The Impact of Health Insurance Programs on Out-of-Pocket Expenditures in Indonesia

An Increase or a Decrease

Bibliographic Data

ID15501397
AuthorsBudi Aji (0000-0001-7148-5808, Heidelberg University, corresponding author), Manuela De Allegri (0000-0002-8677-1337, Heidelberg University), Aurélia Souares (0000-0002-3984-5866, Heidelberg University), Rainer Sauerborn (0000-0002-3201-4058, Heidelberg University)
Year2013
Volume10
Issue7
Pages2995-3013
Publication date2013-07-18
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph10072995
PMID23873263
PMCIDPMC3734472
OpenAlexW2030799990
LanguageEN
Citations received14
References cited22

We used panel data from the Indonesian Family Life Survey to investigate the impact of health insurance programs on reducing out-of-pocket expenditures. We employed three linear panel data models, two of which accounted for endogeneity: pooled ordinary least squares (OLS), pooled two-stage least squares (2SLS) for instrumental variable (IV), and fixed effects (FE). The study revealed that two health insurance programs had a significantly negative impact on out-of-pocket expenditures by using IV estimates. In the IV model, Askeskin decreased out-of-pocket expenditures by 34% and Askes by 55% compared with non-Askeskin and non-Askes, respectively, while Jamsostek was found to bear a nonsignificant effect on out-of-pocket expenditures. In the FE model, only Askeskin had a significant negative effect with an 11% reduction on out-of-pocket expenditures. This study showed that two large existing health insurance programs in Indonesia, Askeskin and Askes, effectively reduced household out-of-pocket expenditures. The ability of programs to offer financial protection by reducing out-of-pocket expenditures is likely to be a direct function of their benefits package and co-payment policies

Actuarial science · Business · Demographic economics · Econometrics · Economic growth · Economics · Endogeneity · Environmental health · Fixed effects model · Health care · Health insurance · Instrumental variable · Ordinary least squares · Panel data · Payment · Public economics · Global Health Care Issues · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine · Finance