Health Insurance Ownership and Factors Related to the Utilization of Health Services in Blitar, Central Java, Indonesia
DOI:
https://doi.org/10.26911/Abstract
Background: Blitar City, Indonesia, aims to achieve 99.74% universal health coverage (UHC) by 2024. However, public health services are only accessible to 34.6% of the population. Utilization of services for non-communicable diseases such as hypertension remains below 20%. The aim of this research was to analyze the relationship between health insurance ownership, predisposing factors, and supporting factors on the utilization of health services.
Subjects and Method: This was a cross-sectional study design and involved 405 respondents in Blitar City, Central Java, Indonesia. Data collection was conducted using a structured questionnaire instrument measuring demographic characteristics, socioeconomic status, health status, health insurance ownership, and psychological behavioral aspects (self-efficacy, attitude, and intention) rated on a Likert scale. Data were analyzed using a structural equation modeling (SEM) approach for path analysis.
Results: Path analysis revealed five main factors that significantly influenced healthcare utilization. Directly, gender (b=0.15; CI 95%=0.05 to 0.26; p=0.005), marital status (b=0.13; CI 95%=0.02 to 0.24; p=0.017), and behavioral intention (b=0.07; CI 95%=0.03 to 0.12; p=0.003) had a significant positive effect. Indirectly, self-efficacy was the most dominant positive predictor of behavioral intention (b= 0.54; CI 95%=0.49 to 0.59; p<0.001), followed by behavioral attitude (b=0.09; CI 95%= 0.02 to 0.15; p=0.009).
Conclusion: Self-efficacy, gender, marital status, attitudes, and intentions are dominant factors. The government needs to simplify digital systems, optimize men's health programs, and transform service quality to keep pace with the high pace of UHC achievement.
Keywords:
health insurance, health services, path analysisHow to Cite
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