Jurnal Manajemen Pelayanan Kesehatan
Vol 13, No 03 (2010)


Hidayat, Budi (Unknown)

Article Info

Publish Date
12 Dec 2013


Objective: Research that produced empirical evidences forhealth policy formulation presumably limited. This articleelaborates this perception by synthesizing four studies on thedemand for outpatient care (OP), e.g., (i) health insurance andthe number of OP visits, social health insurance and (ii) theuse of OP, (iii) providers choices, and (iv) equity in access.Methods: This study uses data from the second round of theIndonesian Family Life Survey (IFLS). Two considerations havebeen taken into account in selecting estimation methods: thedesign of observational study and type of the data used tomeasure the demand. To predict the number of OP visits, theauthor explored six count data estimators, whilst to investigatethe impact of social insurance on the use of OP, providerchoices, and equity, the author applied a multinomial logisticregression.Results: Whilst the distribution of health insurance isconcentrated on the rich, the highest effect of insurance onaccess found among the lowest income group. Given provideralternatives, the insured tend to choose public rather thanprivate providers. Those who are sicker, not married, wealthierand highly educated also prefer to use private than publicproviders. The impact of social insurance on equity in accessto health care was not observed.Conclusions: Efforts to increase access to health careservices through a national health insurance (NHI) will be moreeffective if the program accommodates consumer preferences.Changes in the demand from public to private providers mustbe taken into account, especially when setting premium subsidyand benefits baskets of the NHI. In general, the NHI policy hasalready empirical evidences. However, NHI implementationrequires a set of technical regulations as a translation of theNational Social Security Act, which also must be supportedfrom the results of empirical studies.Keywords: social health insurance, demand for health care,endogeneity, applied econometrics in health

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