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      Urban and Rural Disparities in Hospital Utilization among Indonesian Adults

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          Abstract

          Background:

          Equal access to healthcare facilities, patient’s satisfaction, and respect for the desire of the patient were recognized as the basic principles of each of the health care system. Each person must be given the opportunity to access health services in accordance with the requirements of their health. We aimed to prove the existence of disparities hospital utilization based on the category of urban-rural areas.

          Methods:

          The research used the 2013 Indonesian Basic Health Survey (RKD) as analysis material, that was designed a cross-sectional survey. With the multi-stage cluster random sampling method, 722,329 respondents were obtained. Data were analyzed using Multinomial Logistic Regression tests.

          Results:

          The results showed adults living in urban were likely to use hospital outpatient facilities 1.246 times higher than adults living in rural areas (OR 1.246; 95% CI 1.026 – 1.030). The likelihood of utilizing at the same time outpatient and inpatient facilities at 1.134 times higher in adults living in urban than those in rural areas (OR 1.134; 95% CI 1.025 – 1.255). While for the category of hospital inpatient utilization, there was no significant difference.

          Conclusion:

          There was a disparity in hospital utilization between urban-rural areas. Urban show better utilization than rural areas in outpatient and at the same time the use of inpatient care.

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          Most cited references28

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          Racial disparities in neurologic health care access and utilization in the United States.

          To evaluate racial and ethnic differences in the utilization of neurologic care across a wide range of neurologic conditions in the United States.
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            Inequities in utilization of reproductive and maternal health services in Ethiopia

            Background Disparities in health services utilization within and between regional states of countries with diverse socio-cultural and economic conditions such as Ethiopia is a frequent encounter. Understanding and taking measures to address unnecessary and avoidable differences in the use of reproductive and maternal health services is a key concern in Ethiopia. The aim of the study was to examine degree of equity in reproductive and maternal health services utilization in Ethiopia. Method Data from Ethiopia demographic health survey 2014 was analyzed. We assessed inequities in utilization of modern contraceptive methods, antenatal care, facility based delivery and postnatal checkup. Four standard equity measurement methods were used; equity gaps, rate-ratios, concertation curve and concentration index. Results Inequities in service utilization were exhibited favoring women in developed regions, urban residents, most educated and the wealthy. Antenatal care by skilled provider was three times higher among women with post-secondary education than mothers with no education. Women in the highest wealth quantile had about 12 times higher skilled birth attendance than those in lowest wealth quantile. The rate of postnatal care use among urban resident was about 6 times that of women in rural area. Use of modern contraceptive methods was more equitably utilized service while, birth at health facility was less equitable across all economic levels, favoring the wealthy. Conclusion Considerable inequity between and within regions of Ethiopia in the use of maternal health services was demonstrated. Strategically targeting social determinants of health with special emphasis to women education and economic empowerment will substantially contribute for altering the current situation favorably.
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              Rural-urban differences in the prevalence of chronic disease in northeast China.

              Rural-urban differences in the prevalence of chronic diseases in the adult population of northeast China are examined. The Jilin Provincial Chronic Disease Survey used personal interviews and physical measures to research the presence of a range of chronic diseases among a large sample of rural and urban provincial residents aged 18 to 79 years (N = 21 435). Logistic regression analyses were used. After adjusting for age and gender, rural residents had higher prevalence of hypertension, chronic ischemic heart disease, cerebrovascular disease, chronic low back pain, arthritis, chronic gastroenteritis/peptic ulcer, chronic cholecystitis/gallstones, and chronic lower respiratory disease. Low education, low income, and smoking increased the risk of chronic diseases in rural areas. Reducing rural-urban differences in chronic disease presents a formidable public health challenge for China. The solution requires focusing attention on issues endemic to rural areas such as poverty, lack of chronic disease knowledge, and the inequality in access to primary care. © 2014 APJPH.
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                Author and article information

                Journal
                Iran J Public Health
                Iran. J. Public Health
                IJPH
                IJPH
                Iranian Journal of Public Health
                Tehran University of Medical Sciences
                2251-6085
                2251-6093
                February 2019
                : 48
                : 2
                : 247-255
                Affiliations
                [1. ] National Institute of Health Research and Development, Indonesian Ministry of Health, Jl. Percetakan Negara 29, Jakarta, Indonesia
                [2. ] Doctoral Program, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
                [3. ] Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
                Author notes
                [* ] Corresponding Author: Email: agung.dwi.laksono-2016@ 123456fkm.unair.ac.id
                Article
                IJPH-48-247
                6556184
                31205878
                02ab1adc-a4f9-4d2b-8682-6b09d02e69d1
                Copyright© Iranian Public Health Association & Tehran University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 January 2018
                : 19 March 2018
                Categories
                Original Article

                Public health
                disparities,hospital utilization,urban-rural,indonesia
                Public health
                disparities, hospital utilization, urban-rural, indonesia

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