Abstract

Indonesia's health financing is still dominated by out-of-pocket (OOP) spending by households. The larger the OOP, the heavier the burden on the household, which threatens its welfare. It is important to know the factors that influence household OOP expenditure, especially based on the type of intended use, namely curative (OOPCHE) and preventive (OOPPHE), which mutually influence each other. This research aims to see the simultaneous relationship between OOPCHE and OOPPHE and the variables that influence both. This research uses the latest 2023 National Socio-Economic Survey data conducted by BPS-Statistics Indonesia. This survey is a national scale survey involving 345,000 household samples. This research employed a simultaneous equation model with a three-staged least squares estimation method. This research tries to improve the estimated value caused by the problem of many zero-value observations on household OOP spending. The research results show that in 2023, OOPCHE will be the largest spent on inpatient treatment at a private hospital while OOPPHE on other health care. The OOPCHE and OOPPHE have a simultaneous relationship or influence each other. Variables that Significantly influencing OOPCHE are ownership of health insurance, hospitalization record and outpatient record, as well as several other socio-economic variables. Meanwhile, the variable that significantly influences OOPPHE are health insurance expenditure, and the presence of toddlers and the elderly, as well as some other social economics factors. Efforts to reduce OOP need to be made in both curative and preventive health care spending.