Regional disparities in hospital utilisation in Indonesia: a cross-sectional analysis data from the 2018 Indonesian Basic Health Survey

BMJ Open. 2023 Jan 3;13(1):e064532. doi: 10.1136/bmjopen-2022-064532.

Abstract

Objectives: Policymakers must ensure that the entire population has equal access to health services, and efforts to minimise inequalities are needed. This study aimed to analyse the regional disparities in hospital utilisation in Indonesia.

Design: A cross-sectional study analysing secondary data from the 2018 Indonesian Basic Health Survey.

Setting: National-level survey data from Indonesia.

Participants: A total of 629 370 participants were included in the study.InterventionWe employed no interventionPrimary and secondary outcome measuresThe primary outcome was hospital utilisation. Aside from region, we utilise residence type, age, gender, marital status, educational level, occupation, wealth, insurance and travel time as control variables. We used binary logistic regression in the final analysis RESULTS: The respondents in Sumatra were 1.079 times (95% CI 1.073 to 1.085) more likely than those in Papua to use the hospital. Furthermore, compared with the respondents in Papua, those in the Java-Bali region (1.075 times, 95% CI 1.069 to 1.081), Nusa Tenggara (1.106 times, 95% CI 1.099 to 1.113), Sulawesi (1.008 times, 95% CI 1.002 to 1.014) and Kalimantan (1.212 times, 95% CI 1.205 to 1.219) were more likely to use the hospital. However, those in Maluku were less likely than those in Papua to use the hospital (0.827 times, 95% CI 0.820 to 0.835). Six demographic variables (age, gender, marital status, educational level, occupation and wealth) and three other control variables (residence type, insurance and travel time to the hospital) were found to be associated with hospital utilisation.

Conclusions: Our findings highlight the existence of regional disparities in hospital utilisation in Indonesia.

Keywords: health economics; health policy; organisation of health services; primary care; public health.

MeSH terms

  • Cross-Sectional Studies*
  • Educational Status
  • Health Surveys
  • Humans
  • Indonesia / epidemiology
  • Socioeconomic Factors
  • Surveys and Questionnaires