The evolution of socioeconomic inequalities in healthcare utilisation in Indonesia: 1993 to 2014

Abstraksi

Objective To describe the trends of socioeconomic inequalities in healthcare utilisation in Indonesia during the period of 1993 to 2014. Methods We conducted a repeated cross-sectional study used data from four Indonesian Family Life Survey (IFLS) in 1993, 2000, 2007, and 2014. We used income to measure socioeconomic status. Healthcare utilisation was measured for outpatient and inpatient care for overall utilisation, public provider, and private provider. Standardised prevalence rate and Relative index inequality (RII) was used to measure the extent of inequality. Findings Large extent of inequalities both in absolute and relative inequalities in all type of healthcare and provider were observed in 1993. Inequalities in outpatient care tend to decrease from 1993 to 2007, but have an increase in 2014. Inequalities in inpatient care show increases in total utilisation and in public provider from 1993 to 2000 and gradually decrease from 2000 to 2014. Inequalities of inpatient care in private provider continue to decrease from 1993 to 2014. Private provider has relatively larger extent of inequalities in healthcare utilisation compare to public provider. Trends of healthcare inequalities are significant for every level of care and type of provider. Conclusion There are significant trends in healthcare inequalities in Indonesia during the period of 1993-2014. Changes in healthcare system and the general living situation likely explained how healthcare inequalities evolve over the time in Indonesia.