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Impact evaluation of subsidized health insurance programs on utilization of healthcare facilities: evidence from Indonesia

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  • Riska Dwi Astuti

    (Universitas Islam Indonesia)

  • Rindang Nuri Isnaini Nugrohowati

    (Universitas Islam Indonesia)

Abstract

Despite subsidized health insurance has long been proclaimed by many countries including Indonesia, the variety of evaluation results showing that the optimization of benefits obtained by recipients is still questionable. The objective of this study is to analyze the impact of subsidized health insurance programs (ASKESKIN and JAMKESMAS) on the utilization of healthcare facilities in Indonesia. Data from two waves longitudinal data, the Indonesian Family Life Survey (IFLS), were analyzed using the propensity score matching method. This study found that in general, ASKESKIN and JAMKESMAS had very small impacts on the utility of healthcare facilities measured by outpatient and inpatient visits by program’s beneficiaries. It implies that being subsidized health insurance holders does not necessarily encourage them to visit formal healthcare facilities. In addition, the comparison of average treatment effect on the treated (ATT) between ASKESKIN and JAMKESMAS also did not show any significant improvement even though the program had tried to be improved. The results of this study provide the basis for advising policy makers that there needs to revisit the effectiveness of subsidized health insurance program implementation.

Suggested Citation

  • Riska Dwi Astuti & Rindang Nuri Isnaini Nugrohowati, 2022. "Impact evaluation of subsidized health insurance programs on utilization of healthcare facilities: evidence from Indonesia," International Journal of Health Economics and Management, Springer, vol. 22(3), pages 315-331, September.
    • Handle: RePEc:kap:ijhcfe:v:22:y:2022:i:3:d:10.1007_s10754-021-09321-6
    DOI: 10.1007/s10754-021-09321-6
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    References listed on IDEAS

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    1. Johar, Meliyanni, 2009. "The impact of the Indonesian health card program: A matching estimator approach," Journal of Health Economics, Elsevier, vol. 28(1), pages 35-53, January.
    2. Antonio Trujillo & Jorge Portillo & John Vernon, 2005. "The Impact of Subsidized Health Insurance for the Poor: Evaluating the Colombian Experience Using Propensity Score Matching," International Journal of Health Economics and Management, Springer, vol. 5(3), pages 211-239, September.
    3. Sparrow, Robert & Suryahadi, Asep & Widyanti, Wenefrida, 2013. "Social health insurance for the poor: Targeting and impact of Indonesia's Askeskin programme," Social Science & Medicine, Elsevier, vol. 96(C), pages 264-271.
    4. Fernando Ruiz & Liliana Amaya & Stella Venegas, 2007. "Progressive segmented health insurance: Colombian health reform and access to health services," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 3-18, January.
    5. Liu, Hong & Zhao, Zhong, 2014. "Does health insurance matter? Evidence from China’s urban resident basic medical insurance," Journal of Comparative Economics, Elsevier, vol. 42(4), pages 1007-1020.
    6. Shankar Prinja & Pankaj Bahuguna & Indrani Gupta & Samik Chowdhury & Mayur Trivedi, 2019. "Role of insurance in determining utilization of healthcare and financial risk protection in India," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-16, February.
    7. Acharya, Arnab & Vellakkal, Sukumar & Taylor Fiona & Masset Edoardo & Satija, Ambika & Burke, Margaret & Ebrahim, Shah, 2013. "The impact of health insurance schemes for the informal sector in low- and middle-income countries : a systematic review," Policy Research Working Paper Series 6324, The World Bank.
    8. Khaled Makhloufi & Bruno Ventelou & Mohammad Abu-Zaineh, 2015. "Have health insurance reforms in Tunisia attained their intended objectives?," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 29-51, March.
    9. Ajantha Sisira Kumara & Ramanie Samaratunge, 2020. "Health insurance ownership and its impact on healthcare utilization," International Journal of Social Economics, Emerald Group Publishing Limited, vol. 47(2), pages 244-267, January.
    10. Hiwot Tilahun & Desta Debalkie Atnafu & Geta Asrade & Amare Minyihun & Yihun Mulugeta Alemu, 2018. "Factors for healthcare utilization and effect of mutual health insurance on healthcare utilization in rural communities of South Achefer Woreda, North West, Ethiopia," Health Economics Review, Springer, vol. 8(1), pages 1-7, December.
    11. Arnab Acharya & Sukumar Vellakkal & Fiona Taylor & Edoardo Masset & Ambika Satija & Margaret Burke & Shah Ebrahim, 2013. "The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries: A Systematic Review," The World Bank Research Observer, World Bank, vol. 28(2), pages 236-266, August.
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