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Disparity in Health Care Utilization by Income Level and Insurance Status at Gamping Muhammadiyah Hospital, Yogyakarta, Indonesia

R. Haryo Nugroho, Bhisma Murti, Arif Suryono

Abstract

Background: Ideal equity in health is defined as each individual has the same opportunity to get the best health and not be harmed in the process of obtaining the health services. Communities with different socio-economic status should receive the same health services according to their needs, including equal access rights in the utilization of health services. Nowadays, the quality health services cannot be enjoyed equally by the Indonesian. The purpose of this study was to examine disparity in health care utilization by income level and insurance status at Gamping Muhammadiyah Hospital, Yogyakarta, Indonesia.

Subjects and Method: This study was an observational analytic study with a cross-sectional design. The study was conducted at PKU Muhammadiyah Gamping Hospital, Sleman Yogyakarta. 200 subjects were selected using simple random sampling. The dependent variable was the frequency of use of health services. The independent variables were the health insurance (BPJS) status, patient income, patient education level, and residence. The data were collected by questionnaire and analyzed by a multiple linear regression.

Results: Frequency of health care utilization decreased with health insurance membership status (b= -4.49; 95% CI= -1.53 to -0.60; p <0.001) and longer distance (b= -7.33; 95% CI= -0.07 to -0.04; p<0.001). Frequency of health care utilization increased with patient age (b= 10.20; 95% CI= 0.06 to 0.09; p<0.001), family income (b= 3.30; 95% CI= 0.00 to 0.01; p = 0.001), and residence (b= 3.11; 95% CI= 0.33 to 1.47; p= 0.002).

Conclusion: Frequency of health care utilization decreases with health insurance membership status and longer distance. Frequency of health care utilization increases with patient age, family income, and residence.

Keywords: disparity, health insurance

Correspondence: R. Haryo Nugroho. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: haryo_sleman@yahoo.co.id.

Journal of Health Policy and Management (2019), 4(3): 195-203
https://doi.org/10.26911/thejhpm.2019.04.03.07

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