Social health insurance improves women’s healthcare use: Evidence from Indonesia

Samarakoon, Shanika and Parinduri, Rasyad (2015): Social health insurance improves women’s healthcare use: Evidence from Indonesia.

Abstract

To improve the poor’s access to healthcare services, the Indonesian government introduced Askeskin, a subsidized social health insurance for the poor. We examine the effects of this social health insurance on women’s use of healthcare—maternal, preventive, and curative healthcare—services. Using propensity- score- and difference-in-differences matching strategies, we find the insurance increases the use of public facilities for maternal healthcare, discourages the use of midwives’ services, and increases the use of contraception; it does not seem to increase the use of preventive and curative care, however.

• Item Type: MPRA Paper
• Language: English
• Keywords: Social health Insurance; maternal healthcare; women’s preventive and curative healthcare; Indonesia; South East Asia
• Subjects: I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets; I - Health, Education, and Welfare > I1 - Health > I12 - Health Behavior; I - Health, Education, and Welfare > I1 - Health > I13 - Health Insurance, Public and Private; I - Health, Education, and Welfare > I1 - Health > I15 - Health and Economic Development

References

Arifanto, A., Budiyati, S., Marianti, R., & Tan, E (2005). Making Services Work for the Poor in Indonesia: A Report on Health Financing Mechanisms (JPK-GAKIN) Scheme in Kabupaten Purbalingga, East Sumba, and Tabanan. Jakarta: The SMERU Research Institute.

Baicker, K., Taubman, S.L., Allen, H., Bernstein, M., Gruber, J., Newhouse, J., Schneider, E., Wright, B.J., Zaslavsky, A.M., Finkelstein, A. (2013). The Oregon Experiment-Effects of Medicaid on Medical Outcomes. The New England Journal of Medicine.368, 1713-1722.

Ensor, T., Nadjib, M., Quayyum, Z., Megraini, A. (2008). Public Funding for Community Based Skilled Delivery Care in Indonesia: To What Extent Are the Poor Benefiting . European Journal of Health Economics. 9 (4), 385-392.

Frankenberg, E., Beegle, K., Thomas, D., Suriastini, W. (1999). Health, Education and the Economic Crisis in Indonesia. RAND Working Paper 1999. California.

International Labor Organization (2008a). Social Health Protection: an ILO Strategy Towards Universal Healthcare. Geneva. Available at: http://www.ilo.org/gimi/gess/ShowRessource.action?ressource.ressourceId=5956. Last accessed 30th January 2014.

International Labour Organization (2008b) Social Security in Indonesia: Advancing the Development Agenda. Jakarta: ILO

Heckman, J., Ichimura, H., Todd, P.E. (1997). Characterizing Selection Bias Using Experimental Data. Econometrica. 66 (5), 1017-1098.

Indonesian Demographic and Health Survey, (2007). IRD/Macro Systems Inc. Columbia, Maryland, USA.

Johar, M (2009). The Impact of the Indonesian Health Card Program: A Matching Estimator Program. Journal of Health Economics. 28, 35-53.

Liabsuetrakul, T., & Oumudee, N. (2011). Effect of Health Insurance on Delivery Care Utilization and Perceived Delays and Barriers Among Southern Thai Women . BMC Public Health. 11 (510).

Miller, G., Pinto, D., & Vera-Hernandez, M. (2013). Risk Protection, Services Use, and Health Outcomes Under Colombia’s Health Insurance Program for the Poor. American Economic Journal: Applied Economics. 5(4), 61-91.

Pradhan, M., Saadah, F & Sparrow, R. (2007). Did the Health Card Program Ensure Access to Medical Care for the Poor During Indonesia's Economic Crisis? World Bank Economic Review. 21 (1), 125-150.

Rosenbaum, P.R. & Rubin, D.B. (1983). The Central Role of the Propensity Score in observational Studies for Causal Effects. Biometrika. 70 (1), 41-55.

Rubin, D.B. (1977). Assignment to a Treatment Group on the Basis of a Covariate. Journal of Educational Statistics. 2, 1-26.

Smith, K.V., Sulzbach, S. (2008). Community-Based Health Insurance and Access to Maternal Health Services: Evidence from Three West African Countries. Social Science and Medicine. 66 (12), 2460-2473.

Somanthan, A. (2008). The Impact of Price Subsidies on Child Health Care Use: Evaluation of the Indonesian Healthcard. Policy Research Working Paper. The World Bank

Sparrow, R. (2008). Targeting the Poor in Times of Crisis: the Indonesian Health Card. Health Policy and Planning. 23, 188-199.

Sparrow, R., Suryahadi, A., & Widyanti, W. (2012). Social Health Insurance for the Poor: Targeting and Impact of Indonesia’s Askeskin Programme. Social Science and Medicine. 1-8.

Strauss, J., Witoelar, F., Sikoki, B., & Wattie, A.M. (2009a). The Fourth Wave of the Indonesian Family Life Survey (IFLS4): Overview and Field Report. April 2009. WR-675/1-NIA/NICHD.

Titaley, C.R., Hunter, C.L., Heywood, P., Dibley, M.J.. (2010). Why don't some women attend antenatal and postnatal care services?: a qualitative study of community members' perspectives in Garut, Sukabumi and Ciamis districts of West Java Province, Indonesia. BMC pregnancy and childbirth. 10 (61), 1-12.

United Nations (2009) Women and Health: Today’s Evidence Tomorrow’s Agenda. Available at: http://www.who.int/gender/women_health_report/en/index.html. Last accessed 8th February 2014.

Wagstaff, A & Lindelow. (2008). Can Insurance Increase Financial Risk? The Curious Case of Health Insurance in China. Journal of Health Economics. 27 (4), 990-1005. Wagstaff, A. (2010). Estimating Health Insurance Impacts Under Unobserved Heterogeneity: The Case of Vietnam’s Health Care Fund for the Poor. Health Economics.19(2), 189-208.

Wagstaff, A., Lindelow, M., Jun, G., Ling., X & Juncheng, Q. (2009). Extending Health Insurance to the Rural Population: An Impact Evaluation of China's New Cooperative Medical Scheme. Journal of Health Economics. 28 (1), 1-19.

Weerdt, J.D. & Dercon, S., (2006). Risk Sharing Networks and Insurance Against Illness. Journal of Development Economics. 81 (2), 337-356.

WHO (2010). Health Systems Financing. The Path to Universal Health Coverage. World Health Report. Available at: http://www.who.int/whr/2010/10_chap01_en.pdf?ua=1. Last accessed 30th January 2014.

World Bank (2010). “..And Then She Died”. Indonesia Maternal Health Assessment. Available: https://openknowledge.worldbank.org/bitstream/handle/10986/2837/533270ESW0Whit10Box345625B01PUBLIC1.pdf?sequence=1. Last accessed 15th August 2013.

World Bank (2015). World Development Indicators. World Bank. Available: http://data.worldbank.org/indicator/SH.STA.MMRT. Last accessed 20th January 2015.