ArticleBMJ open2025
Disparities in cancer care and outcomes by insurance membership type in Indonesia: a retrospective cross-sectional analysis of national health insurance claims, 2017-2022.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Differences in Hemodialysis Claim Patterns Across Membership Types Among Patients With Renal Failure Based on National Health Insurance Data From 2017 to 2022: Cross-Sectional Analysis.JMIR public health and surveillance · 2025Article
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Authors and funding
4 authors.
Funding
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Abstract
objectivesTo examine disparities in health services and outcomes for cancer among different membership types within the national health insurance in Indonesia. DESIGN AND
settingThis study employed a retrospective cross-sectional analysis of health insurance claim data. The setting was inpatient claims from public and private hospitals across Indonesia during 2017-2022. We assessed the associations between membership types in the National Health Insurance system (
participantsWe analysed 34 904 inpatient claim records for patients with cancer aged 16 years and older enrolled in BPJS. Membership types included: the poorest members subsidised by the national budget (
resultsSignificant disparities were observed across BPJS membership types. Compared with the poorest group (PBI APBN), informal non-workers (BP) and informal workers (PBPU) had higher odds of receiving transfusions (adjusted OR (AOR): 1.43 and 1.26, respectively), while formal workers (PPU) had shorter hospital stays (-0.27 days) and higher claim costs. Interestingly, PBI APBN members had greater odds of receiving biopsies than PBI APBD (AOR: 0.62) and PPU (AOR: 0.77) members. In terms of health outcomes, PBI APBN members experienced higher odds of severe cases and mortality, whereas PPU members had significantly lower odds of severity (AOR: 0.78) and death (AOR: 0.67).
conclusionSubstantial socioeconomic disparities persist in cancer diagnostics, treatment and outcomes among BPJS members. Poorer groups face greater barriers to care and worse outcomes. Policies should prioritise equitable cancer care access for low-income and subsidised members of Indonesia's national health insurance.
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