Mini Health Technology Assessment of Urban and Rural Health Care in Indonesia

Abstract

Background: Health Technology Assessment (HTA) is a program to evaluate the use of technology in healthcare. HTA proposed by World Health Organization (WHO) will affect the government’s decision-making in the development of healthcare technology. The use of technology should be assessed from its cost-effectiveness to its potential ethical problems. HTA Unit – a division who organizes HTA in government in Indonesia – has emerged in ministry of health in 2003 and focused in drugs and vaccines problems. However, HTA in Indonesia has not been formally effective until today.Objectives: To evaluate the usage, supply, and demand of the health technology and the spread of health technology in urban and rural areas.Methods: This study is a cross-sectional study using questionnaire to gather quantitative and qualitative data. The respondents of this study are medical doctors in Indonesia, and the selection of the respondents is done consecutively. We divide respondents’ area into urban and rural areas, and health practitioners as field executors (general practitioners or GP and specialists) and head of healthcare facilities.Results: The total samples are 48 health practitioners and 14 head of healthcare facilities. Statistical analysis shows that the two settings (urban and rural) are not significantly different (p=0.478), while descriptive analysis shows that the inadequacy of health technology is higher in rural than that in urban areas (70% VS 52.63%). The relationship between the field of health practitioners (GP and specialist) and the adequacy of health technology is not significant. More GP than specialists complain about the inadequacy of health technology in giving the health service to the patients. About 92.8% head of health facility said that technology is needed to support the health service, while only 35.71% agreed that their health facilities still have inadequate health technology.Conclusion: The use of health technology in Indonesia is still inadequate. The spread of health technology is not equal in urban and rural areas. The lack of health technology in rural areas, especially for GP, affect in diagnosing and giving therapy to patients. The poor spread of technology in healthcare also make gap between health research and health clinical practice.