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国家健康保险在贫困地区医院利用中的作用:来自印度尼西亚的证据。

National Health Insurance Role in Hospital Utilisation in Disadvantaged Areas: Evidence from Indonesia.

作者信息

Wulandari Ratna Dwi, Latifah Leny, Laksono Agung Dwi, Nugraheni Wahyu Pudji, Suryati Tati, Rachmawati Tety, Yunitawati Diah, Mubasyiroh Rofingatul, Ardani Irfan, Kusnali Asep

机构信息

Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.

National Research and Innovation Agency, Jakarta, Indonesia.

出版信息

Malays J Med Sci. 2024 Dec;31(6):205-216. doi: 10.21315/mjms2024.31.6.16. Epub 2024 Dec 31.

Abstract

BACKGROUND

The Indonesian government policy regarding obtaining universal coverage through National Health Insurance (NHI) is expected to increase public access to health service facilities, including in disadvantaged areas. This study analysed the role of NHI in hospital utilisation in underprivileged areas of Indonesia.

METHODS

Data from the 2023 National Socioeconomic Survey were used in this cross-sectional study that included 130,331 participants. Hospital utilisation was the dependent variable and NHI membership was the independent variable. Residence, age, sex, marital status, education, occupation, and wealth status were control factors. A multinomial logistic regression was employed in the final stage for data evaluation.

RESULTS

In 2023, the hospital utilisation rate in Indonesia's disadvantaged regions was 1.5% and the percentage of NHI members was 74.5%. People with an NHI membership were 3.01 times more likely to utilise the hospital than those without [95% confidence interval (CI) 2.58-3.50]. Seven control variables related to hospital utilisation were identified, namely, residence type, age, sex, marital status, education level, employment status, and wealth status.

CONCLUSION

This study concluded that NHI membership influenced hospital utilisation in disadvantaged areas of Indonesia. Individuals with NHI membership were three times more likely to visit hospitals.

摘要

背景

印度尼西亚政府通过国家医疗保险(NHI)实现全民覆盖的政策有望增加公众,包括贫困地区民众,获得医疗服务设施的机会。本研究分析了NHI在印度尼西亚贫困地区医院利用情况中的作用。

方法

本横断面研究使用了2023年全国社会经济调查的数据,该调查包括130331名参与者。医院利用情况为因变量,NHI参保情况为自变量。居住地、年龄、性别、婚姻状况、教育程度、职业和财富状况为控制因素。最后阶段采用多项逻辑回归进行数据评估。

结果

2023年,印度尼西亚贫困地区的医院利用率为1.5%,NHI参保人员比例为74.5%。参保NHI的人利用医院服务的可能性是未参保者的3.01倍[95%置信区间(CI)2.58 - 3.50]。确定了与医院利用情况相关的七个控制变量,即居住类型、年龄、性别、婚姻状况、教育水平、就业状况和财富状况。

结论

本研究得出结论,NHI参保情况影响了印度尼西亚贫困地区的医院利用情况。参保NHI的人去医院就诊的可能性是未参保者的三倍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a56/11740819/dd48f420b4e1/16mjms3106_oaf1.jpg

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