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Does Health Insurance Protect Indonesians from Catastrophic Health Expenditure and Impoverishment?: The Analysis of if Health Insurance is protective against Catastrophic Health Expenditure and Impoverishment In Indonesia
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
2017 (English)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: The World Health Organization has called for implementing universal health coverage to protect households from catastrophic health expenditure and impoverishment. However, few studies in Indonesia has focused on the benefits of health insurance in protecting against catastrophic health expenditure and impoverishment. This study aims to examine whether health insurance protects the household from catastrophic health expenditure and impoverishment and if so what characteristics are to some extent associated with catastrophic health expenditure and impoverishment.

Methods: Cross-sectional data at household level from Indonesia Family Life Survey (IFLS) in wave 5 (2014-2015) have been used. 14.080 households are included in the analysis. The distribution of health payments and catastrophic expenditure methodology was used to measure catastrophic health expenditure and impoverishment. Multiple logistic regressions were done for examining the association between catastrophic health spending, impoverishment and health insurance, after adjusting for other socio-demographic factors (household size, area, health care utilization, chronic disease, etc.). Sensitivity analysis was used to check the sensitivity of the main result.

Results: Household with up to one-third and more than two third of the family member have health insurance have a lower risk of catastrophic health spending. In contrast, we found a non-significant association of health insurance and impoverishment after adjustment (p>0.05). The household characteristics that are associated with catastrophic health expenditure and impoverished were a family lives in rural area, have more than two third of its member have chronic diseases, have higher inpatient visit, have at least one member<5 years old or >55 years old, and lower level of education for a household leader.

Conclusion: This study found that health insurance has the possibility to protect the households from catastrophic health expenditure, but not from impoverishment. The study presents important implications for health policymakers, which increasing the coverage of health insurance especially for vulnerable group or households in Indonesia setting is important to protect and reduce the burden of out-of-pocket health expenditures.

Place, publisher, year, edition, pages
2017. , p. 36
Series
Centre for Public Health Report Series, ISSN 1651-341X ; 2017:33
Keywords [en]
Health Insurance, Catastrophic Health Expenditure, Impoverishment, household expenditure, Indonesia Family Life Survey (IFLS)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-142722OAI: oai:DiVA.org:umu-142722DiVA, id: diva2:1163961
External cooperation
Indonesian Family Life Survey (IFLS) - Rand Corporation
Educational program
Master's Programme in Public Health
Presentation
2017-05-22, Room N260, Natural Sciences building, Umeå University, Umeå, 11:00 (English)
Supervisors
Examiners
Available from: 2017-12-19 Created: 2017-12-08 Last updated: 2017-12-19Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
  • ieee
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More styles
Language
  • de-DE
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  • nn-NB
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  • Other locale
More languages
Output format
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  • asciidoc
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