Haemmerli, M; (2022) On the road to Universal Health Coverage: measuring socioeconomic inequalities in access to and use of high quality care in Indonesia. PhD thesis, London School of Hygiene & Tropical Medicine. DOI: https://doi.org/10.17037/PUBS.04670677
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Abstract
The objective of Universal Health Coverage (UHC) is to ensure that everyone, regardless of their socio-economic background or ability to pay, has access to high quality health services without financial hardship. In countries that are on the path to achieving UHC, such as Indonesia, monitoring progress on key outcomes, including access to quality care and financial protection, is critical. Using several primary and secondary datasets at the household and facility level, this PhD aims to inform policy decisions about the current state of UHC by measuring and assessing the socioeconomic disparities in access to and use of quality care in Indonesia. Using multiple methods from the discipline of health economics, I find that inequalities in the quality of care exist in Indonesia, especially between provinces and between rural and urban areas. Some aspects of quality of care are shown to influence provider choice, implying that individuals are likely to respond to quality of care improvement initiatives. My research also shows that following the introduction of the national health insurance program, the Jaminan Kesehatan Nasional, health care utilisation has increased, especially at the secondary care level, though the amount of out-of-pocket (OOP) payments remains high. Importantly, the impact of the national health insurance has not been significant in improving financial protection among the Indonesian population. Indonesia is an ideal setting for this research especially in light of growing concerns that in the rush to achieve UHC, some aspects of quality of care and financial protection have been overlooked. This thesis highlights the need for the Government of Indonesia to realise its intended goal: to establish an insurance scheme that protects its members from the financial burden of health care costs. Globally, this thesis calls for a greater integration of quality of care into measurement of progress towards UHC.
Item Type | Thesis |
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Thesis Type | Doctoral |
Thesis Name | PhD |
Contributors | Wiseman, V; Powell-jackson, T and Goodman, C |
Faculty and Department | Faculty of Public Health and Policy > Dept of Global Health and Development |
Research Group | Centre for Global Health Economics |
Funder Name | Economic and Social Research Council |
Copyright Holders | Manon Haemmerli |
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Filename: 2022_PHP_PHD_Haemmerli_M.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
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