インドネシアにおける初等保健医療利用における都市と農村の格差:横断的な研究
Asep Kusnali1, Wahyu Pudji Nugraheni1, Rofingatul Mubasyiroh1
1National Research and Innovation Agency, Jakarta, Indonesia.
Korean journal of family medicine
|February 20, 2026
まとめ
インドネシアのプライマリーヘルスケアの利用率は,全体的に同様の割合にもかかわらず,格差を示しています. 裕福な都市部住民はPHCを少なく,裕福な農村部住民はより多く使用し,構造的不平等を強調しています.
科学分野:
- 医療サービス 研究 医療サービス
- 公共衛生政策 公共衛生政策
- 健康の社会経済的決定要因
背景:
- インドネシアの都市部と農村部の人口の間で,初等保健医療 (PHC) の利用における格差を調査しています.
- PHCへのアクセスに影響を与える社会経済的および人口学的要因に焦点を当てています.
- 国民健康保険 (Jaminan Kesehatan Nasional, JKN) プログラム内の公平性を促進するために不可欠です.
研究 の 目的:
- インドネシアにおける初等保健医療利用の社会経済的および人口学的決定要因を分析する.
- 都市部と農村部の住民の間でPHCの使用の特定のパターンを特定する.
- JKNプログラムの下で公平な健康保険の政策を策定する.
主な方法:
- 2023年全国社会経済調査 (n=334,887) のデータを活用した.
- 個々の特徴とPHC利用の間の関連性を評価するために,バイナリロジスティック回帰を使用しました.
- 医療を求める行動における都市と農村の差異を調査した.
主要な成果:
- 総合的なPHC利用率は都市部と農村部でほぼ同じであったが,大きな格差がある.
- 女性ではPHCの利用率が高かった (OR,1.12). 高等教育はPHC使用とネガティブに相関していた (OR,0.78).
- 裕福な都市部住民はPHCを少なく使った (OR,0.84),裕福な農村住民はより多く使った (OR,1.09). 双重保険の所有権は,田舎の保健医療の利用を助長した (OR, 1.56).
結論:
- 調査結果は,インドネシアの人口全体でPHC利用の構造的不平等を明らかにしています.
- 政策の勧告には,都市部におけるPHCの質の向上,農村部における金融保護とインフラ整備の強化,デジタル格差の縮小などが含まれている.
- 対象を絞った介入は,JKNの下で公平で包括的な健康保険の実現に不可欠です.
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