The effects of mandatory health insurance on equity in access to outpatient care in Indonesia

Budi Hidayat, Hasbullah Thabrany, Hengjin Dong, Rainer Sauerborn

Research output: Contribution to journalReview articlepeer-review

74 Citations (Scopus)

Abstract

This paper examines the effects of mandatory health insurance on access and equity in access to public and private outpatient care in Indonesia. Data from the second round of the 1997 Indonesian Family Life Survey were used. We adopted the concentration index as a measure of equity, and this was calculated from actual data and from predicted probability of outpatient-care use saved from a multinomial logit regression. The study found that a mandatory insurance scheme for civil servants (Askes) had a strongly positive impact on access to public outpatient care, while a mandatory insurance scheme for private employees (Jamsostek) had a positive impact on access to both public and private outpatient care. The greatest effects of Jamsostek were observed amongst poor beneficiaries. A substantial increase in access will be gained by expanding insurance to the whole population. However, neither Askes nor Jamsostek had a positive impact on equity. Policy implications are discussed.

Original languageEnglish
Pages (from-to)322-335
Number of pages14
JournalHealth policy and planning
Volume19
Issue number5
DOIs
Publication statusPublished - 1 Sep 2004

Keywords

  • Access
  • Concentration index
  • Equity
  • Health insurance
  • IFLS
  • Indonesia

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