Out-of-pocket costs for child immunization in Indonesia: Can national health insurance truly protect families?

Abstract

This study aimed to analyze the role of National Health Insurance (NHI) in reducing the out-of-pocket costs (OOP) of children's immunization services in Indonesia by using National Socio-economic Survey data in 2019. The design of this study uses the descriptive method of Quantitative research. This cross-sectional study only included households with children who utilized the immunization service during 2019 using National Socio-economic Survey data. This study used an econometric approach to evaluate the amount of OOP in NHI participants using two stages of least squares regression to assess the odds of decreasing OOP among children immunized for NHI participants using Instrumental Variable (IV) Probit. This study shows that OOP practices still exist in households that utilize child immunization services in a certain percentage. However, the incidence of OOP in household members who are NHI participants has decreased significantly compared to household members who do not have health insurance and those who have dual health insurance. The conclusion of this study shows that although OOP costs still exist in childhood immunization services in Indonesia, participation in the NHI program can significantly reduce these costs and reduce the likelihood of OOP events.