Access inequity, health insurance and the role of supply factors

Access inequity, health insurance and the role of supply factors

Given the improvement in health indicators and health facilities worldwide, inequity in access to health services is one of the most pertinent and relevant issues for health policy and public health. This paper analyses the extent of the access inequities to various health care services in Indonesia, in conjunction with its recent rapid move towards universal social health insurance (SHI).

The sample is derived from individuals in the national socio-economic data, SUSENAS, years 2011-2016. We find that only access to outpatient care at public health centres is pro-poor whilst access to other types of health care is prorich. The expansion of SHI reduces the extent of the pro-rich access by weakening the relationship between utilisation and a household’s economic status. Despite wider coverage, however, the poor were still disadvantaged in the health care market. Progress towards universal coverage, supply-side improvements, pro-poor insurance schemes and policies that can stimulate economic growth may further reduce the wealth-related access gaps to health services.

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