Expanding national health insurance coverage in Indonesia’s remote areas: who should be prioritized?

Early Abstract:

Objectives: The objective of this study was to ascertain the target for expanding National Health Insurance (NHI) coverage in remote areas of Indonesia.
Methods: This study used secondary data from the 2023 National Socio-economic Survey, a nationally representative cross-sectional household survey conducted by Indonesian Statistics to investigate 130,331 people. NHI membership was used as a dependent variable. The study examined residence, age, gender, marital status, education, and occupation as independent variables. In the last phase, binary logistic regression was used. 
Results: The NHI membership rate in disadvantaged regions of Indonesia was 74.5%. People in rural areas were 1.11 times more likely to be NHI members than those in non-rural areas (95% CI 1.06-1.16). Age was related to NHI membership. Married people were 1.29 times more likely than those never married to be NHI members (95% CI 1.25-1.34). Divorced/widowed people were 1.16 times more likely than those never married to own NHI (95% CI 1.08-1.23). People with all education levels were likelier than those with primary school to be NHI members. Employed people were 1.36 times more likely to be NHI members than those unemployed (95% CI 1.31-1.40). The wealthier the people, the higher the possibility of being NHI members.
Conclusion: Based on the study's results, the people who are specific targets include non-rural residents in disadvantaged regions alongside never-married individuals, those with primary education or less, the unemployed, and the poorest wealth quintile requiring interventions like mobile enrolment units and simplified registration protocols.
Keywords: disadvantaged areas, Indonesia, National Health Insurance, public health, rural health.