Department of Public Health, Graduate School of Medicine, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8511, Japan.
Department of Public Health, Universitas Padjadjaran, Jl. Eycman No.38, Bandung, 40161, Indonesia.
BMC Public Health. 2020 Mar 18;20(1):351. doi: 10.1186/s12889-020-8408-3.
Life expectancy acts as a population measure of the performance of healthcare systems. Regional disparities on life expectancy in Indonesia has been persisted and become a public health policy challenge. A systematic clustering of provinces can be a valuable alternative for organizing cooperation that aimed to increase life expectancy and reduce disparities. This study aimed to identify determinants of life expectancy and designate clusters of Indonesian provinces with similar characteristics. This approach can be useful in generating alternative cooperation strategies to improve life expectancy.
We carefully selected variables that have been shown to impact life expectancy and gathered 2015 data from Indonesia's Ministry of Health. All 34 Indonesian provinces were included as analysis units. We performed structural equation modeling (SEM) to select domains that needed to work on from theoretical models. Based on SEM results, we performed cluster analysis to arrange cooperation groups.
Life expectancy showed correlations with mean years of schooling, expenditure per capita, health workforce, healthcare facilities, and environment. Expenditure per capita also was the strongest of all constructs. Based on SEM results, we performed cluster analysis to arrange cooperation groups of total 34 provinces and generated five clusters of provinces.
Enhancing the economy is the most effective approach for improving life expectancy and other constructs. These clusters can build cooperation that is new, within, and across clusters. These results may be useful in formulating cooperation strategies aimed at increasing life expectancy.
预期寿命是衡量医疗保健系统绩效的人口指标。印度尼西亚的预期寿命在各地区之间存在持续存在的差距，这是公共卫生政策面临的挑战。对省份进行系统聚类可以作为组织合作的一种有价值的替代方法，旨在提高预期寿命并减少差距。本研究旨在确定影响预期寿命的决定因素，并确定印度尼西亚各省具有相似特征的聚类。这种方法可以在制定提高预期寿命的替代合作策略方面发挥作用。
我们仔细选择了已证明对预期寿命有影响的变量，并从印度尼西亚卫生部收集了 2015 年的数据。将所有 34 个印度尼西亚省作为分析单位。我们进行了结构方程建模（SEM），以从理论模型中选择需要解决的领域。根据 SEM 结果，我们进行了聚类分析，以安排合作小组。
预期寿命与平均受教育年限、人均支出、卫生人力、医疗保健设施和环境相关。人均支出是所有结构中最强的。根据 SEM 结果，我们进行了聚类分析，对总共 34 个省份进行分组，并生成了五个省份聚类。
增强经济是提高预期寿命和其他结构的最有效方法。这些集群可以在集群内部、集群之间建立新的合作关系。这些结果可能有助于制定旨在提高预期寿命的合作策略。
