Abstract
In 2020, the number of persons with disabilities in Indonesia reached 22.97 million. One of the main challenges this population faces is the high burden of health expenditures, particularly those that are urgent and unpredictable. This study aims to analyze the influence of socioeconomic status on out-of-pocket (OOP) health expenditures among households with persons with disabilities in Indonesia. A quantitative approach was employed using secondary data from the 2022 National Socioeconomic Survey (Susenas), utilizing the core module (KOR) and the household expenditure module (KP). Data were analyzed using the two-part regression model to identify the determinants of OOP health spending. The results indicate that total household expenditure, educational attainment, and age of persons with disabilities are positively and significantly associated with higher OOP health expenditures. Conversely, health insurance ownership negatively and significantly affects OOP spending. These findings highlight the importance of social protection policies and expanded access to health insurance in reducing the economic burden on households with disabled members.
References
Badan Pusat Statistik Indonesia. (2024). Potret Penyandang Disabilitas di Indonesia: Hasil Long Form SP2020. https://www.bps.go.id/id/publication/2024/12/20/43880dc0f8be5ab92199f8b9/potret-penyandang-disabilitas-di-indonesia-hasil-long-form-sp2020.html
Badan Pusat Statistik Indonesia. (2024). Profil Kesehatan Ibu dan Anak 2024. https://www.bps.go.id/id/publication/2024/12/31/a919c55a72b74e33d011b0dc/profil-kesehatan-ibu-dan-anak-2024.html
Chikhata, F. (2024). Determinants of out-of-Pocket Healthcare Expenditure by Households in Sierra Leone. International Journal of Research and Scientific Innovation. https://doi.org/10.51244/IJRSI
Furuoka, F., Lim, B., Yee, F., Kok, E., Hoque, M. Z., & Munir, Q. (2011). What Are the Determinants of Health Care Expenditure? Empirical Results from Asian Countries. https://core.ac.uk/outputs/148366622/?utm_source=pdf&utm_medium=banner&utm_campaign=pdf-decoration-v1
Hailemichael, Y., Hanlon, C., Tirfessa, K., Docrat, S., Alem, A., Medhin, G., Lund, C., Chisholm, D., Fekadu, A., & Hailemariam, D. (2019). Catastrophic health expenditure and impoverishment in households of persons with depression: A cross-sectional, comparative study in rural Ethiopia. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7239-6
Kementerian Sosial Republik Indonesia. (2021). Pedoman Operasional Asistensi Rehabilitasi Sosial. https://kemensos.go.id/uploads/topics/16384433731911.pdf
Lee, J. E., Shin, H. I., Do, Y. K., & Yang, E. J. (2016). Catastrophic health expenditures for households with disabled members: Evidence from the Korean health panel. Journal of Korean Medical Science, 31(3), 336–344. https://doi.org/10.3346/jkms.2016.31.3.336
Marlina, I., Wibowo, G., Bastias, D. D., Sijapati Basnett, B., Prasetyo, D. D., & Nasiir, M. (2024). Counting the costs: understanding the extra costs of living with disability in Indonesia to advance inclusive policies within the SDG framework. Frontiers in Rehabilitation Sciences, 5. https://doi.org/10.3389/fresc.2024.1236365
Masiye, F., & Kaonga, O. (2016). Determinants of healthcare utilisation and out-of-pocket payments in the context of free public primary healthcare in Zambia. International Journal of Health Policy and Management, 5(12), 693–703. https://doi.org/10.15171/ijhpm.2016.65
Najafi, Z., Najafi, E., & Yarandi, R. B. (2025). Socioeconomic Inequalities in Healthcare and Rehabilitation Expenditure: An Analysis of Costs for People with Disabilities in Iran. Middle East J Rehabil Health Stud. 2, 12(2).
Nopiah, R., Wahyuni, H., Ekonomi, J., Bisnis, D., & Ekonomi, F. (2021). Pengaruh Asuransi Kesehatan dan Ekonomi terhadap Aksesibilitas Layanan Kesehatan Penyandang Disabilitas di Indonesia. Convergence: The Journal of Economic Development, 3(2), 127–146.
Pham, H.L., Kizuki, M., Takano, T., Seino, K. and Watanabe, M. (2013). Out-of-pocket costs of disabilities and their association with household socioeconomic status among school-aged children in Vietnam', Journal of Rural Medicine, 8(2), pp. 212–221. https://doi.org/10.2185/jrm.2876
Singh, J., Paul, K., & Pradhan, J. (2022). Hospitalization & health expenditure in Odisha: Evidence from National Sample Survey (1995-2014). Indian Journal of Medical Research, 156(1), 130–138. https://doi.org/10.4103/ijmr.IJMR_412_19
Sultana, M., Mahumud, R. A., & Sarker, A. R. (2017). Burden of chronic illness and associated disabilities in Bangladesh: Evidence from the Household Income and Expenditure Survey. Chronic Diseases and Translational Medicine, 3(2), 112–122. https://doi.org/10.1016/j.cdtm.2017.02.001
Wagstaff, A., Eozenou, P., & Smitz, M. (2020). Out-of-Pocket expenditures on health: A global stocktake. The World Bank Research Observer, 35(2), 123–157. https://doi.org/10.1093/wbro/lkz009
World Health Organization. (2020). Out-of-pocket payments, user fees and catastrophic expenditure. https://www.who.int/health_financing/topics/financial-protection/out-of-pocket-payments/en/
World Health Organization (WHO). (2023) Disability and health. https://www.who.int/news-room/fact-sheets/detail/disability-and-health
Yadav, J., John, D., Menon, G.R., & Singh, R. (2024). Gender Inequality in Out-of-pocket Expenditure on Healthcare Among Persons with Disabilities in India. Journal of Health Management, 26(2): 238–255. https://doi.org/10.1177/09720634241229247
Yadav, J., Tripathi, N., Menon, G. R., Nair, S., Singh, J., Singh, R., & Vardhana Rao, M. V. (2023). Measuring the financial impact of disabilities in India (an analysis of national sample survey data). PLoS ONE, 18. https://doi.org/10.1371/journal.pone.0292592
Zachary Morris, S. A., Brook University, S., Rennane, S., Corporation, R., Goodman, N., & Blatt, B. (2024). The Disability Squeeze: Out-of-Pocket Expenses and Unmet Needs for Disability-Related Goods and Services in the U.
Bahasa Abstract
Pada tahun 2020, jumlah penyandang disabilitas di Indonesia mencapai 22,97 juta jiwa. Salah satu tantangan utama yang dihadapi kelompok ini adalah tingginya beban pengeluaran kesehatan, terutama yang bersifat mendesak dan tidak terduga. Penelitian ini bertujuan untuk menganalisis pengaruh status sosial ekonomi terhadap pengeluaran kesehatan out-of-pocket (OOP) pada rumah tangga dengan penyandang disabilitas di Indonesia. Studi ini menggunakan pendekatan kuantitatif berbasis data sekunder dari Survei Sosial Ekonomi Nasional (Susenas) tahun 2022, dengan memanfaatkan Modul Inti (KOR) dan Modul Kelompok Pengeluaran (KP). Analisis dilakukan menggunakan metode regresi two-part model untuk mengidentifikasi faktor-faktor yang memengaruhi pengeluaran OOP. Hasil penelitian menunjukkan bahwa variabel total pengeluaran rumah tangga, tingkat pendidikan, dan usia penyandang disabilitas berpengaruh positif dan signifikan terhadap besarnya pengeluaran kesehatan OOP. Sementara itu, kepemilikan asuransi kesehatan menunjukkan pengaruh negatif dan signifikan terhadap pengeluaran tersebut. Temuan ini mengindikasikan bahwa intervensi kebijakan berbasis perlindungan sosial dan peningkatan akses terhadap asuransi kesehatan sangat penting untuk menurunkan beban ekonomi rumah tangga penyandang disabilitas.
Recommended Citation
Nainggolan, Maxent RG and Relaksana, Riki
(2025)
"Status Sosial Ekonomi dan Pengeluaran OOP Kesehatan Penyandang Disabilitas,"
Jurnal Ekonomi Kesehatan Indonesia: Vol. 10:
No.
1, Article 6.
DOI: 10.7454/eki.v10i1.1148
Available at:
https://scholarhub.ui.ac.id/eki/vol10/iss1/6
