Analysis of health services use for respiratory illness in Indonesian children: implications for policy
1Department of Health Services, UCLA School of Public Health, USA.
Insights
Understanding health service use for childhood respiratory illness in Indonesia is key. Factors like age, education, and illness severity influence provider choice, guiding inclusive managed care policies.
Area of Science:
- Public Health
- Health Services Research
- Pediatrics
Background:
- Respiratory illness is a major cause of child sickness and death in Indonesia.
- Indonesia's healthcare system is reforming towards managed care post-1997 financial crisis.
- Understanding health service utilization patterns is crucial for effective provider contracting.
Purpose of the Study:
- To identify determinants of healthcare provider utilization for pediatric respiratory illness in Indonesia.
- To inform the design of managed care contracts within Indonesia's evolving health system.
Main Methods:
- Utilized data from the Indonesia Demographic and Health Survey.
- Employed multinomial logistic regression models based on the Andersen Behavioral Model.
- Analyzed factors influencing the choice between private, public, and non-formal healthcare providers.
Main Results:
- Key predictors of provider choice include child's age, household size, mother's education, religion, socioeconomic status (asset index), geographic location, and illness severity.
- These demographic and clinical factors significantly influence whether families choose private, public, or non-formal healthcare services.
Conclusions:
- The Indonesian government should adopt inclusive managed care strategies, contracting with a diverse range of providers.
- An inclusive approach is essential to protect the health of children under five suffering from respiratory conditions.
Abstract:
Respiratory illness continues to be a leading cause of paediatric morbidity and mortality in Indonesia. The Indonesian government is moving towards a more managed care-based approach as it reforms its health care system following the 1997 financial crisis. In order to better design contractual relationships between the payor and different providers, there needs to be a better understanding of the patterns and predictors of health services utilization for respiratory illness. This study uses the Indonesia Demographic and Health Survey to study the determinants of private, public and non-formal provider utilization for respiratory illness. Multinomial logistic regression models for predicting use were constructed using the Andersen Behavioural Model as the conceptual framework. The findings indicate that age, household size, maternal education, religion, the asset index, location and illness severity play a role in determining use of private, public or non-formal providers. The results indicate that from a policy perspective, the Indonesian government needs be inclusive rather than exclusive in the choice of providers that are contracted by the managed care plans, in order to safeguard the health of the under-five population.
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