School of Pharmacy, The University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4012 Australia.
Int J Qual Health Care. 2013 Oct;25(5):488-96. doi: 10.1093/intqhc/mzt057. Epub 2013 Aug 14.
The merits of mixed public and private health systems are debated. Although private providers have become increasingly important in the Indonesian health system, there is no comprehensive assessment of the quality of private facilities. This study examined the quality of physical resources of public and private facilities in Indonesia from 1993 to 2007.
Data from the Indonesian Family Life Surveys in 1993, 1997, 2000 and 2007 were used to evaluate trends in the quality of physical resources for public and private facilities, stratified by urban/rural areas and Java-Bali/outer Java-Bali regions.
The quality of six categories of resources was measured using an adapted MEASURE Evaluation framework.
Overall quality was moderate, but higher in public than in private health facilities in all years regardless of the region. The higher proportion of nurses and midwives in private practice was a determinant of scope of services and facilities available. There was little improvement in quality of physical resources following decentralization.
Despite significant increases in public investment in health between 2000 and 2006 and the potential benefits of decentralization (2001), the quality of both public and private health facilities in Indonesia did not improve significantly between 1993 and 2007. As consumers commonly believe the quality is better in private facilities and are increasingly using them, it is essential to improve quality in both private and public facilities. Implementation of minimum standards and effective partnerships with private practice are considered important.
混合公共和私人卫生系统的优点存在争议。尽管私营提供者在印度尼西亚卫生系统中的作用日益重要，但对私营设施的质量尚无全面评估。本研究考察了 1993 年至 2007 年期间印度尼西亚公共和私营设施的物质资源质量。
使用 1993 年、1997 年、2000 年和 2007 年印度尼西亚家庭生活调查的数据，评估了公共和私营设施物质资源质量的趋势，按城市/农村地区和爪哇-巴厘/外爪哇-巴厘地区进行分层。
使用经过改编的 MEASURE 评估框架评估了六个类别的资源质量。
总体质量中等，但在所有年份，无论地区如何，公共卫生设施的质量均高于私营卫生设施。私人执业护士和助产士比例较高是服务范围和设施可用的决定因素。权力下放后，物质资源质量几乎没有改善。
尽管 2000 年至 2006 年期间公共卫生投资大幅增加，权力下放（2001 年）具有潜在好处，但 1993 年至 2007 年期间，印度尼西亚公共和私营卫生设施的质量并未显著提高。由于消费者普遍认为私营设施的质量更好，并越来越多地使用它们，因此必须改善私营和公共设施的质量。实施最低标准和与私人执业的有效伙伴关系被认为是重要的。
