Health Expenditure Patterns by Marginal and Vulnerable Groups

Abstract

Health expenditure patterns by marginal and vulnerable groups. Utilization of health care is influenced by many factors. Most important are geography, socioeconomic, gender inequality, culture, and quality of care. This study aimed at providing policy formulations evidence based in formation for RRO poor, The study is a cross sectional study using National Socioeconomic Survey data set of 1998 representing about 205.000 households. This analysis is conducted to respond the equity issue in Indonesia, with particular emphasize to equity of access (health services use). The study revealed that in urban areas 88.8% of the people pay the outpatient services from their out-of-pocket, while in rural the fi gure is 94.3%. The data shows that in urban areas, among the lowest group, expenditure for health placed about 13% of non-food expenditure. In rural areas the health expenditure accounted to around an average of 12% non-food expenditure. For the highest group of socioeconomic status, expenses on health reached only 10% of non-food expenditure. In rural areas, the highest group has spent for health about 14% of their non-food expenses. Most of the poor (almost 90%) have spent for health below a quarter of non-food expenses. In general, households have spent about 6-15% and 20-71% of their non-food expenses for outpatient and in-patient respectively. Those who spent more than 50% of their non-food expenditure for outpatient is accounted to 3.63% of the households in urban and 4.31% in rural areas. A relatively small percentage of the households in urban and rural areas used a catastrophic spending for outpatient care. Nevertheless, almost 77% of them in urban and rural areas have spent more than 50% of their non-food expenditures per month for inpatient care. This catastrophic spending has affected 72.88% of the households in the urban area and 80.98% in rural areas. Apparently the fi nancial risk is very high for the people in responding the probability of loss due to sickness. Since most Indonesian people are not insured, this phenomenon will become a burden for them.