Research on Public Health Described by Researchers at University Hospital Muenster (Availability and Accessibility of Primary Care for the Remote, Rural, and Poor Population of Indonesia): Health and Medicine – Public Health

2021 SEP 01 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Data detailed on public health have been presented. According to news reporting originating from Munster, Germany, by NewsRx correspondents, research stated, “Adopting Universal Health Coverage for implementation of a national health insurance system [Jaminan Kesehatan Nasional (JKN)/Badan Penyelenggara Jaminan Sosial or the Indonesian National Social Health Insurance Scheme (BPJS)] targets the 255 million population of Indonesia. The availability, accessibility, and acceptance of healthcare services are the most important challenges during implementation. Referral behavior and the utilization of primary care structures for underserved (rural/remote regions) populations are key guiding elements.”

Our news journalists obtained a quote from the research from University Hospital Muenster: “In this study, we provided the first assessment of BPJS implementation and its resulting implications for healthcare delivery based on the entire insurance dataset for the initial period of implementation, specifically focusing on poor and remote populations. Demographic, economic, and healthcare infrastructure information was obtained from public resources. Data about the JKN membership structure, performance information, and reimbursement were provided by the BPJS national head office. For analysis, an ANOVA was used to compare reimbursement indexes for primary healthcare (PHC) and advanced healthcare (AHC). The usage of primary care resources was analyzed by comparing clustered provinces and utilization indices differentiating poor [Penerima Bantuan Iur (PBI) membership] and non-poor populations (non-PBI). Factorial and canonical discrimination analyses were applied to identify the determinants of PHC structures. Remote regions cover 27.8% of districts/municipalities. The distribution of the poor population and PBI members were highly correlated (r2 > 0.8; p < 0.001). Three clusters of provinces [remote high-poor (N = 13), remote low-poor (N = 15), non-remote (N = 5)] were identified. A discrimination analysis enabled the >82% correct cluster classification of infrastructure and human resources of health (HRH)-related factors. Standardized HRH (nurses and general practitioners [GP]) availability showed significant differences between clusters (p < 0.01), whereas the availability of hospital beds was weakly correlated. The usage of PHC was ~2-fold of AHC, while non-PBI members utilized AHC 4- to 5-fold more frequently than PBI members. Referral indices (r2 = 0.94; p < 0.001) for PBI, non-PBI, and AHC utilization rates (r2 = 0.53; p < 0.001) were highly correlated.”

According to the news reporters, the research concluded: “Human resources of health availability were intensively related to the extent of the remote population but not the numbers of the poor population. The access points of PHC were mainly used by the poor population and in remote regions, whereas other population groups (non-PBI and non-Remote) preferred direct access to AHC. Guiding referral and the utilization of primary care will be key success factors for the effective and efficient usage of available healthcare infrastructures and the achievement of universal health coverage in Indonesia. The short-term development of JKN was recommended, with a focus on guiding referral behavior, especially in remote regions and for non-PBI members.”

For more information on this research see: Availability and Accessibility of Primary Care for the Remote, Rural, and Poor Population of Indonesia. Frontiers in Public Health, 2021,9. (Frontiers in Public Health - http://journal.frontiersin.org/journal/public-health). The publisher for Frontiers in Public Health is Frontiers Media S.A.

A free version of this journal article is available at https://doi.org/10.3389/fpubh.2021.721886.

Our news editors report that additional information may be obtained by contacting Supriyatiningsih Wenang, Department of Pediatric Oncology, University Hospital Muenster, Muenster, Germany. Additional authors for this research include Juergen Schaefers, Andi Afdal, Ali Gufron, Siegfried Geyer, Iwan Dewanto, Joerg Haier.

(Our reports deliver fact-based news of research and discoveries from around the world.)