
| title | The evolution of income-related inequalities in healthcare utilisation in Indonesia, 1993-2014. |
| title_full | The evolution of income-related inequalities in healthcare utilisation in Indonesia, 1993-2014. |
| title_fullStr | The evolution of income-related inequalities in healthcare utilisation in Indonesia, 1993-2014. |
| title_full_unstemmed | The evolution of income-related inequalities in healthcare utilisation in Indonesia, 1993-2014. |
| title_short | The evolution of income-related inequalities in healthcare utilisation in Indonesia, 1993-2014. |
| title_sort | evolution of income related inequalities in healthcare utilisation in indonesia 1993 2014 |
| url | https://doi.org/10.1371/journal.pone.0218519 |
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