Assessing inequalities in the hypertension management under national health insurance: Evidence from Southern Central Java, Indonesia 10.55131/jphd/2024/220215
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Abstract
Equal access to disease management is crucial to control the impact of hypertension on the burden of disease in Indonesia. This study aimed to assess the extent of inequalities in the use, quality, and outcomes of hypertension management for beneficiaries of the National Health Insurance (NHI) program. This cross-sectional study consecutively recruited 797 beneficiaries of National Health Insurance who participated in the hypertension management program in the Banyumas District, Indonesia, between July and October 2021. The outcomes were regular visits, standard medication, and disease control. The inequalities were measured based on educational level, employment type, type of beneficiaries, and place of residence. The rate difference, rate ratio, and multiple logistic regression were used to estimate the extent of inequality. Compared to informal workers, formal workers had more regular visits to healthcare facilities (OR 1.78; 95%CI: 1.01-3.18) and had better disease control (OR 2.36; 95%CI: 1.28-4.38). Non-subsidized participants had fewer regular visits compared to subsidized participants (OR 0.51; 95%CI: 0.30-0.84). Urban residents tended to have more regular visits compared to rural residents (OR 2.14; 95%CI: 0.90-5.05). A substantial extent of inequalities in the use and outcomes of hypertension management still exists among beneficiaries of the NHI program. The future implementation of the hypertension management program of National Health Insurance in Indonesia should consider the geographical and socio-economic background of its participants.
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