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Utilization of health services in Indonesia

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  • Chernichovsky, Dov
  • Meesook, Oey Astra

Abstract

This paper examines the utilization patterns of traditional and modern health services in Indonesia, using household sample survey socio-economic data in conjunction with community-level data on availability of services. The results strongly suggest that low household income is a barrier to the utilization of modern health services, even where they are publicly provided. The relatively well-to-do use the services of trained practitioners and physicians more and spend more on these services than do the poor. That is, income has a qualitative effect shown as a shift to more expensive and sophisticated practitioners and services rather than increased expenditures on the same type of services. Nevertheless, public facilities do make a difference; where they are available people prefer them to indigenous practitioners. Despite limitations of data and method of estimation, it is clear that both income and availability of services matter and hence that public services are more important to the poor than to the rich. The results further suggest that exposure to modern services that may involve health education brings about the right kinds of substitutions from an efficiency viewpoint: paramedics for traditional practitioners as well as physicians.

Suggested Citation

  • Chernichovsky, Dov & Meesook, Oey Astra, 1986. "Utilization of health services in Indonesia," Social Science & Medicine, Elsevier, vol. 23(6), pages 611-620, January.
    • Handle: RePEc:eee:socmed:v:23:y:1986:i:6:p:611-620
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    Cited by:

    1. Castro-Leal, Florencia & Dayton, Julia & Demery, Lionel & Mehra, Kalpana, 1999. "Public Social Spending in Africa: Do the Poor Benefit?," The World Bank Research Observer, World Bank, vol. 14(1), pages 49-72, February.
    2. Laxminarayan, Ramanan & Deolalikar, Anil, 2000. "Socioeconomic Determinants of Disease Transmission in Cambodia," RFF Working Paper Series dp-00-32, Resources for the Future.
    3. Mocan, H. Naci & Tekin, Erdal & Zax, Jeffrey S., 2004. "The Demand for Medical Care in Urban China," World Development, Elsevier, vol. 32(2), pages 289-304, February.
    4. Gan, Lydia L. & Frederick, James R., 2010. "The Willingness to Spend on Healthcare: Evidence from Singapore," Review of Applied Economics, Lincoln University, Department of Financial and Business Systems, vol. 6(1-2), pages 1-15, April.
    5. Ardeshir Sepehri & Robert Chernomas, 2001. "Are user charges efficiency- and equity-enhancing? A critical review of economic literature with particular reference to experience from developing countries," Journal of International Development, John Wiley & Sons, Ltd., vol. 13(2), pages 183-209.
    6. Habtom, GebreMichael Kibreab & Ruys, Pieter, 2007. "The choice of a health care provider in Eritrea," Health Policy, Elsevier, vol. 80(1), pages 202-217, January.
    7. Buor, Daniel, 2004. "Gender and the utilisation of health services in the Ashanti Region, Ghana," Health Policy, Elsevier, vol. 69(3), pages 375-388, September.
    8. Li, Bin & Li, Tuo & Yu, Man & Chen, Bin, 2017. "Can equalization of public services narrow the regional disparities in China? A spatial econometrics approach," China Economic Review, Elsevier, vol. 44(C), pages 67-78.
    9. Buor, Daniel, 2003. "Mothers' education and childhood mortality in Ghana," Health Policy, Elsevier, vol. 64(3), pages 297-309, June.
    10. Bautista, Cristina M., 1995. "Patterns of Health Care Expenditures, Utilization and Demand for Medical Care in Sample Philippine Households," Discussion Papers DP 1995-09, Philippine Institute for Development Studies.
    11. van de Walle, Dominique, 1992. "The distribution of the benefits from social services in Indonesia, 1978-87," Policy Research Working Paper Series 871, The World Bank.
    12. Majid S. Kermani & Hossein Ghaderi & Ayoub Yousefi, 2008. "Demand for medical care in the urban areas of Iran: an empirical investigation," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 849-862, July.
    13. Asfaw, Abay & Braun, Joachim von & Klasen, Stephan, 2004. "How Big is the Crowding-Out Effect of User Fees in the Rural Areas of Ethiopia? Implications for Equity and Resources Mobilization," World Development, Elsevier, vol. 32(12), pages 2065-2081, December.
    14. Lloyd Amaghionyeodiwe, 2008. "Determinants of the choice of health care provider in Nigeria," Health Care Management Science, Springer, vol. 11(3), pages 215-227, September.
    15. Lu, Yao, 2008. "Test of the 'healthy migrant hypothesis': A longitudinal analysis of health selectivity of internal migration in Indonesia," Social Science & Medicine, Elsevier, vol. 67(8), pages 1331-1339, October.
    16. Hongyun Zhou & Jiqing Hong & Su Yang & Yuxuan Huang, 2022. "The Impact of Social Capital on Rural Residents’ Medical Service Utilization in China—An Empirical Study Based on CFPS Data," IJERPH, MDPI, vol. 19(23), pages 1-19, November.
    17. Awad Mataria & Stéphane Luchini & Yousef Daoud & Jean-Paul Moatti, 2007. "Demand assessment and price-elasticity estimation of quality-improved primary health care in palestine: a contribution from the contingent valuation method," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1051-1068.
    18. Chernichovsky, Dov*Zangwill, Linda, 1988. "Microeconomic theory of the household and nutrition programs," Policy Research Working Paper Series 82, The World Bank.
    19. Standing, H. & Chowdhury, A. Mushtaque R., 2008. "Producing effective knowledge agents in a pluralistic environment: What future for community health workers?," Social Science & Medicine, Elsevier, vol. 66(10), pages 2096-2107, May.
    20. Baird, John & Ma, Steven & Ruger, Jennifer Prah, 2011. "Effects of the World Bank's maternal and child health intervention on Indonesia's poor: Evaluating the safe motherhood project," Social Science & Medicine, Elsevier, vol. 72(12), pages 1948-1955, June.
    21. Awad Mataria & Stéphane Luchini & Yousef Daoud & Jean‐Paul Moatti, 2007. "Demand assessment and price‐elasticity estimation of quality‐improved primary health care in palestine: a contribution from the contingent valuation method," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1051-1068, October.

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